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
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
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
This proposal will focus on determining the effect that disruption of molecules involved in repairing DNA has on development of adverse reactions following cancer radiation treatment. Radiation is efective for cancer but tissues that reside next to the tumour are also exposed to radiation (which can damage DNA) during radiotherapy. About 1-5% of radiotherapy patients develop unexpectedly severe side effects in their normal tissues. The dose of radiation used for treatment to the rest of patients ....This proposal will focus on determining the effect that disruption of molecules involved in repairing DNA has on development of adverse reactions following cancer radiation treatment. Radiation is efective for cancer but tissues that reside next to the tumour are also exposed to radiation (which can damage DNA) during radiotherapy. About 1-5% of radiotherapy patients develop unexpectedly severe side effects in their normal tissues. The dose of radiation used for treatment to the rest of patients (>95%) is restrained to assure only a small proportion risk developing severe reactions. If one could predict which individuals were more susceptible to these reactions, then their large dose could be lowered to avoid the problem, and importantly, the dose could be increased for the majority of the patients, which would lead to a higher cancer cure rate. There are over 130 genes involved in repairing DNA. We hypothesize that dysfunctional DNA repair molecules are likely candidates to cause radiosensitivity in these individuals. In fact, a few of these genes have already been found to cause radiosensitivity, but we aim to assess all of the DNA repair genes in samples from patients that have had severe reactions to radiotherapy. Here we will use biospecimens, unique to our study and obtained from clinically radiosensitive cancer patients. We will use very sensitive, state-of-the-art procedures to test RNA and protein levels in our patients' cells and the latest technology to test what happens when candidate DNA repair molecule levels are altered. Additionally, we will determine the changes in DNA repair molecule numbers in response to different doses of radiation. We anticipate that results from these experiments will lead to the development of a clinical assay to test the likelihood of an individual having a severe reaction to radiotherapy, thus allowing individualization of treatment and, reducing radiotherapy side effects ultimately increasing cancer cure rates.Read moreRead less
Radiotherapy (RT) is a curative anti-cancer treatment employed in around half of all cancer sufferers. Very occasionally, a cancer patient will manifest an unexpected adverse reaction to RT and there is strong evidence for a genetic basis to such RT sensitivity. Despite two decades of research, such reactions cannot currently be predicted prior to treatment and their occurrence limits the intensity, and hence cure rates, of RT for the majority of patients. This project will employ cutting edge t ....Radiotherapy (RT) is a curative anti-cancer treatment employed in around half of all cancer sufferers. Very occasionally, a cancer patient will manifest an unexpected adverse reaction to RT and there is strong evidence for a genetic basis to such RT sensitivity. Despite two decades of research, such reactions cannot currently be predicted prior to treatment and their occurrence limits the intensity, and hence cure rates, of RT for the majority of patients. This project will employ cutting edge technology (DNA Chips, or microarrays) to attempt to understand why some patients suffer significant RT side-effects, while the vast majority do not. We have developed a tissue bank of samples from cancer patients who have had adverse RT reactions, and these samples (and samples from unaffected cancer patients) will be examined by microarrays: the activity of thousands of genes will be evaluated in each experiment, and we shall search for patterns of gene activity which track with RT sensitivity. Should we determine a pattern, this pattern will be checked against a larger number of cases and if it accurately predicts RT sensitivity, could lead to the routine testing of cancer patients prior to RT and the individualisation of cancer therapy. In parallel, we will evaluate the tissues of sensitive patients with assays capable of detecting abnormalities in the response to radiation, which may give clues as to an underlying gene fault(s) which might predispose to radiosensitivity in that individual.Read moreRead less
Rectal Invivo Radiotherapy Dosimetry Using A Fibre Optic Array
Funder
National Health and Medical Research Council
Funding Amount
$438,963.00
Summary
For pelvic cancer patients too much radiation causes rectal problems which are hard to avoid. To reduce the problem we have developed a tiny dosimeter, which we will network to measure the radiation in the rectum as it is being received. This will tell us the maximum safe dose of radiation we can give before causing rectal complications. This will be an effective quality assurance and radiation safety tool.
DNA Binding Ligands For Auger Therapy And Receptor Imaging
Funder
National Health and Medical Research Council
Funding Amount
$589,532.00
Summary
Our aim is to develop new technologies for very specific cancer radiotherapy and diagnostic imaging. The system involves the use of a protein linked to a radioactive DNA binding drug. The radioactivity we use has a very small range -a few millionths of a millimetre- allowing us to selectively kill cancer cells with minimal harm to healthy tissue. For diagnosis we use smaller amounts of radiation to obtain a clear image of the areas and extent of disease, which facilitates appropriate treatment.