Investigating the potential benefits of MRI-linac for delivery of Stereotactic ablative RT (SBRT) in hepatobiliary malignancies
SBRT has been investigated as an alternative to conventionally fractionated radiotherapy for the local treatment of pancreatic cancer and as consolidative treatment in liver malignancies. Advantages of SBRT include the possibility to deliver higher biological effective doses compared to conventional radiotherapy and increased patient comfort. Additionally, it has better integration with multidisciplinary treatment concepts due to significantly shorter treatment courses, shorter interruption of full-dose chemotherapy and potential immune effects. SBRT in the GI tract has potentially severe toxicity due to poor tolerance of the GI tract to radiation and the need of large margins due to poor tumour visualization and motion. Novel radiotherapy technologies (proton and MRI linac) offer the opportunity to improve SBRT delivery in these challenging to treat cancers. The project aims are:
- to analyse and calculate delivered dose for patients treated in a phase I SBRT pancreatic trial and a cholangiocarcinoma trial.
- to estimate potential improvement in dose delivery to tumour and normal tissue (TCP/NCTP modelling) comparing the use of motion managed linac RT, MRI linac or protons for pancreas and HPB malignancies, and to investigate potential benefits using novel toxicity estimation models (“duodenal unfolding”).
- to develop an MRI linac RT protocol including putative functional sequences to be tested prospectively for the malignancies studied.
The ideal applicant will have a background in radiation oncology, understanding of imaging in radiation oncology and radiotherapy planning. Secondary supervision will be provided by Frank Van den Heuvel.