Quantitative HYpoxia imaging for charged ParticlE Radiation treatment guidance: an improved strategy for Aggressive brain Cancers Treatment

Glioblastoma and skull base chordoma are two of the most aggressive types of brain cancers and have an extremely poor prognosis, with most tumours recurring within months of surgical and chemoradiation treatments.

Recurrence is caused by tumour heterogeneity, as regions of the tumour with different biological properties respond differently to treatment.

Tumour hypoxia (low oxygenation) is the leading cause of resistance to radiotherapy in heterogeneous cancers and is linked to poor patient prognosis.

Effectively counteracting tumour hypoxia requires delivering higher doses of radiation selectively to hypoxic tumour regions.

This is hard to achieve with conventional radiation treatment, where a uniform moderate radiation dose is delivered to the entire tumour target and dose-escalation strategies are limited by toxicity constraints established to limit damage to important surrounding brain structures.

Standard radiotherapy plans do not incorporate any measure of tumour hypoxia, due to limitations in imaging techniques currently used for planning.

The work proposed in this fellowship aims to improve radiation treatment for heterogeneous cancers by combining quantitative MRI/PET imaging, to non-invasively characterise regions of tumour hypoxia, and carbon ions radiotherapy, to deliver higher doses of radiation to those regions, whilst sparing surrounding healthy tissue.

This strategy will deliver a more effective radiation dose distribution, providing an opportunity to improve local tumour control and patients’ survival outcomes and quality of life.