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Making the most of proton beam therapy

Proton beam therapy is coming to University College London Hospital (UCLH) - and UCL researchers will help to ensure that best possible use is made of this innovative new form of cancer treatment.

Proton beam therapy is a type of radiotherapy in which high-energy beams of protons are used to target and kill cancer cells. One of its key advantages is that the beams of protons stop once they hit target tissues, limiting the damage to surrounding tissue. It is therefore well suited to treatment of cancers in challenging locations and when it is particularly important to avoid damage to surrounding tissue - brain tumours in children being one obvious example.

UK patients who require proton beam therapy are currently sent overseas for treatment, but two treatment centres are being built in the UK - one at UCLH and one in Manchester (a low-power facility, used to treat eye cancers, already exists in Merseyside). Testing of the UCLH facility will begin in 2019, with first patients scheduled to be treated in 2020.

As a relatively new technology, there is still considerable scope to refine the development of proton beam therapy and extend its range of applications. A key role in these developments is being taken by a team of scientists led by Professor Gary Royle in UCL Engineering. Members of his team are currently working in US proton beam therapy facilities to familiarise themselves with the technology and to explore technological innovations that could be implemented in the new facility in the UK.

This work is part of a wider collaboration between engineers and physicists in Professor Royle's team and the multidisciplinary teams involved in the delivery of radiotherapy at UCLH, including radiation oncologists, medical physicists, medical oncologists, diagnostic radiologists and radiographers. Professor Royle has developed a close working relationship with the clinical team, jointly identifying key clinical challenges and formulating a programme of research on technological and software innovations to overcome them.

A key aim of radiotherapy - still the most effective form of cancer treatment - is to focus radiation as tightly as possible on tumours, to avoid damage to surrounding tissue. Targeting is facilitated by sophisticated imaging techniques, used to guide the delivery of radiation. One particular challenge being addressed by Professor Royle's team is the need to adjust the delivery of radiation to reflect the changes that occur in the patient both during the treatment and between treatments. Team members are also working with partner hospitals to optimise use of new imaging technology for planning patient treatments more precisely and monitoring the effectiveness of treatment.

For the future, collaborations with clinical colleagues will begin to explore new applications of proton beam therapy, where theoretical consideration suggest it would have value but there is currently insufficient clinical evidence to justify its use. More generally, these collaborations will also explore how best to deploy radiotherapy as part of multimodal treatment strategies, such as the pretreatment of tumours to make them more sensitive to radiation damage. 

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Professor Gary Royle