EMERALD - Pancreas
Research type
Research Study
Full title
Evaluation of hypofractionated adaptive radiotherapy using the MR Linac in localised pancreatic cancer
IRAS ID
279946
Contact name
Somnath Mukherjee
Contact email
Sponsor organisation
University of Oxford, Research Governance, Ethics and Assurance
ISRCTN Number
ISRCTN10557832
Duration of Study in the UK
2 years, 5 months, 31 days
Research summary
Localised pancreatic cancer has a poor outlook. The best radiotherapy dose for pancreatic cancer that is safe and effective is unknown. Radiotherapy aims to deliver a high dose to the cancer and avoid the surrounding normal organs as much as possible. This gives the best combination of getting the highest chance of treating the cancer with the lowest risk of toxicity.
Radiotherapy for pancreatic cancer is usually given in 25-30 daily treatments combined with chemotherapy. More recently, high-dose precision radiotherapy called stereotactic radiotherapy has been shown to be similarly effective when delivered in 1-5 treatments. However, although the tumour and surrounding organs is clearly visualised on the planning CT scan, day-to-day variation during treatment is difficult to visualise on the current CT-guided radiotherapy, which causes some inaccuracy. Furthermore, some organs in the body move all the time- as we breathe and as food moves through the intestines. These impact on the dose the cancer and normal organs gets. We are using a machine which combines Magnetic Resonance Imaging(MRI) with a radiotherapy machine(MR-linac). The MR-linac allows us to see the cancer and surrounding organs more accurately and use that information to update the radiotherapy plan one each treatment day. Also, during treatment the cancer is imaged continuously and if it moves out of the treatment field the machine switches off, and switches back on when the cancer moves back within the field.
Our initial research using planning scans shows that, higher doses could be delivered to the tumour on the MR-linac over 5, 3 and 1 treatments without over-dosing the normal organs. This research study aims to see if we can safely deliver this in actual patients. This could improve cancer control. In future, this may also allow us to explore combining radiotherapy with other treatments to improve pancreatic cancer outcome.
REC name
West Midlands - Black Country Research Ethics Committee
REC reference
22/WM/0122
Date of REC Opinion
7 Jul 2022
REC opinion
Further Information Favourable Opinion