ARTFORCE

Adaptive and innovative Radiation Treatment FOR improving Cancer patients treatment outcomE

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 Obiettivo del progetto (Objective)

'Loco-regional treatment is the mainstay of cancer cures in non small lung and head and neck cancer. For advanced stage cancer, dose intense multimodality treatment is required yet affected by substantial side effects. Our aim is to improve treatment outcome in locally advanced head and neck and lung cancer patients by: 1. Optimizing local control by introducing novel radiation techniques resulting in redistribution of the radiation dose, creating inhomogeneous dose distribution towards the most active part of the tumour instead of conventional homogenous doses. This redistribution can be performed without increase of toxicity. As recently reported radiation accidents in the US demonstrate, QA is of outmost importance for safe radiation delivery in complex treatments. To assure accurate delivery over time, we will monitor both the patient’s geometry as well as the delivered dose using image guided adaptive plan modifications and 3D in-vivo dosimetric verification. 2. Maximizing the benefit of combined modality treatment Both cisplatin and Cetuximab in combination with radiotherapy have shown to improve local control and survival but both drugs have severe side effects. As these drugs are not active in all patients, there is a large need to select patients which are sensitive to either drug. For this purpose the uptake of Cetuximab will be estimated by imaging tumour uptake with Zr89 labelled Cetuximab, while cisplatin sensitive tumours can be selected by biomarkers. This proposal will: 1 optimise efficiency by selecting patients on treatment specific tumour response predictors and tailoring radiation to most active parts of the tumour. 2 improve quality of life by withholding ineffective, toxic treatments and redistribution of dose. 3 decrease community costs by reserving expensive treatments for those who will benefit. This will be studied in randomized phase II clinical trials in top European institutes, followed by phase III trials outside this proposal.'

Introduzione (Teaser)

A combined system of therapy that redefines radiation dosage and pharmaceutical use in cancer patients is slated to be much more effective in treating this often defiant illness.

Descrizione progetto (Article)

Intensive radiation therapy is often burdensome for cancer patients, prompting researchers to explore more efficient and less harmful ways of administering this treatment. The EU-funded project 'Adaptive and innovative radiation treatment for improving cancer patient's treatment outcome' (ARTFORCE) is working on enhancing treatment for locally advanced head/neck and lung cancer patients.

The project is introducing new techniques that redirect the radiation to the most active part of the tumour, and finding ways to overcome tumour resistance. It is using image-guided and three-dimensional (3D) technology to distribute precise doses and ensure safe radiation delivery. Another major project objective is to re-evaluate the use of toxic medicines that are given in conjunction with radiation therapy, identifying at an early stage those patients who respond well to specific pharmaceutical interventions and those that do not.

To achieve its aims ARTFORCE has brought together a powerful team of radiation oncologists, dosimetrists, radiographers, physicists and nuclear medicine specialists. It is now conducting clinical trials and selecting ideal patients, i.e. those who are sensitive to standard drug treatments given in combination with radiotherapy. In this context, the project has begun conducting two separate tests, a lung trial and a head and neck trial, with early results looking very promising indeed.

Furthermore, these clinical trials are supported by fundamental research in molecular biology and radiation physics. To illustrate these two fields, changes in genes and proteins predicting treatment outcome in individual patients will be investigated; while in the radiation physics area, modern imaging techniques are explored to identify the precise tumour extension and its characteristics.

Based on the concept of higher yet more targeted radiation doses, the expected results are nothing short of significantly better survival rates and fewer side effects.

Lastly, the project has articulated more rigorous quality assurance procedures and methods to prevent radiation therapy accidents and enhance the treatment's accuracy. These developments represent very welcome news to certain cancer patients who may now have a much stronger chance of leading better, more comfortable lives.