Improving radiotherapy techniques
The Royal Marsden has been a major contributing centre to national trials in both prostate and breast cancer, assessing new radiotherapy techniques and drugs to modify the natural history of these common forms of cancer.
Prostate cancer radiotherapy
Professor David Dearnaley was Chief Investigator for the Medical Research Council (MRC) trial RT01 in prostate cancer that assessed dose-escalated radiotherapy with conformal radiotherapy techniques.
The results of the trial led to NICE guidance in 2008 establishing dose-escalated conformal radiotherapy in prostate cancer as the new national standard of care in the NHS.
Breast cancer radiotherapy
In early breast cancer, Professor John Yarnold led the START trials which showed that lower overall radiotherapy dosing given in fewer but larger amounts was as effective as the international standard dosage regimen, in which a larger total dosage is given over a longer period.
This has defined a new radiotherapy treatment standard for women with early-stage breast cancer in the UK.
Other radiotherapy breakthroughs
Radiotherapy programme grant
The Royal Marsden and The Institute of Cancer Research have secured a five-year radiotherapy programme grant from Cancer Research UK to support further pioneering research within the Department of Physics, under the joint leadership of Professor Alan Horwich and Professor Steven Webb.
Conformal radiotherapy for gynaecological cancer
New technology in CT scanning called ‘virtual simulation’ has improved radiotherapy for gynaecological cancer patients by increasing the accuracy of treatment through positioning radiation within the body to give the biggest dose to the tumour and the smallest dose to the adjacent normal tissues.
This is called conformal therapy. It causes fewer side effects and can potentially give a bigger dose to the cancer, improving the chance of cure.
Image-guided radiotherapy (IGRT)
Two new systems have been installed on treatment machines called ‘cone beam’ and ‘on-board imaging’. These check that the patient’s organs are in the correct position relative to the radiation beam when the treatment is given.
This can then reduce variations of dose to the tumour on a day-by-day basis particularly in relation to bladder or bowel filling. It is possible to track the movement of the tumour during the treatment. This will increase the accuracy of the treatment and is called image-guided radiotherapy (IGRT).