Revolutionising radiotherapy: how we’re innovating a century old cancer treatment – Cancer Research UK

Reducing harmful side effects

One such trial is TORPEdO, led by Dr David Thompson at The Christie Hospital in Manchester. Supported by the Taylor Foundation, this flagship study is looking at whether proton beam therapy can improve the treatment of head and neck cancers. People with these cancers currently have few treatment options and those that do survive often experience long-term side effects.

TORPEdO is testing whether PBT instead of conventional radiotherapy can improve both survival and quality of life. The trial has been enthusiastically received, with the number of study sites increasing from 15 to 19, demonstrating how keen clinicians and patients are for new possibilities to treat these cancers. As Dr Thompson says, “A few of the newly opened trial sites recruited patients immediately after opening, which is testament to how meaningful trials like this are for patients and how much hope it gives them”.

Alongside the TORPEdO trial, its sub-studies are gathering information that could be used to assess how someone will respond to treatment. Such as whether the effect of proton radiotherapy on the healthy tissues surrounding a tumour can be predicted by MRI images or whether it’s possible to see how well a person is responding to a treatment using a simple blood test.

PBT has also shown promise for other cancer types, like breast cancer. Conventional radiotherapy for breast cancer carries a very small risk of heart damage because breast cancers are near the heart. In most people this risk is very low, less than 1%, but for a few, pre-existing health conditions mean they’re at greater risk of experiencing this potentially fatal side effect.

Led by Professor Charlotte Coles at the University of Cambridge, PARABLE is investigating if proton beam therapy can more safely treat people most at risk of heart damage. “Most patients treated with radiotherapy have decades of healthy life ahead of them, but we need to do everything we can to avoid possible future heart problems related to treatment. Standard breast radiotherapy is really effective for most people with very few side effects, but there is a small group of patients for whom proton beam therapy may be a better option.”

The PARABLE trial is a great example of how scientific advances are making it easier to personalise cancer care, offering people with cancer an individualised treatment plan that gives them the highest chance of both long-term survival and quality of life.

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