AIM - AC

• Research type

  Research Study

• Full title

  Optimising Radiotherapy Planning using Advanced Imaging Techniques in Anal Cancer

• IRAS ID

  205051

• Contact name

  Hema Sekhar

• Contact email

  hema.sekhar@christie.nhs.uk

• Duration of Study in the UK

  1 years, 3 months, 4 days

• Research summary

  There are approximately 1000 new anal cancer cases per year in the UK and incidence is increasing. First line treatment is chemoradiotherapy, with the aim of balancing the risk of locoregional relapse (LRR) against that of treatment-related toxicity. LRR occurs in 20-25%. These patients require radical surgery which is associated with significant morbidity and an ultimately poor outcome. Currently all patients undergo the same chemoradiotherapy treatment, irrespective of the extent and characteristics of disease, with large areas of tissue being irradiated, exposing the patient to risks of treatment related complications.

  Patients with early disease probably have a low risk of LRR and are currently being over-treated and exposed to treatment related toxicity. By contrast, patients at high-risk of LRR may benefit from treatment intensification. A one-size fits all approach is clearly no longer appropriate in the treatment of anal cancer and tailoring treatment to individual risk of disease relapse would be better. To do this we need information on:
  • Individual patient risk
  • Patterns of nodal spread
  • Patterns of LRR in relation to radiotherapy treatment.
  This information is currently lacking.

  Building upon work already performed as part of a clinical audit, we aim to develop information on the above via an umbrella of studies as follows:
  1. MRI derived tumour and nodal characteristics to inform individual patient risk in anal cancer
  2. 3D volumetric assessment of anal cancer as a novel predictor for LRR
  3. Relating differences in 3D radiotherapy dose distribution to LRR in anal cancer

  All work will be conducted on images already acquired as part of the patients’ disease staging prior to any treatment. The results will ultimately help to formulate accurate risk stratification in patients with anal cancer to inform future radiotherapy planning protocols and provide more personalised treatment.

• REC name

  East of Scotland Research Ethics Service REC 1

• REC reference

  16/ES/0080

• Date of REC Opinion

  2 Jun 2016

• REC opinion

  Favourable Opinion