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National Institute for Health Research Biomedical Research Centre
Our Research: Advanced Radiotherapy

Precision radiotherapy

New technology can help us target tumour cells with radiation more accurately to reduce side-effects and improve quality-of-life.

Radiotherapy is given to maximise the amount of tumour killed while minimising the amount of damage in surrounding healthy tissue. Before treatment, scans are required to identify the area to be treated and the radiation doses required. These radiotherapy ‘plans’ use guidelines and constraints (the maximum dose a particular normal tissue can tolerate) established through routine clinical practice.

Some ‘constraints’ are not well defined. Patients may have radiotherapy with no check on whether the plan that was accurate at the start of treatment is still accurate during treatment when tumours might be shrinking.

There is potential to more accurately target tumour cells by imaging at the same time as delivering each dose or ‘fraction’ of radiotherapy. This approach would allow us to adapt a plan as the radiotherapy is delivered, and is now possible for some cancers with new technology that combines MRI scanning and radiotherapy in one hi-tech package – the MR-linac.

Through our research we are:

  • Focusing on lung, prostate, cervix, head and neck and/or paediatric cancers
  • Optimising pre-treatment imaging to more accurately distinguish between tumour cells and healthy tissue
  • Using advanced modelling to personalise treatment, by more accurately predicting an individual’s benefit versus risk in relation to different radiotherapy approaches
  • Working with Informatics and Data Sciences colleagues, to develop MR-based auto-segmentation models. These models will enable tumours to be more closely analysed, as part of an automated real-time planning approach (during radiation delivery)
  • Optimising the ability to adapt treatment during a course of radiotherapy in response to the real-time imaging

Progress to date

Grants

PCUK – A tool for predicting an individual prostate cancer patient’s risk of metastasis and need for lymph node irradiation £224,739 over 3 years

YCR – Avoiding cardiac toxicity in lung cancer patients treated with curative-intent radiotherapy to improve survival. £416,703 over 2 years

DCS – Analysis tool for contouring education. £166,386 over 2 years

Future work

  • Treat first patient on MR linac
  • Comparative study of respiratory motion management techniques
  • Develop methods which can include patient and tumour characteristics directly in the analysis
  • Translate results from the data mining studies into clinical practice.