Title

Investigating the Potential Benefits of MRI-LINAC for Delivery of Stereotactic Ablative Radiotherapy (SBRT) in Hepatobiliary Malignancies

SBRT has been investigated as an alternative to conventionally fractionated radiotherapy for the local treatment of pancreatic cancer and liver malignancies. Advantages of SBRT include possibility to deliver higher biological effective doses compared to conventional radiotherapy. It has better integration with multidisciplinary treatments due to significantly shorter treatment courses, and potential immune effects. SBRT in the GI tract has potentially severe toxicity due to poor tolerance of the GI tract to radiation and the need for large margins due to poor tumour visualization and motion. Novel radiotherapy technologies (proton and MRI LINAC [MRL]) offer the opportunity to improve SBRT delivery. The project aims are:

1.     to analyse/calculate delivered dose for patients treated in pancreatic and  cholangiocarcinoma trials.

2.     to estimate potential improvement in dose delivery to tumour and normal tissue (TCP/NCTP modelling) comparing the use of motion managed LINAC, MRL or protons for pancreas and HPB malignancies,  to investigate potential benefits using novel toxicity estimation models (“duodenal unfolding”).

3.     to develop an MRL protocol including putative functional sequences to be tested prospectively for the  malignancies studied.

The ideal applicant will have a background in radiation oncology, understanding of imaging in radiation oncology and radiotherapy planning.

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