Adaptive and innovative Radiation Treatment FOR improving Cancer patients’ treatment outcome
The aim of the project is to improve treatment outcome more specifically in advanced head and neck and non-small cell lung cancer (NSCLC) patients by:
- Improving the therapeutic ratio between tumour control and normal tissue damage by redistributing the dose of radiation• Ensuring 3-D quality control in vivo• Maximizing the benefit of combined modality treatment• Disseminating the results to the community by means of exposure throughout the scientific community and development of generally applicable software and tools in combination with commercial partners.
Redistribution of the radiation dose will be made possible through the use of FDG-PET scans which can identify areas of the tumour which are most active, i.e. the area which should receive the highest dose of radiation. This redistribution of the dose can be performed without increasing the dose to the surrounding areas.
To assure accurate radiation delivery, novel 3-dimensional (3-D) optimized imaging-guided radiation (IGRT) techniques will be used which demand an extra level of quality control. 3-D monitoring and adaptation of the radiation dose will be performed with repetitive anatomical cone beam CT scans on linear accelerators as well as biological imaging by FDG-PET. 3-D in vivo portal imaging will be performed during the course of radiotherapy for quality assurance. This tool, combined with the cone beam CT scans of the day, not only detects errors in beam delivery, but also the effect of shape changes of the patients and the impact on the patient’s critical structures.
The combination of cisplatin or Cetuximab with radiation has been shown to improve local control and survival. However, cisplatin is only effective in a fraction of patients – those with tumours which are sensitive to cisplatin. Furthermore, Cetuximab is an expensive drug which has been shown to be useful only in tumours where high concentrations of the drug can be incorporated. Therefore, with careful selection of the patients to be treated with this combination, it will be possible to minimize toxicity and reduce the cost of treatment; avoiding also unnecessary treatment of non-sensitive patients.
The participating institutes of this project and the SME’s involved have a large experience and leading role in the development of combined modality treatments in both head and neck cancer and lung cancer. They are experienced in adaptive IGRT and stereotactic radiotherapy as well as the novel quality assurance methods. Furthermore, their knowledge of molecular predictive assays will be of benefit to the project.The European Society for Therapeutic Radiology Oncology (ESTRO) will play a major role in the dissemination of the project results through its network and will be instrumental in organizing educational events on these topics, PhD student exchange programs and research fellowships with regard to the work within this project.
The ARTFORCE project starting date was April 1, 2011.