To quantify the differences between planned dose and the dose actually delivered during the whole course of radiotherapy, and to link these data to differences between expected and observed toxicity. To determine the relative contributions to individual variation in toxicity from underlying biological factors or physical dose variation. Develop a suite of integrated software tools for dose review during the treatment course, with the objective of individualising treatment, based on predicted toxicity.
We will analyse the discrepancy between RT doses which are planned, and those actually delivered, based on daily CT data acquired within our clinical programme of high precision image-guided radiotherapy. In Cambridge we have a unique archive of daily volumetric imaging of patients treated on our TomoTherapy units. We will develop systems to map the location of each point (voxel) within the patient outline, and then to re-compute the dose at that point each day during treatment. We will apply techniques from image processing, materials modelling, tumour & tissue modelling and radiation biology to construct models of cumulative dose during treatment that cannot be achieved using current techniques. To do this we will bring together a cross-disciplinary group of clinicians and clinically-orientated scientists from the University of Cambridge Department of Oncology, the NHS Oncology Centre, the University of Cambridge Cavendish Laboratory, the University of Cambridge Engineering Department and the CR UK Cambridge Research Institute.
How will the results be used?
The results will be used to improve radiotherapy based on individualised toxicity. More accurate data on the relative contributions to individual variation from underlying biological factors or physical dose variation will feed in to studies of genetic determinants of individual variation in toxicity (radiogenomics). The development of an integrated suite of software tools for dose review during the treatment course will allow individual toxicity prediction and provide capability to re-plan treatment including toxicity as an optimisation parameter. Together, these tools will allow individualised treatment with reduced toxicity. The core tools will be provided free for use by the radiotherapy community.