Grand Challenge Network+ in Proton Therapy

Lead Research Organisation: University of Manchester
Department Name: School of Medical Sciences

Abstract

In the UK one in two people are diagnosed with cancer during their lifetimes and of those who survive 41% can attribute their cure to a treatment including radiotherapy. Proton beam therapy (PBT) is a radical new type of radiotherapy, capable of delivering a targeted tumour dose with minimal damage to the surrounding healthy tissue. The NHS is investing £250m in two new "state of the art" PBT centres in London and Manchester. In addition, Oxford has attracted £110m (from HEFCE and business partners) for its new Centre for Precision Cancer Medicine, incorporating PBT.
This EPSRC Network+ proposal seeks to bring the EPS community together with clinical, consumer and industrial partners and develop a national research infrastructure and roadmap in proton therapy. It capitalises on ~£300m of government investment and affords an opportunity for those not directly involved in the new proton centres to be actively involved in the national research effort in this area. This project has the backing of NCRI Clinical and Translational Radiotherapy Working Group and NHS England and will work with the national Proton Physics Research and Implementation Group of the National Physical Laboratory. It also involves industrial stakeholders, consumer groups and international partners (including PBT centres in Europe and USA and CERN).
While PBT offers patients many advantages it also presents a wealth of technical challenges and opportunities where there is an unmet research and training need. This is where there the involvement of the EPS community is vital since this challenge in Healthcare Technologies requires expertise from across the EPS spectrum and maps on to themes in ICT, Digital Economy, Engineering, Mathematics, Manufacturing the Future, and the Physical Sciences and also finds synergies within quantum technologies. It directly maps onto the cross cutting capabilities identified in the Healthcare Technologies Grand Challenges. This is a highly multi-disciplinary area at the frontiers of physical intervention, which achieves high precision treatment with minimal invasiveness. This Network+ is particularly timely; it will afford the UK the opportunity to develop a world-leading research capability to inform the national agenda, capitalising on existing research excellence and the synergies that can be developed by bringing the clinical and EPS areas together. It will also collaborate with existing doctoral training provision to train the next generation of leaders where a national need has been identified.
This proposed Network+ will create a national infrastructure to meet a national research and training need and will allow the UK community to work together in the multi-disciplinary field of proton research. This proposed Network+ will create a sustainable national proton beam infrastructure by drawing together sites where proton beams are already available (albeit at lower energies) and providing a route for the research community to access these facilities. As the new proton centres come on line they will add to this national resource and the centres will work together to provide a virtual national infrastructure for the UK, which by the end of the Network+ will be fully sustainable. The Network+ will also provide a route for those interested in the field but not requiring proton experiments to become involved. In addition, the Network+ will offer secondments ("Discipline Hops") into the clinical environment in both the UK and in PBT centres overseas. Working with NHS England the Network+ will develop a PBT training scheme. This will link the existing NHS provision with EPSRC Centres for Doctoral Training and allow equivalencies to be established and so provide a "fast track" to a skilled workforce and the next generation of leaders. The Network+ will also seek to engage with industry through joint research and secondments and with consumer groups, policy makers and the general public.

Planned Impact

This Network+ in Proton Therapy is designed to bring the EPS community together with clinicians and medical physicists working in hospitals, the major manufacturers in the field, consumer groups (patients, carers and charities), policy makers from NHS England and national and international leaders in the field. The Network+ will establish a sustainable national infrastructure for proton therapy research and allow the whole UK academic community to benefit from access to these facilities. It will also establish Pathfinder projects with industrial or international partners to initiate new research ideas and pump-prime collaborations. The Network+ will also develop a secondment scheme through "Discipline Hops" enabling the EPS community to work closely with the clinical, industrial and international communities.
Proton therapy is an emerging field of research requiring a multi-disciplinary palette of skills and capabilities and there are still many challenges to overcome. The EPS community has the skills to work in partnership with the proton therapy community to find innovative solutions to these challenges. This opens up a whole spectrum of opportunities for innovative research involving the EPS community working in partnership with the public and private sectors both nationally and internationally.
Consumer groups will be actively involved in this Network+ and will help to inform its direction. The ultimate aim will be better treatment and better patient outcomes, achieved by bringing together a wide-ranging and multi-disciplinary community and pump-priming collaborations (through Pathfinder projects, "Discipline Hops" and travel grants).
There will also be benefits through close collaboration with industry, taking EPS research up the technology readiness levels so that it can generate income for the UK economy and society. The fact the four of the worlds major manufacturers in this field want to be involved is testament to the importance they ascribe to this Network+. It is envisaged that this research will prove to be mutually beneficial and is likely to result in industrially sponsored research, knowledge exchange, patents, licensing agreements or spin out companies.
Likewise the involvement at a very senior level of NHS England demonstrates a serious commitment and undoubtedly this Network+ will play a part in informing government research strategy.
The Network+ will produce a vibrant energised community who will actively work together and start to train the next generation to do the same. Through working with NHS England and Health Education England we will address the skills shortage in this area and look at ways to establish equivalencies between the NHS clinical scientist training and that offered by EPSRC through its CDTs. This will help to address an area where there is a national need. In terms of timescale, some impacts will be realised on a short timescale and are likely to be developed as the UK proton therapy service ramps up, through informing treatment strategies and the clinical indications list. Other impacts will take longer to achieve and are likely to result in smaller compact devices, improved real-time imaging, adaptive treatment planning and detection. Impacts involving advanced materials and innovative manufacturing may take even longer. All of these activities will form the pipeline of innovation generated by this Network+, which has a strong industrial and clinical pull.

Publications

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Biglin ER (2019) Preclinical dosimetry: exploring the use of small animal phantoms. in Radiation oncology (London, England)

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Dimitriadis A (2016) Current status of cranial stereotactic radiosurgery in the UK. in The British journal of radiology

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Galer S (2017) Monte Carlo simulation of a TEPC for microdosimetry of carbon ions in Radiation Physics and Chemistry

 
Title Bragg peak glass 
Description working with a glassblower on a glass sculpture to represent the Bragg peak 
Type Of Art Artwork 
Year Produced 2020 
Impact this will form a piece of artwork 
 
Title protons the play 
Description Story of proton therapy in Manchester from Rutherford to clinical treatment. Due to Covid -19 these could not be pursued 
Type Of Art Performance (Music, Dance, Drama, etc) 
Year Produced 2020 
Impact story of how PBT came to Manchester 
 
Description Mechanistic mathematical models have been incorporated in to treatment plans to enable biological effects of proton therapy to be evaluated. This has been aided by research licenses for research version of clinical treatment planning Eclipse and Velocity being donated by Varian. fair market value $75k.
Patient information booklets developed with Brains Trust
The group hosted 5 summer placements in summer 2019
Organised PTCOG 58 in 2019 which brought over 1350 people to Manchester and generated over £2.5M for the local economy
First UK RCT PBT clinical trial TORPEDO funded by CRUK and opened in 2020.
Ideas from mechanistic mathematical models incorporated in to PBT PARABLE breast trial funded by NIHR and this modelling will be used to biologically augment the treatment planning of patients enrolled on this study. A second PBT trial APPROACH on low grade gliomas was also funded.
VM interface for patient demand software Malthus developed and has now been extended to cover patient waiting times funded by GM cancer £20k. EPSRC funded Mathus Covid to look at changes in RT due to Covid19. A paper has been submitted to Clinical Oncology on this research
Proto-type for prompt gamma imaging for range verification developed, detectors likely to be funded through Christie Charity appeal
Framework agreement developed with Varian and 2 projects on PBT FLASH funded
PBT Research room commissioning undertaken and research room is now operational and high through put experiments being conducted. Hypoxia end station with integrated robot arm operational
First PBT FLASH beam Feb 2021 and experiments now being undertaken with both FLASH and non FLASH beams
Research incorporated in NIH Topas nBio and available Open Access
Work on motion management with UCL, this is being developed into an MRC grant and an STFC Impact Innovation award was successful (£60k).
Contributed to Science Museum Cancer Revolution Exhibition
Exploitation Route Patients using information booklets
clinicians and clinical scientists using biologically augmented treatment plans to inform and improve patient treatment and models being used in clinical trials (examples include TORPEDO and PARABLE clinical trials
Government looking at equipment demand and this has been adapted to incorporate Covid19 information.
Industry improving tumour targetting through better measurement of range and stopping powers
Work on patient screening for lung cancer using Malthus model now being extended nationally
Research included in NIHR Parable breast PBT trial and also commissioning for evaluation head and neck trial. Included in trial PROTIS which has just been funded
EMBRACE clinical trail on wearables funded https://www.manchester.ac.uk/discover/news/trial-of-wearable-health-technology-for-cancer-patients-opens/
Sectors Healthcare,Government, Democracy and Justice,Culture, Heritage, Museums and Collections

URL https://brainstrust.org.uk/brain-tumour-support/resources/downloads/patient-guides/
 
Description Developing material with BrainsTrust on proton therapy which is being used to inform patients and carers about proton therapy. https://brainstrust.org.uk/brain-tumour-support/resources/downloads/patient-guides/ POST note for Members of Parliament on proton therapy published in 2019 https://post.parliament.uk/research-briefings/post-pn-0598/ In collaboration with CRUK ART-NET organised meeting for patients and carers to give views on proton beam therapy (PBT) clinical trials. RCT TORPEDO funded by CRUK on head and neck cancers started to recruit patients in 2020. At the end of 2020 2 PBT clinical trials PARABLE (breast) and APPROACH (low grade glioma were funded by NIHR and will start to recruit 2021/22. PARABLE uses LET/RBE modelling developed through a pilot project from this Network which will now be applied to clinical patients to help to optimise their treatment planning. Invited to join with NIH Topas-nBio project led by Massachusetts General Hospital / Harvard Medical School this is the gold standard radiobiological MC model and now has work developed through this Network at its heart. Topas n-Bio is available to the research community open access Undertaking a report in collaboration with NHS-E to look at bringing doctoral training provision within NHS and research councils together. This is now being integrated with National School of Clinical Sciences HSST. Public engagement activities with patients, carers, schools donors in 2018, 2019, less work done in 2020 and 2021 due to Covid19 although online courses being developed Radiotherapy and me videos now available https://wearevocal.org/wlrs/topics/radiotherapy-me/case-studies/radiotherapy-me/ BBC interview on FLASH radiotherapy Talked to patient groups on potential impact of FLASH radiotherapy and received their feedback Video on past 12 months for GM cancer conference Master research agreement with Varian and 2 projects on FLASH PBT funded Submission of project on impact of Covid19 on radiotherapy demand funded through this project with agreement of EPSRC Working with a glassblower to produce art that emulates the Bragg peak with a display that will be used in patient waiting areas Projects ongoing on PBT motion management National meeting on particle therapy in UK produced paper and roadmap in BJR and now working with CRUK RADNET on future meetings to develop roadmap. Presented output at IOP meeting in December 2020 Working with IAEA on document for advising countries that want to develop PBT. This looks at staffing and training required and costs of this training. This will be an international guidance document for countries looking to develop PBT Developed international proton school. Worlds first online proton school over 106 attendees from all over the world. Course took place Nov-Dec 2020 over 6 weeks working with Science museum on new exhibit on PBT Cancer Revolution opened in Manchester in October 2021 and Transferring to London in 2022. This work was featured in The Guardian in Dec 21 2021 https://www.theguardian.com/cancer-revolutionaries/2021/dec/21/how-radiotherapy-became-a-lifesaver-from-x-rays-to-the-proton-beam PBT patient fact sheets with Brains Trust https://brainstrust.org.uk/brain-tumour-support/resources/downloads/pbt/ framework agreement with varian Development of a hypoxia cabinet with integrated robotic arm with Don Whitley Scientific. This is now complete and we are looking at an agreement with DWS if other groups wish to purchase BBC interview on FLASH radiotherapy work incorporated into NIH grant Topas n-Bio with MGH now available Open Source https://gray.mgh.harvard.edu/research/multi-scale-monte-carlo-modeling-lab/269-currently-under-development Developing relationship with IAEA on PBT Organised international conference on FLASH radiotherapy and particle therapy in 1-3 Dec 2021, over 730 people attended from over 40 countries. FRPT 2 being planned for Barcelona in 2022. International consensus on paper on LET and RBE paper published Organised PTCOG58 in 2019 largest conference on particle therapy brought over 1350 people to Manchester from all over the world and generated £2.5M for local economy Contributed to On cancer in 2021On Cancer is a new 44-page collection of research-led policy recommendations authored by academics from The University of Manchester, and The Christie which aim to highlight areas where research can inform policy changes and improve the lives of patients living with cancer. Started work with EMBRACE team on wearable devices, this involves clinicians from Manchester Foundation Trust and The Christie. A clinical trial has opened https://www.manchester.ac.uk/discover/news/trial-of-wearable-health-technology-for-cancer-patients-opens/
First Year Of Impact 2019
Sector Healthcare,Government, Democracy and Justice,Culture, Heritage, Museums and Collections
Impact Types Cultural,Societal,Economic,Policy & public services

 
Description Heavy Charged Particle Beam Therapy and related new Radiotherapy technologies: The Clinical Potential, Physics and Technical Developments Required to Deliver Benefit for Patients with Cancer
Geographic Reach National 
Policy Influence Type Participation in a national consultation
Impact 2 day meeting to look at clinical implications of heavy ion charged particle therapy and develop a road map. This is now published and formed the basis for the UK ITRF
URL https://www.research.manchester.ac.uk/portal/en/publications/heavy-charged-particle-beam-therapy-and...
 
Description Patient information booklets on PBT
Geographic Reach National 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
 
Description Training
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
 
Description Work with IAEA on developing a resource and training in partocle therapy
Geographic Reach Multiple continents/international 
Policy Influence Type Participation in a national consultation
Impact Working with IAEA to provide an international guidance document on proton therapy which looks at staffing and skillset involved. This will be used by countries looking to set up new PBT facilities. Web page will follow shortly once document released
 
Description Workstream 4 CoChair NCRI CTRad
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
Impact National body pioneering new developments in radiotherapy
URL https://www.ncri.org.uk/how-we-work/ctrad/
 
Description Advanced Radiotherapy Network + (ARN+) extension
Amount £365,748 (GBP)
Funding ID ST/S005382/1 
Organisation Science and Technologies Facilities Council (STFC) 
Sector Public
Country United Kingdom
Start 08/2019 
End 09/2022
 
Description CRUK ART-NET
Amount £4,500,000 (GBP)
Organisation Cancer Research UK 
Sector Charity/Non Profit
Country United Kingdom
Start 08/2016 
End 08/2021
 
Description CRUK Major Centre
Amount £48,500,000 (GBP)
Organisation Cancer Research UK 
Department Manchester Institute
Sector Academic/University
Country United Kingdom
Start 03/2017 
End 03/2022
 
Description Cockcroft Phase 4 Award
Amount £7,772,375 (GBP)
Funding ID Cockcroft phase 4 
Organisation Science and Technologies Facilities Council (STFC) 
Sector Public
Country United Kingdom
Start 03/2021 
End 03/2025
 
Description EC Research and Infrastructure
Amount € 5,000,000 (EUR)
Funding ID 730983 INSPIRE 
Organisation European Commission H2020 
Sector Public
Country Belgium
Start 03/2018 
End 02/2022
 
Description EMPIR
Amount € 2,000,000 (EUR)
Organisation European Commission 
Sector Public
Country European Union (EU)
Start 04/2016 
End 04/2019
 
Description Equipment application
Amount £265,000 (GBP)
Organisation University of Manchester 
Department Manchester Cancer Research Centre
Sector Charity/Non Profit
Country United Kingdom
Start 08/2017 
End 10/2018
 
Description Improving preclinical proton radiation dosimetry using a biologically relevant murine dosimetry phantom
Amount £121,654 (GBP)
Funding ID NC/W002256/1 
Organisation National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs) 
Sector Charity/Non Profit
Country United Kingdom
Start 01/2022 
End 01/2024
 
Description Infrastructure in FLASH Radiotherapy
Amount £199,904 (GBP)
Funding ID RRNIA-Feb22\100002 
Organisation Cancer Research UK 
Sector Charity/Non Profit
Country United Kingdom
Start 05/2022 
End 05/2024
 
Description MCRC PhD Studentship
Amount £145,000 (GBP)
Organisation University of Manchester 
Department Manchester Cancer Research Centre
Sector Charity/Non Profit
Country United Kingdom
Start 08/2018 
End 08/2022
 
Description Manchester RADNET
Amount £16,500,000 (GBP)
Organisation Cancer Research UK 
Sector Charity/Non Profit
Country United Kingdom
Start 09/2019 
End 09/2026
 
Description Modelling anomalous transport of nanoparticles and DNA repair to improve radiotherapy
Amount £702,576 (GBP)
Funding ID EP/V008641 
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 03/2021 
End 03/2024
 
Description NIHR
Amount £100,000 (GBP)
Organisation National Institute for Health Research 
Department NIHR Biomedical Research Centre
Sector Public
Country United Kingdom
Start 09/2017 
End 09/2021
 
Description NIHR BRC
Amount £28,500,000 (GBP)
Organisation National Institute for Health Research 
Department NIHR Biomedical Research Centre
Sector Public
Country United Kingdom
Start 03/2017 
End 03/2022
 
Description Proton FLASH
Amount £227,974 (GBP)
Organisation Varian Inc 
Sector Private
Country United States
Start 08/2019 
End 08/2021
 
Description Responsive Mode
Amount £3,400,000 (GBP)
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 04/2018 
End 12/2021
 
Description Topol Digital Fellowship
Amount £20,000 (GBP)
Organisation Health Education England 
Sector Public
Country United Kingdom
Start 04/2022 
End 04/2023
 
Title Proton Therapy Research room in the clinical PBT centre at the Christie 
Description Research infrastructure to conduct research in proton therapy, funded by Christie Charity £5.6M. Over the past year we have been comissioning the research room and bioprep room. This has been slowed down due to Covid. first experiments March 2021 Experiments are now ongoing in the research room and the hypoxia cabinet with integrated robotic arm (designed with don Whitley Scientific) is now fully operational and performing high throughput experiments. Accurate QA and dosimetry < 3% comparable with clinical system achieved for protons. FLASH capability delivered, dosimetry <5% one of the best in the world. 
Type Of Material Improvements to research infrastructure 
Year Produced 2020 
Provided To Others? Yes  
Impact The plan is to make this research infrastructure available via UKRI and CRUK grants. The facility has to pay its own costs so funding would need to be applied for via competitive grants. CRUK now funding research room through RadNet as a national proton hub and have just funded a national FLASH infrastructure. 
URL https://protonsinspire.eu/facilities/the-christie-nhs-foundation-trust
 
Title Anonymisation of PBT overseas data and data from patients treated at The Christie with PBT 
Description Means to access anonymised patient data from PBT patients treated overseas and at the Christie. This allows real patient data to be used to validate models developed in BioProton and other UKRI grants 
Type Of Material Database/Collection of data 
Year Produced 2020 
Provided To Others? No  
Impact Means research outputs can be validated on real patient data 
 
Description IAEA PBT 
Organisation International Atomic Energy Agency
Country Austria 
Sector Charity/Non Profit 
PI Contribution international guidance on developing a PBT centre
Collaborator Contribution developing international guidance on training and workforce for governments or institutions wishing to develop a new PBT centre
Impact international guidance document being developed
Start Year 2019
 
Description MGH 
Organisation Eindhoven University of Technology
Department Medical Physics
Country Netherlands 
Sector Academic/University 
PI Contribution New collaboration to incorporate research undertaken by 2 current PhD students and a new PhD who will work directly with MGH. MGH are providing software licenses free of charge and the software developed will be incorporated in to TOPAS which is used internationally. The PhDs have now visited but there is an ongoing collaboration with weekly telephone conferences. 1 publication in Nature Scientific Reports and 4 further publications in the process of being submitted
Collaborator Contribution software licenses, hosting PhDs at MGH expertise
Impact Software now incorporated in Open Access Software Topas n-Bio; 1 publication and 4 further publications being written; Workshop to be held in Belfast in April 2018 (all workshop places filled). Active ongoing collaboration.
Start Year 2016
 
Description Malthus on Azure cloud 
Organisation Microsoft Research
Country Global 
Sector Private 
PI Contribution Uses Malthus model for radiotherapy demand
Collaborator Contribution Access to Microsoft cloud allowing us to demonstrate a cloud based solution of our radiotherapy demand model
Impact The research is going to feature in a short film of Microsoft's research collaborations, will be published and demonstrated at conferences world wide
Start Year 2017
 
Description Modelling national demand for radiotherapy internationally 
Organisation International Atomic Energy Agency
Country Austria 
Sector Charity/Non Profit 
PI Contribution This work also involves ESTRO HERO project the project combines radiotherapy demand with health economic costing models to understand the real cost of RT, PBT and in the future new modalities such as FLASH therapy
Collaborator Contribution access to IAEA costing methodology; access to ESTRO HERO costing methodology. Will feed in to ESTRO EPTN WP7. Also allows impact of Covid to be assessed.
Impact publications being written ESTRO presentations
Start Year 2020
 
Description NPL2 
Organisation National Physical Laboratory
Country United Kingdom 
Sector Academic/University 
PI Contribution Proton Physics Research Implementation Group (PPRIG) Hosts annual international workshop
Collaborator Contribution Costs of hosting the annual workshop, experience and expertise
Impact Presentations can be found below http://www.pprig.co.uk/pprig/meetings/pprig-proton-therapy-physics-workshop-dec-2016.html
Start Year 2016
 
Description National audit using "plastic mouse" 
Organisation Queen's University Belfast
Department Centre for Cancer Research and Cell Biology
Country United Kingdom 
Sector Academic/University 
PI Contribution National audit of SARRP with "plastic mouse" using film and alanine pellets
Collaborator Contribution access to personnel and SARRP equipment to plan a static dose and arc dose to plastic mouse. The work also compared with cabinet irradiators in Manchester. This group now feeds in to a RADNET committee The plan is to 1. recommend the use of "plastic mouse" in routine dosimetry 2. carry out a larger audit of PBT centres initially with non FLASH beams but then moving on to FLASH
Impact output being prepared on this collaboration
Start Year 2020
 
Description National audit using "plastic mouse" 
Organisation University College London
Country United Kingdom 
Sector Academic/University 
PI Contribution National audit of SARRP with "plastic mouse" using film and alanine pellets
Collaborator Contribution access to personnel and SARRP equipment to plan a static dose and arc dose to plastic mouse. The work also compared with cabinet irradiators in Manchester. This group now feeds in to a RADNET committee The plan is to 1. recommend the use of "plastic mouse" in routine dosimetry 2. carry out a larger audit of PBT centres initially with non FLASH beams but then moving on to FLASH
Impact output being prepared on this collaboration
Start Year 2020
 
Description National audit using "plastic mouse" 
Organisation University of Cambridge
Department School of Clinical Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution National audit of SARRP with "plastic mouse" using film and alanine pellets
Collaborator Contribution access to personnel and SARRP equipment to plan a static dose and arc dose to plastic mouse. The work also compared with cabinet irradiators in Manchester. This group now feeds in to a RADNET committee The plan is to 1. recommend the use of "plastic mouse" in routine dosimetry 2. carry out a larger audit of PBT centres initially with non FLASH beams but then moving on to FLASH
Impact output being prepared on this collaboration
Start Year 2020
 
Description National audit using "plastic mouse" 
Organisation University of Glasgow
Department Institute of Cancer Sciences
Country United Kingdom 
Sector Academic/University 
PI Contribution National audit of SARRP with "plastic mouse" using film and alanine pellets
Collaborator Contribution access to personnel and SARRP equipment to plan a static dose and arc dose to plastic mouse. The work also compared with cabinet irradiators in Manchester. This group now feeds in to a RADNET committee The plan is to 1. recommend the use of "plastic mouse" in routine dosimetry 2. carry out a larger audit of PBT centres initially with non FLASH beams but then moving on to FLASH
Impact output being prepared on this collaboration
Start Year 2020
 
Description National audit using "plastic mouse" 
Organisation University of Leeds
Department Leeds School of Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution National audit of SARRP with "plastic mouse" using film and alanine pellets
Collaborator Contribution access to personnel and SARRP equipment to plan a static dose and arc dose to plastic mouse. The work also compared with cabinet irradiators in Manchester. This group now feeds in to a RADNET committee The plan is to 1. recommend the use of "plastic mouse" in routine dosimetry 2. carry out a larger audit of PBT centres initially with non FLASH beams but then moving on to FLASH
Impact output being prepared on this collaboration
Start Year 2020
 
Description Patient Reported Outcomes 
Organisation Leeds Teaching Hospitals NHS Trust
Country United Kingdom 
Sector Public 
PI Contribution Funding from Network which also links in to CRUK ART-NET grant to develop patient reported outcomes for proton therapy
Collaborator Contribution CRUK ART-NET funds post at University of Leeds
Impact Electronic patient reported outcomes for mobile phone or tablet. Able to be used for different types of radiotherapy for a range of patient ages.
Start Year 2017
 
Description Patient Reported Outcomes 
Organisation University of Leeds
Country United Kingdom 
Sector Academic/University 
PI Contribution Funding from Network which also links in to CRUK ART-NET grant to develop patient reported outcomes for proton therapy
Collaborator Contribution CRUK ART-NET funds post at University of Leeds
Impact Electronic patient reported outcomes for mobile phone or tablet. Able to be used for different types of radiotherapy for a range of patient ages.
Start Year 2017
 
Description PhD studentship 2 
Organisation Eindhoven University of Technology
Department Medical Physics
Country Netherlands 
Sector Academic/University 
PI Contribution brings together research at MGH, The Christie and University in modeling DNA damage and repair and incorporating it into a commercial software
Collaborator Contribution experience and expertise, software licenses and funding for 50% of PhD
Impact multidisciplinary incorporating Geant 4 DNA into TOPAS nBio. We are in the process of developing this in to treatment planning and have had preliminary discussions with Varian to obtain software license free of charge.
Start Year 2017
 
Description PhD studentship 2 
Organisation Massachusetts General Hospital
Country United States 
Sector Hospitals 
PI Contribution brings together research at MGH, The Christie and University in modeling DNA damage and repair and incorporating it into a commercial software
Collaborator Contribution experience and expertise, software licenses and funding for 50% of PhD
Impact multidisciplinary incorporating Geant 4 DNA into TOPAS nBio. We are in the process of developing this in to treatment planning and have had preliminary discussions with Varian to obtain software license free of charge.
Start Year 2017
 
Description PhD studentship 2 
Organisation University of Manchester
Department School of Physics and Astronomy Manchester
Country United Kingdom 
Sector Academic/University 
PI Contribution brings together research at MGH, The Christie and University in modeling DNA damage and repair and incorporating it into a commercial software
Collaborator Contribution experience and expertise, software licenses and funding for 50% of PhD
Impact multidisciplinary incorporating Geant 4 DNA into TOPAS nBio. We are in the process of developing this in to treatment planning and have had preliminary discussions with Varian to obtain software license free of charge.
Start Year 2017
 
Description Topas nBio 
Organisation University of Oxford
Country United Kingdom 
Sector Academic/University 
PI Contribution Open access Topas-nBio software includes our research in the radiobiological gold standard
Collaborator Contribution Working together on joint projects and sharing research to incorporate in to Topas n-Bio
Impact Joint publications Joint abstract submission PTCOG, AAPM, FRPT New software release in Topas n-Bio
Start Year 2020
 
Description Varian Framework agreement 
Organisation Varian Inc
Country United States 
Sector Private 
PI Contribution All IP through the Framework agreement belong to UoM / Christie but Varian have first refusal to exploit. Strong collaboration working on LET and RBE., FLASH RT
Collaborator Contribution Varian have provided access to latest versions of Eclipse software through T boxes (fair market value $75k). We can bid to Varian through Framework agreement for funding for projects. Amount shown is $1USD as actual amount is commercial in confidence.
Impact Publications Abstracts to international conferences Talks at Varian events https://www.varian.com/resources-support/blogs/clinical-oncology-news/industryacademic-partnership-yields-fruit-ultra-high?mkt_tok=NzYwLURaTy0xNTUAAAF_91-kFzOl1w84B0apMtXzvKu7hkm8hlShdATmyb5CxEAbXxpP-tODhdQBFJCIUOJjlEcMr2KiIyBxtUvfhhqVLZLQdSC9Rv-XXQFbD0DZaSk
Start Year 2019
 
Title EMBRACE wearables clinical trial 
Description wearables for real time monitoring of cancer patients. A new trial opens in Greater Manchester today which is to test cutting-edge wearable technologies involving patients who have received cancer treatment. The commercially-available health sensors and devices produce a digital fingerprint of vital signs that could allow doctors to assess the progress of their patients. Called, EMBRaCE, (Enhanced Monitoring for Better Recovery and Cancer Experience), the trial is a collaboration between Manchester University NHS Foundation Trust, The Christie NHS Foundation Trust and The University of Manchester. The trial opens initially for blood cancer, lung, and colorectal cancer patients and will run across Greater Manchester. The technologies under investigation include: a smart ring, worn on any finger made by the company Oura the Withings ScanWatch, a hybrid smartwatch the Isansys system, which is worn on the chest. The technologies can assess a range of vital signs, including electrocardiogram (ECG), heart rate, temperature, physical activity levels and sleep. 
Type Diagnostic Tool - Non-Imaging
Current Stage Of Development Early clinical assessment
Year Development Stage Completed 2022
Development Status Under active development/distribution
Clinical Trial? Yes
UKCRN/ISCTN Identifier N/A
Impact Real time monitoring of patients. Has the potential of producing digital fingerprints to allow personalisation of treatment Cancer places a huge burden on the lives of people everywhere. This study uses cutting-edge technology that can monitor people during their treatment, with devices that they can wear all the time. We hope that it will provide new insights into how people cope with cancer treatment and what we can do to improve their recovery." This trial will assess if the latest wearable technology has a role in cancer care. "It will help us to identify ways that clinical staff can individualise treatment before, during, and after therapy. "We will find out if 24/7 data from these wearable sensors can be used to support patient recovery and provide accurate measurement outside clinic. "It could even support the development of new cancer treatments by developing a digital platform for clinical trials in cancer involving wearable devices or fitness trackers." 
URL https://www.manchester.ac.uk/discover/news/trial-of-wearable-health-technology-for-cancer-patients-o...
 
Title PARABLE Clinical Trial 
Description randomised Proton therapy clinical trial for breast cancer patients 
Type Therapeutic Intervention - Radiotherapy
Current Stage Of Development Late clinical evaluation
Year Development Stage Completed 2022
Development Status Under active development/distribution
Clinical Trial? Yes
Impact Bioproton is being used for the biologically augmented treatment planning in this trial 
 
Title RCT TORPEDO 
Description TORPEO RCT has been developed and is funded by CRUK, it started recruiting patients in Feb 2020 then paused due to Covid-19 and resumed again in late 2020 
Type Therapeutic Intervention - Radiotherapy
Current Stage Of Development Refinement. Clinical
Year Development Stage Completed 2022
Development Status Under active development/distribution
Clinical Trial? Yes
Impact First UK RCT in PBT 
URL https://www.ncri.org.uk/ncri-blog/the-journey-of-torpedo-the-uks-first-proton-beam-therapy-clinical-...
 
Title Topas nBio 
Description Since the open-source beta-release of TOPAS-nBio in 2019, the framework offers to connect energy deposition within irradiated cells (physics) via molecular reactions (chemistry) to cell kill/repair (biology) at the level of sub-cellular targets such as DNA. To facilitate the setup of simulations we further developed a Graphical User (GUI) Interface. TOPAS-nBio is an extension to TOPAS and layered on top of the Geant4/Geant4-DNA MC toolkit. The new release was built for TOPAS release 3.6 (based on Geant4.10.6.p3) and will be compatible with all future releases of TOPAS. First release in 2019 but our models incorporated 2020 onwards 
Type Of Technology Software 
Year Produced 2021 
Open Source License? Yes  
Impact The new features of TOPAS-nBio v1.0, offers improved modeling from initial DNA damage to cell outcome, Gold standard for radiobiology research 
URL https://topas-nbio.readthedocs.io/en/latest/getting-started/Members.html
 
Description Article in the Guardian newspaper Dec 2021 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact How radiotherapy became a lifesaver, advances in radiotherapy
https://www.theguardian.com/cancer-revolutionaries/2021/dec/21/how-radiotherapy-became-a-lifesaver-from-x-rays-to-the-proton-beam
Year(s) Of Engagement Activity 2021
URL https://www.theguardian.com/cancer-revolutionaries/2021/dec/21/how-radiotherapy-became-a-lifesaver-f...
 
Description BBC interview of FLASH radiotherapy 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact media interview for BBC on Flash proton therapy as part of CRUK RADNET launch
https://www.bbc.co.uk/news/uk-england-manchester-50289393
Year(s) Of Engagement Activity 2019
URL https://www.manchesterbrc.nihr.ac.uk/news-and-events/manchester-scientists-lead-way-next-generation-...
 
Description Charity events for patient groups and carers 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Patients, carers and/or patient groups
Results and Impact Have participated in about 3 charity events per year for charitable donors patients and carers
Year(s) Of Engagement Activity 2017,2018
 
Description Cyclotron installation The Christie 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Installation of cyclotron in to Christie proton therapy centre
Year(s) Of Engagement Activity 2017
 
Description Film on proton therapy for GM cancer conference 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Film "what we have achieved in the last 12 months" which was shown during GM cancer conference. I also spoke at this conference
Year(s) Of Engagement Activity 2019
URL https://gmcancer.org.uk/greater-manchester-cancer-conference-2019/
 
Description Flash radiotherapy and Particle Therapy 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Development of a new international conference on FLASH in Dec 2021 with PCO Kenes and leading international reserchers. This conference was very successful and attracted over 730 people from 40 countries the 2nd in the series will be held in Barcelona Nov 30-Dec 2nd 2022.
the top 15 papers will be published in The Green Journal with further papers in Physica Medica where the abstracts will also be published
Year(s) Of Engagement Activity 2020,2021,2022
URL https://frpt-conference.org/
 
Description Launch 1 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact First of the Network launch events
Year(s) Of Engagement Activity 2016
URL http://protontherapynetwork.com/
 
Description On cancer UoM and The Christie 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact On Cancer is a new 44-page collection of research-led policy recommendations authored by academics from The University of Manchester, and The Christie which aim to highlight areas where research can inform policy changes and improve the lives of patients living with cancer. It is a collaboration between the Manchester Cancer Research Centre, the Cancer Beacon, and the Policy@Manchester team at The University of Manchester and involves the thoughts and research activities of four CRUK RadNet Manchester affiliated radiotherapy researchers.

Specific relevant examples included in On Cancer relate to work by Professor Karen Kirkby and Professor Ananya Choudhury (Advanced radiotherapies: what are the challenges and opportunities). Here, Ananya and Karen argue that researchers need to work with policymakers to produce a cost-benefit analysis of MR-Linac and Proton Beam Therapies and engage with leadership to determine opportunities for informed and enhance patient consent.
As the recommendations have only been recently published, direct influence on policy is still unknown. The authors involved are all committed to helping to promote the activities of the articles further, and we are continuing to work with Policy@Manchester a team dedicated to connecting policymakers and researchers to further expand on these recommendations.
Year(s) Of Engagement Activity 2022
 
Description One day workshop on FLASH radiotherapy: Transforming Radiotherapy in a FLASH 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact One day workshop organised with NCRI CTRad to inform UK researchers about Flash radiotherapy
Year(s) Of Engagement Activity 2020
URL https://www.eventbrite.co.uk/e/transforming-radiotherapy-in-a-flash-tickets-84136780375#
 
Description POST Note 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact POST note for members of the House of commons and Lords
Advances in Cancer Treatment
Year(s) Of Engagement Activity 2019
URL https://researchbriefings.parliament.uk/ResearchBriefing/Summary/POST-PN-0598
 
Description PTCOG 58 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Largest conference ever held on particle therapy attracted over 1355 people to a 5.5 day event in Manchester and contributed over 2.5M to the local economy
Year(s) Of Engagement Activity 2019
URL https://ptcog58.org/
 
Description Presentations at House of Commons 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Presentation to politicians at House of Commons by at least 1 PGR from the group
Year(s) Of Engagement Activity 2017,2018
 
Description School Visit (Oldham) 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Policymakers/politicians
Results and Impact Talk on Proton Therapy for national Science week
Year(s) Of Engagement Activity 2016
 
Description School visit (Withington) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact School visit to 6th form to talk about proton therapy
Year(s) Of Engagement Activity 2016
 
Description Spotlight event on proton therapy 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Talk on proton therapy and the building of the Manchester facility
Year(s) Of Engagement Activity 2016
 
Description Talks for GM Cancer 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact GM cancer conference talking about proton therapy
link to the new PRECISE YouTube channel:
https://www.youtube.com/channel/UCTAyoUeLIYQu5Gokqle4-Pg/featured

And to the video:
https://www.youtube.com/watch?v=j2QR4PQvaeI
Year(s) Of Engagement Activity 2021
URL https://www.youtube.com/watch?v=j2QR4PQvaeI
 
Description Webinar on UK Ion Therapy Research Facility 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact First of a meeting to engage the community in UK ITRF
Year(s) Of Engagement Activity 2022
 
Description You tube channel 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact You tube channel to promote research
Year(s) Of Engagement Activity 2021
URL https://www.youtube.com/channel/UCTAyoUeLIYQu5Gokqle4-Pg/featured
 
Description radiotherapy and me 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Patients, carers and/or patient groups
Results and Impact event to listen to patients experience of radiotherapy
Year(s) Of Engagement Activity 2019
URL https://publicprogrammes.co.uk/radiotherapy-and-me