Radiotherapy for prostate cancer can cause severe, long-term bowel and urinary damage, and a new approach aims to map and avoid the specific healthy tissue regions most vulnerable to that harm. Prostate cancer is the most common male cancer in the UK, and radiotherapy is a key treatment. But when radiation also hits the pelvic lymph nodes—increasingly done to improve cancer control—toxicity rates rise. Current planning methods do not account for which tiny sub-regions of normal tissue are most sensitive. This project uses a technique called voxel-based analysis (VBA) to identify those sensitive sub-regions from scans of previously treated patients, then designs radiotherapy plans that deliberately spare them. If successful, the research will produce a clinically feasible, VBA-optimised radiotherapy planning method ready for a randomised trial. That trial could show whether the new plans meaningfully reduce bowel and urinary side effects without compromising cancer control. For patients, that would mean fewer life-altering complications from a treatment they need. For the NHS, it could lower the costs of managing long-term toxicity. The project also includes qualitative interviews with patients and carers—including under-served groups—to ensure that what matters to them shapes how toxicity is measured and communicated.
View original technical description
Research question Can we optimise pelvic radiotherapy (PRT) to reduce toxicity for patients with prostate cancer? Background Radiotherapy is an important treatment for prostate cancer, the commonest male cancer in the UK. However, radiotherapy may cause severe, long-term bowel/urinary toxicities, with consequences for patients, healthcare services and wider society. Increasingly, pelvic lymph nodes are irradiated, which might improve disease-related outcomes but can further increase toxicities. Research into treatment consequences is a priority. We need to understand patient/carer perspectives regarding PRT and its toxicity. We need to understand radiotherapy-toxicity relationships and optimise radiotherapy design, known as planning, to reduce toxicity risks. Voxel-based analysis (VBA) can identify normal tissue sub-regions associated with radiotherapy toxicities. Optimising radiotherapy planning to spare sub-regions could reduce toxicity. However, VBA-optimised PRT requires development and feasibility assessment before it can be evaluated to determine patient benefit. Aims To understand patient/carer perspectives regarding PRT for PCa To use VBA to optimise PRT planning and model toxicity benefit compared to standard planning To evaluate feasibility of clinical use of VBA-optimised PRT To develop a clinical trial and funding application for VBA-optimised PRT Methods This research will be conducted across four workstreams (WS). WS1- Patient/carer perspectives regarding PRT: Qualitative interviews with patients previously treated and due treatment with PRT for PCa will be performed, to understand impact of toxicity, explore perspectives regarding risks and benefits and information/support needs. Perspectives of carers and under-served groups will be included. WS2- Optimising PRT using VBA: WS2.1- VBA will be used to identify sub-regions associated with toxicities in previously treated patients WS2.2 - PRT planning will be optimised in silico using identified sub-regions and toxicity benefit modelled compared to standard planning WS3- Feasibility of clinical use of VBA-optimised PRT planning: A prospective multicentre study to determine feasibility within clinical workflows will be performed to understand if VBA-optimised planning is ready for clinical evaluation. Primary endpoint will be time taken for VBA-optimised versus standard planning. Secondary endpoints will be plan quality/clinical acceptability. WS4- Development of a clinical trial of VBA-optimised PRT: Development of a randomised trial and funding application to compare efficacy (toxicity benefit) of VBA-optimised versus standard planning. Engagement with key stakeholders will shape trial design. Timelines I will complete the fellowship over 60 months: WS1: Months 1-33 WS2: Months 1-48 WS3: Months 25-54 WS4: Months 49-60 Mentorship, patient and public involvement (PPI) and training coincide with relevant WSs. PPI and Equality, Diversity and Inclusion People from across West Yorkshire shaped this application and will be involved throughout. Contacts in local communities will help me reach people from under-served groups to participate in the research and as PPI partners. Impact and Dissemination Insights into patient/carer experience, including under-served groups, will inform videos and workshops to shape provision of information/support/services for patients before and after PRT. Developmental/modelling work and feasibility assessment of VBA-optimised PRT will inform clinical trial development to determine patient benefit. Open access publications, national/international conference presentations and co-designed public engagement activities with PPI partners, including co-presentations, will highlight my research and its impact.
Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.
Is something wrong? Let us know