Optimising Synchrotron Microbeam Radiation Therapy For Cancer Treatment
Funder
National Health and Medical Research Council
Funding Amount
$682,000.00
Summary
Over 50% of cancer patients receive radiotherapy (RT). Tumour control using RT is limited by adverse normal tissue reactions. Unlike conventional RT machines, the Australian synchrotron has the capability to deliver strong radiation in very thin slices, termed microbeam RT (MRT). Tumour control has been obtained in animal models with a remarkable sparing of normal tissue using MRT. We will optimize MRT as a crucial step towards a potentially revolutionary cancer treatment.
A Randomised Controlled Trial Comparing Intraoperative To Conventional Radiotherapy In Women With Early Beast Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$874,046.00
Summary
With the advent of breast screening in Australia many women are diagnosed with small low risk cancers that can be treated with breast conserving therapy with good outcomes. Surgery and radiotherapy in this situation are used to minimise the risk of local recurrence. It is now being questioned whether we can tailor radiotherapy to suit individual patients rather than recommending the daily 6-7 weeks of standard external beam radiotherapy to all patients. This trial aims to answer this question as ....With the advent of breast screening in Australia many women are diagnosed with small low risk cancers that can be treated with breast conserving therapy with good outcomes. Surgery and radiotherapy in this situation are used to minimise the risk of local recurrence. It is now being questioned whether we can tailor radiotherapy to suit individual patients rather than recommending the daily 6-7 weeks of standard external beam radiotherapy to all patients. This trial aims to answer this question as a new device which can deliver radiotherapy intraoperatively in a single session has now been tested and proven safe to use in the breast. The main objective of this trial is to demonstrate that a single dose of radiotherapy delivered intraoperatively (IORT) gives an equivalent local control rate to standard external beam radiotherapy in women with early low risk breast cancer who are suitable for breast conserving therapy. Other objectives include comparing the two treatments with respect to; disease-free-overall survival, cosmetic outcome, patient satisfaction-preference, quality of life and cost benefit. If the study finds that IORT alone after breast conserving surgery is as effective in achieving local control as standard external beam radiotherapy, a major benefit to patients would be shorter treatment duration by avoiding the 6-7 weeks of standard radiotherapy. A reduction in the number of early breast cancer patients requiring access to standard radiotherapy would also benefit treatment centres and other cancer patients by reducing the waiting times for radiotherapy. Consumer groups have supported the concept from the beginning and there has been recent increase in level of support by originally unsupportive groups. Of great significance is this trial offers an opportunity to formally investigate the efficacy of delivering IORT in the safe confines of a clinical trial, before allowing it to become a standard treatment which is occurring in other countries.Read moreRead less
Value Of Androgen Deprivation And Bisphosphonate In Patients Treated By Radiotherapy For Localised Prostate Cancer
Funder
National Health and Medical Research Council
Funding Amount
$2,533,827.00
Summary
Following on from significant findings in the TROG 96.01 trial, the 03.04 trial, known as the RADAR trial was developed. This is a large-scale randomised controlled clinical trial currently conducted at 23 cancer treatment centres throughout Australia and New Zealand. The RADAR trial aims to recruit 1000 men with localised but inoperable prostate cancer. It was anticipated that the length of time required to enrol 1000 participants to the trial would be 5 years. However, because enrolment has ex ....Following on from significant findings in the TROG 96.01 trial, the 03.04 trial, known as the RADAR trial was developed. This is a large-scale randomised controlled clinical trial currently conducted at 23 cancer treatment centres throughout Australia and New Zealand. The RADAR trial aims to recruit 1000 men with localised but inoperable prostate cancer. It was anticipated that the length of time required to enrol 1000 participants to the trial would be 5 years. However, because enrolment has exceeded expectations and 728 patients have already been recruited, it is anticipated that the recruitment target will be reached in mid 2007. Patients are randomly assigned to receive one of four treatment options in the RADAR trial. The first option: Option A: Radiation Therapy and 6 months of Hormone Therapy (Leuprorelin acetate), is currently the standard of care. Option C is a further 12 months of hormone therapy after the current standard of care. Two of the options (B and D) are identical to options A and C except that subjects also receive 18 months of zoledronate (a 'bone' drug) in addition to hormone therapy and radiotherapy. The main goal of the RADAR trial is to determine whether 12 months of hormone therapy using Leuprorelin acetate starting immediately after standard therapy (ie 6 months of Leuprorelin acetate before and during radiotherapy) will reduce risk of return of the cancer, either within the prostate region or at remote sites in the body, and prolong life. An additional goal is to see whether 18 months of bisphosphonate therapy (bone density therapy) using zoledronate will reduce the risk of cancer returning in the bones as well as stopping dangerous bone thinning which can sometimes be caused by hormone therapy. The trial also seeks to determine whether the additional therapy given in this trial alters quality of life.Read moreRead less
Optimal Duration Of Neoadjuvant Androgen Deprivation Therapy In Localised Prostate Cancer Treated By Radiotherapy
Funder
National Health and Medical Research Council
Funding Amount
$422,335.00
Summary
The 96.01 trial aims to find out whether androgen deprivation (AD) administered prior to and during radiotherapy (i.e., neo-adjuvant AD) will improve outcomes in patients with locally advanced prostate cancer that is considered inoperable and is treated for cure by radiotherapy. The trial also aims to find out whether six months AD produces outcomes superior to those achieved by three months AD. The trial has been running since 1996 and involves 802 men who attend 19 cancer treatment centres acr ....The 96.01 trial aims to find out whether androgen deprivation (AD) administered prior to and during radiotherapy (i.e., neo-adjuvant AD) will improve outcomes in patients with locally advanced prostate cancer that is considered inoperable and is treated for cure by radiotherapy. The trial also aims to find out whether six months AD produces outcomes superior to those achieved by three months AD. The trial has been running since 1996 and involves 802 men who attend 19 cancer treatment centres across Australia and New Zealand. It would not have been possible without the continuous funding support of the NHMRC. So far this trial has shown that AD does prevent prostate cancer from returning after radiotherapy. This is very important because the need for treatment of recurrent cancer (usually AD for the rest of the patient's life) is halved by 6 months AD compared to standard treatment (radiotherapy alone). However, it is now necessary to observe the patients in this trial for another 5 years to find out whether AD also prolongs life, and whether 6 months AD is more effective than 3 months. Further patient follow up is also necessary to identify whether some men respond better to treatment than others. This is very important because it will enable treatment to be tailored to individual patients, in particular those who require more treatment than is given in this trial. This funding application is therefore to enable patient follow up on this large scale trial for another 5 years.Read moreRead less
A Multi-Centre Feasibility Study Of Online Adaptive Image Guided Radiotherapy For Muscle Invasive Bladder Cancer
Funder
National Health and Medical Research Council
Funding Amount
$580,152.00
Summary
Many studies have shown that the bladder can move, change in size and shape through a course of radiation therapy. As shown in a pilot study, with the online adaptive radiotherapy technique trained staff can daily match the radiation fields to the bladder position and size using a type of CT scan. Potential benefits are better cancer coverage with improved cancer control and less normal tissue irradiation. This study will determine if the technique will work across multiple Australian centres.
Optimal Duration Of Neoadjuvant Androgen Deprivation Therapy In Localised Prostate Cancer
Funder
National Health and Medical Research Council
Funding Amount
$275,000.00
Summary
Each year approximately 8000 men in Australia and New Zealand develop prostate cancer which has not spread widely and which is amenable to attempted cure by surgery or radiation. Prostate cancer depends for its growth on the male hormone, testosterone, which circulates in the blood. As a result treatment which reduces testosterone level ('androgen deprivation' [AD] therapy) can produce shrinkage of prostate cancer. In fact AD has caused temporary but valued relief to millions of men with cancer ....Each year approximately 8000 men in Australia and New Zealand develop prostate cancer which has not spread widely and which is amenable to attempted cure by surgery or radiation. Prostate cancer depends for its growth on the male hormone, testosterone, which circulates in the blood. As a result treatment which reduces testosterone level ('androgen deprivation' [AD] therapy) can produce shrinkage of prostate cancer. In fact AD has caused temporary but valued relief to millions of men with cancer of the prostate that has spread throughout the body for the last five decades, worldwide. It remains uncertain however whether AD administered before surgery or radiation will benefit any of the 8000 men each year who develop localised cancer by shrinking the cancer first. In 1996 a trial involving 800 men across Australia and New Zealand commenced under the auspices of the Trans-Tasman Radiation Oncology Group (TROG) to answer the questions: 1 - Does either 3 or 6 months AD prior to radiotherapy reduce the chances of recurrence of the cancer after radiotherapy? 2 - Does such therapy reduce the volume of tissue requiring radiotherapy and hence the chances of long term side effects after radiotherapy? This grant will support collection of follow-up information from the trial and hence answers to the questions asked.Read moreRead less
AGITG TOP GEAR: A Randomised Phase II/III Trial Of Preoperative Chemoradiotherapy Versus Preoperative Chemotherapy For Resectable Gastric Cancer
Funder
National Health and Medical Research Council
Funding Amount
$621,644.00
Summary
While surgery to remove stomach cancer has been traditionally accepted as the only way to potentially cure the disease, there have been several recent advances using chemotherapy and/or radiotherapy both before and after surgery. Doctors' opinions remain divided regarding best treatments to give and in what order. This trial will address the important question of whether combined chemotherapy plus radiotherapy is more effective than chemotherapy alone in improving cure rates for stomach cancer.
Predicting Dysphagia-related Complications And Improving Outcomes In Patients Treated With Head And Neck Radiotherapy
Funder
National Health and Medical Research Council
Funding Amount
$311,597.00
Summary
This project aims to improve swallow-related quality of life in patients undergoing head and neck radiotherapy by: 1) Identifying throat muscles, critical to swallowing in order to refine future radiation strategies in order to minimise collateral damage to these critical structures; 2) Improve health care management of post-radiotherapy patients via identification of markers that predict response to therapy; 3) Evaluate a therapy to improve swallow dysfunction
The Use Of Electronic Portal Imaging Devices For The Dosimetric Verification Of Complex Radiotherapy Treatments
Funder
National Health and Medical Research Council
Funding Amount
$260,949.00
Summary
The prognosis for someone diagnosed with cancer is much better than commonly believed. If detected early, malignant tumours are generally well localised. During these early stages of tumour growth high doses of radiation therapy can with a high probability, eradicate a cancer but come with the cost of causing unacceptable damage to normal tissue. A specific goal of improving the technology of radiation therapy is to reduce the probability of damage to normal tissue. Achieving this goal may allow ....The prognosis for someone diagnosed with cancer is much better than commonly believed. If detected early, malignant tumours are generally well localised. During these early stages of tumour growth high doses of radiation therapy can with a high probability, eradicate a cancer but come with the cost of causing unacceptable damage to normal tissue. A specific goal of improving the technology of radiation therapy is to reduce the probability of damage to normal tissue. Achieving this goal may allow delivery of higher doses with an associated increase in the chance of controlling the tumour. One of the challenges in radiation therapy is that tumours do not come in shapes that are easy to treat. Tumours extend into cavities and push aside healthy organs growing into complex 3D shapes. The careful shaping of the radiation beams to deliver dose distributions that match the 3D shape of the target is known as 3D conformal radiotherapy (3DCRT). Intensity Modulated Radiotherapy (IMRT) is an advanced form of 3DCRT that allows the delivered dose to be closely tailored to the shape of complex tumour volumes while sparing neighbouring healthy tissues. One of the consequences of increasing the conformality of radiation therapy is an increased sensitivity to errors in the preparation and execution of the treatment. If the maximum gain in the treatment outcome using 3DCRT and IMRT techniques is to be achieved then it is crucial that the correct volume is treated to the correct dose on each day of the treatment. This requires new improved methods and techniques for verifying the daily delivery of the treatment. In this project we aim to develop the use of online digital imaging devices for measuring the delivered dose during treatment. This will increase the confidence with which these new conformal radiotherapy techniques can be delivered allowing their true potential for improving patient treatment outcomes to be realised.Read moreRead less