Big data for small patients - Building "child-size" individual predictive models for life after childhood cancer
Lead Research Organisation:
University of Manchester
Department Name: School of Medical Sciences
Abstract
Many children with cancer have radiation treatment as part of their care. As for all cancer treatments, there is a risk of lasting side-effects such as learning problems and reduced growth. Research is needed to reduce such side-effects, which is particularly important for children because of their long life expectancy. Radiation treatment is planned to give maximal dose to the tumour and minimal doses to nearby healthy organs. However, even with the most advanced ways of giving radiation (e.g. using the new Proton Beam Therapy machine in Manchester) it will never be possible to avoid all healthy organs.
This fellowship will find which parts of healthy organs are particularly damaged by radiation ('the important regions'). This knowledge would be incredibly useful when planning radiation treatments, because it is often possible to spare the important regions of an organ close to the tumour but not the whole organ. Hence, finding these important regions would be a step toward allowing reduced side-effects in many children with cancer.
The cancer centre with the most and the best documented children's health data in the world is St Jude Children's Research Hospital in Memphis, Tennessee. Children treated with radiation at St Jude have a very detailed and complete follow-up, and their side effects are measured using the most up-to-date methods.
In this project, we will:
(1) Set up a joint data analysis structure to show that our new method can be used on St Jude's data; with this, we will discover, for example, regions of the brain where radiation causes the most learning problems.
(2) Measure the changes in organ size and shape between children of different ages and sizes. For this we will use images from St Jude patients as well as from 500 healthy children in the United States, aged from 6 months to 16 years that were scanned every 2 years (we have permission to use these data for research). This information will help us make our method even more precise and able to find smaller "important regions". We will also use those images to build models of growth of the organs of interest (e.g. language center, hormone glands) in children, which will be useful for researchers studying other childhood diseases.
(3) Develop new and better ways to measure side-effects, using all the follow-up information obtained about a child's health as they grow into adulthood. This will mean, for example, that we can use images showing the health of each child even though taken many years after treatment.
This will be the first project of this kind focused on understanding side effects in children with cancer. In the future, the results from this project will help doctors give 'smarter' radiation treatments, with fewer side-effects. The models of growing organs will also be useful for research in other childhood diseases.
This fellowship will find which parts of healthy organs are particularly damaged by radiation ('the important regions'). This knowledge would be incredibly useful when planning radiation treatments, because it is often possible to spare the important regions of an organ close to the tumour but not the whole organ. Hence, finding these important regions would be a step toward allowing reduced side-effects in many children with cancer.
The cancer centre with the most and the best documented children's health data in the world is St Jude Children's Research Hospital in Memphis, Tennessee. Children treated with radiation at St Jude have a very detailed and complete follow-up, and their side effects are measured using the most up-to-date methods.
In this project, we will:
(1) Set up a joint data analysis structure to show that our new method can be used on St Jude's data; with this, we will discover, for example, regions of the brain where radiation causes the most learning problems.
(2) Measure the changes in organ size and shape between children of different ages and sizes. For this we will use images from St Jude patients as well as from 500 healthy children in the United States, aged from 6 months to 16 years that were scanned every 2 years (we have permission to use these data for research). This information will help us make our method even more precise and able to find smaller "important regions". We will also use those images to build models of growth of the organs of interest (e.g. language center, hormone glands) in children, which will be useful for researchers studying other childhood diseases.
(3) Develop new and better ways to measure side-effects, using all the follow-up information obtained about a child's health as they grow into adulthood. This will mean, for example, that we can use images showing the health of each child even though taken many years after treatment.
This will be the first project of this kind focused on understanding side effects in children with cancer. In the future, the results from this project will help doctors give 'smarter' radiation treatments, with fewer side-effects. The models of growing organs will also be useful for research in other childhood diseases.
Planned Impact
Economic and social impact:
Every year in the UK, 1400 children under the age of 15 are diagnosed with cancer. Thanks to advances in treatment, 80% of them survive for at least 5 years. It is estimated that around 20,000 people in England and up to 500,000 European citizens alive today are survivors of childhood cancer, and these numbers will increase with time and advancing therapies. However, many survivors face serious and life-threatening long-term effects as a result of their treatment-related toxicities. It is estimated that most (80%) childhood cancer survivors have one or more chronic health conditions, and that many (~50%) will experience severe or life-threatening complications up to several decades after treatment. US research has demonstrated that, compared to the general population, adult survivors of childhood cancer are twice as likely to report being unable to work because of health issues.
The economic burden of the life-long side effects associated with having cancer and its necessary treatment is considerable. Moreover, at the societal level, it has been shown that the lifetime costs in terms of decreased productivity or lost productivity due to premature death are much higher than direct health costs. By furthering our understanding of which dose to healthy organs/substructures is responsible for long-term side effects, this proposal will contribute to optimising cancer treatment and reducing side-effects in children. This project will therefore translate into increased quality of life, and preserved productivity for children treated in the future and their families.
Clinical impact:
The outputs of this project will enable clinicians to generate "smarter" radiotherapy plans to make sure that radiation doses avoid the sensitive areas identified through this fellowship. Such plans will minimise the incidence of side effects in children with cancer without affecting tumour control. This means that children will have a much better life after cancer treatment. In cases where it is not possible to avoid giving dose to sensitive areas, the doctors will be better able to inform each patient about their chances of getting particular side effects. This will enable patients to make more informed treatment decisions, know what to expect following treatment, and allow directed tests and interventions during follow-up to reduce the impact of the side effects.
Every year in the UK, 1400 children under the age of 15 are diagnosed with cancer. Thanks to advances in treatment, 80% of them survive for at least 5 years. It is estimated that around 20,000 people in England and up to 500,000 European citizens alive today are survivors of childhood cancer, and these numbers will increase with time and advancing therapies. However, many survivors face serious and life-threatening long-term effects as a result of their treatment-related toxicities. It is estimated that most (80%) childhood cancer survivors have one or more chronic health conditions, and that many (~50%) will experience severe or life-threatening complications up to several decades after treatment. US research has demonstrated that, compared to the general population, adult survivors of childhood cancer are twice as likely to report being unable to work because of health issues.
The economic burden of the life-long side effects associated with having cancer and its necessary treatment is considerable. Moreover, at the societal level, it has been shown that the lifetime costs in terms of decreased productivity or lost productivity due to premature death are much higher than direct health costs. By furthering our understanding of which dose to healthy organs/substructures is responsible for long-term side effects, this proposal will contribute to optimising cancer treatment and reducing side-effects in children. This project will therefore translate into increased quality of life, and preserved productivity for children treated in the future and their families.
Clinical impact:
The outputs of this project will enable clinicians to generate "smarter" radiotherapy plans to make sure that radiation doses avoid the sensitive areas identified through this fellowship. Such plans will minimise the incidence of side effects in children with cancer without affecting tumour control. This means that children will have a much better life after cancer treatment. In cases where it is not possible to avoid giving dose to sensitive areas, the doctors will be better able to inform each patient about their chances of getting particular side effects. This will enable patients to make more informed treatment decisions, know what to expect following treatment, and allow directed tests and interventions during follow-up to reduce the impact of the side effects.
Organisations
- University of Manchester (Fellow, Lead Research Organisation)
- European Society for Radiotherapy and Oncology (ESTRO) (Collaboration)
- Princess Máxima Center (Collaboration)
- Paul Scherrer Institute (Collaboration)
- Toronto Princess Margaret Hospital (Collaboration)
- Bellvitge Biomedical Research Institute (Collaboration)
- Rigshospitalet (Collaboration)
- The University of Texas at San Antonio (Collaboration)
- National Cancer Research Institute (NCRI) (Collaboration)
- European Society of Paediatric Oncology (SIOPE) (Collaboration)
- Emory University (Collaboration)
- Trinity St James’s Cancer Institute (Collaboration)
- Gustave-Roussy Institute (Collaboration)
- London School of Hygiene and Tropical Medicine (LSHTM) (Collaboration)
- University Medical Center Utrecht (UMC) (Collaboration)
- St Jude Children's Hospital (Collaboration)
- Ghent University Hospital (Collaboration)
Publications
Taylor PA
(2023)
Prioritizing clinical trial quality assurance for photons and protons: A failure modes and effects analysis (FMEA) comparison.
in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Aznar MC
(2023)
ESTRO-ACROP guideline: Recommendations on implementation of breath-hold techniques in radiotherapy.
in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Hardcastle N
(2024)
Multi-centre evaluation of variation in cumulative dose assessment in reirradiation scenarios.
in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Vandemaele M
(2023)
A systematic literature review of definitions and classification systems for radiotherapy innovation: A first step towards building a value-based assessment tool for radiation oncology.
in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Davey A
(2023)
OC-0777 Automated analysis of internal facial asymmetry on MRI in children
in Radiotherapy and Oncology
Bryce-Atkinson A
(2023)
OC-0776 Are MRI scans needed for precise image-based data mining in paediatric brain tumour cohorts?
in Radiotherapy and Oncology
Wilson L
(2023)
SP-0366 Dealing with legacy treatment data
in Radiotherapy and Oncology
Oguejiofor K
(2023)
MO-0383 Risk factors associated with acute skin toxicities in patients treated with Proton Beam Therapy
in Radiotherapy and Oncology
Benitez-Aurioles J
(2023)
MO-0222 A neural network to create super-resolution MR from multiple 2D brain scans of paediatric patients
in Radiotherapy and Oncology
Taylor P
(2023)
OC-0419 Are we so different? An international risk comparison of photon vs. proton clinical trial QA
in Radiotherapy and Oncology
Zhang Y
(2023)
A survey of practice patterns for real-time intrafractional motion-management in particle therapy.
in Physics and imaging in radiation oncology
Trnkova P
(2023)
A survey of practice patterns for adaptive particle therapy for interfractional changes.
in Physics and imaging in radiation oncology
Wilson LJ
(2022)
Image-based data mining applies to data collected from children.
in Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB)
Gaito S
(2023)
Radiotherapy intensification for atypical and malignant meningiomas: A systematic review
in Neuro-Oncology Practice
Dronne C
(2023)
AUTOMATIC DETECTION OF FACIAL LOCATIONS TO MEASURE FACIAL ASYMMETRY AFTER PAEDIATRIC RADIOTHERAPY
in Neuro-Oncology
Geurts YM
(2023)
Association of Radiation and Procarbazine Dose With Risk of Colorectal Cancer Among Survivors of Hodgkin Lymphoma.
in JAMA oncology
Bates JE
(2023)
Cardiac Disease in Childhood Cancer Survivors Treated With Radiation Therapy: A PENTEC Comprehensive Review.
in International journal of radiation oncology, biology, physics
Olch AJ
(2023)
Physics Considerations for Evaluation of Dose for Dose-Response Models of Pediatric Late Effects From Radiation Therapy.
in International journal of radiation oncology, biology, physics
López-Fernández T
(2023)
European Society of Cardiology Core Curriculum for cardio-oncology.
in European journal of heart failure
Gaito S
(2023)
Assessing Equity of Access to Proton Beam Therapy: A Literature Review.
in Clinical oncology (Royal College of Radiologists (Great Britain))
Gaito S
(2023)
Proton Beam Therapy in the Reirradiation Setting of Brain and Base of Skull Tumour Recurrences.
in Clinical oncology (Royal College of Radiologists (Great Britain))
Gaito S
(2023)
Outcomes of Patients Treated in the UK Proton Overseas Programme: Central Nervous System Group
in Clinical Oncology
Davey A
(2023)
The need for consensus on delineation and dose constraints of dentofacial structures in paediatric radiotherapy: Outcomes of a SIOP Europe survey.
in Clinical and translational radiation oncology
Gaito S
(2023)
Proton Beam Therapy in the Oligometastatic/Oligorecurrent Setting: Is There a Role? A Literature Review
in Cancers
McDaid L
(2024)
Geometric distortion caused by metallic femoral head prosthesis in prostate cancer imaging on an MR Linac: in-vivo measurements of spatial deformation
in British Journal of Radiology
Jaikuna T
(2023)
Contouring variation affects estimates of normal tissue complication probability for breast fibrosis after radiotherapy.
in Breast (Edinburgh, Scotland)
Description | 2022 ESC guidelines on cardio-oncology |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Contribution to new or improved professional practice |
Impact | The guidelines recommend guidelines for how patients (including children) treated with radiation to the chest are followed up by their clinical care team. This will impact the lives of cancer survivors. |
Description | BRAINatomy2 award |
Amount | $4,999,914 (USD) |
Organisation | Stand up to Cancer |
Sector | Charity/Non Profit |
Country | United States |
Start | 01/2024 |
End | 12/2027 |
Description | BRAINatomy: a validated anatomical altas of childhood neuroradiation damage |
Amount | $1,000,000 (USD) |
Funding ID | SU2C#RT6186 |
Organisation | Stand up to Cancer |
Sector | Charity/Non Profit |
Country | United States |
Start | 03/2021 |
End | 03/2023 |
Description | HEE/NIHR Pre-Doctoral Bridging Programme Award |
Amount | £10,000 (GBP) |
Organisation | National Institute for Health Research |
Sector | Public |
Country | United Kingdom |
Start | 11/2022 |
End | 05/2023 |
Description | LINKER: LONGITUDINAL IMAGING LINKING OUTCOMES AND INTERVENTIONS |
Amount | £49,421 (GBP) |
Organisation | University of Manchester |
Sector | Academic/University |
Country | United Kingdom |
Start | 07/2023 |
End | 07/2024 |
Description | MMT Search Pump priming award for a training visit for a group of researchers from Radiotherapy Related Research to Princess Margaret Hospital in Toronto |
Amount | £7,500 (GBP) |
Organisation | University of Manchester |
Sector | Academic/University |
Country | United Kingdom |
Start | 01/2023 |
End | 07/2023 |
Description | NIHR Academy Awards Doctoral Fellowship for Emma Foster |
Amount | £272,238 (GBP) |
Organisation | National Institute for Health Research |
Sector | Public |
Country | United Kingdom |
Start | 08/2023 |
End | 08/2027 |
Description | NIHR Doctoral Fellowship |
Amount | £239,036 (GBP) |
Funding ID | NIHR302988 |
Organisation | National Institute for Health Research |
Sector | Public |
Country | United Kingdom |
Start | 08/2023 |
End | 08/2026 |
Description | PhD Scholarship for Love Goyal sponsored by the Christie Proton Therapy centre |
Amount | £180,123 (GBP) |
Organisation | The Christie NHS Foundation Trust |
Sector | Public |
Country | United Kingdom |
Start | 01/2024 |
End | 12/2027 |
Description | SMILE: MinimiSing long-terM Impact on dentition and faciaL asymmEtry in chIldhood cancer survivors |
Amount | £5,000 (GBP) |
Organisation | University of Manchester |
Sector | Academic/University |
Country | United Kingdom |
Start | 05/2022 |
End | 07/2023 |
Description | TIMELINESS: longiTudinal IMage processing for early dEtection of Late effects IN childhood cancEr Survivors. |
Amount | £21,233 (GBP) |
Organisation | University of Manchester |
Sector | Academic/University |
Country | United Kingdom |
Start | 07/2023 |
End | 07/2024 |
Description | The Christie Proton Beam Therapy Research Funding |
Amount | £2,432 (GBP) |
Organisation | The Christie NHS Foundation Trust |
Sector | Public |
Country | United Kingdom |
Start | 03/2024 |
End | 02/2025 |
Description | Artifical intelligence for treatment planning |
Organisation | Toronto Princess Margaret Hospital |
Country | Canada |
Sector | Hospitals |
PI Contribution | Funding for scientific visit to kick start collaboration Expertise in AI-based segmentation for thoracic treatments Validation of the PMH model on patient cohort from Manchester/ Christie |
Collaborator Contribution | Gave us access to the AI-based model developed for prostate treatment Provided expertise in how to implement AI-based treatment planning (training, safeguarding, etc...) |
Impact | No outcome yet. Several publications, and a change in clinical practice at the Christie NHS are expected. |
Start Year | 2023 |
Description | Collaboration with UMC Utrecht and the Princess Máxima Center |
Organisation | Princess Máxima Center |
Country | Netherlands |
Sector | Hospitals |
PI Contribution | Several discussions with Marinka on late side effects and possible link to treatment toxicities. Marinka was invites to Manchester to attend the SMILE workshop in March 2023 where discussions continued. |
Collaborator Contribution | New collaboration with these organisations principally through Dr Marinka Hol to explore late side effects in paediatric patients following radiotherapy. Focus on dento-facial effects. Marinka has significant expertise in treating patients with Rhabdomyosarcoma and their side effects. |
Impact | Still underway |
Start Year | 2022 |
Description | Collaboration with UMC Utrecht and the Princess Máxima Center |
Organisation | University Medical Center Utrecht (UMC) |
Country | Netherlands |
Sector | Academic/University |
PI Contribution | Several discussions with Marinka on late side effects and possible link to treatment toxicities. Marinka was invites to Manchester to attend the SMILE workshop in March 2023 where discussions continued. |
Collaborator Contribution | New collaboration with these organisations principally through Dr Marinka Hol to explore late side effects in paediatric patients following radiotherapy. Focus on dento-facial effects. Marinka has significant expertise in treating patients with Rhabdomyosarcoma and their side effects. |
Impact | Still underway |
Start Year | 2022 |
Description | ESTRO HERO (Health Economics in Radiation Oncology) |
Organisation | Bellvitge Biomedical Research Institute |
Country | Spain |
Sector | Academic/University |
PI Contribution | The HERO project (Health Economics in Radiation Oncology) is developing a knowledge base and a cost accounting model estimating the national cost of radiotherapy (RT). The overall aim is to provide solid data to the RT community to engage with governments, funders and decision makers, and advocate for better funding for RT, better resource planning and ultimately better care for cancer patients. The project is carried out in close collaboration with the European national societies of radiation oncology. A task force has been formed, consisting of international specialists in the field, including myself since 2021. I provide medical physics expertise, especially around technical innovations in advanced practice of radiation oncology. |
Collaborator Contribution | Prof Lievens (Gent) leads this group of international expert. The group is developing a frameword which will enable the definition and classification of innovations in radiation oncology. |
Impact | please note that as of March 14th 2023, the webpage above was not updated (hence doesn't include the most recent members of the group,including myself). First output (in press in Radiotherapy and Oncology) Title A systematic literature review of definitions and classification systems for radiotherapy innovation: a first step towards building a value-based assessment tool for radiation oncology. Author names and affiliations Miet Vandemaelea, Marianne Aznarb, 1, Pierre Blanchardc, Josep M Borrasd, Michelle Leeche, Ajay Aggarwalf, 1, Yolande Lievensa, 1 |
Start Year | 2021 |
Description | ESTRO HERO (Health Economics in Radiation Oncology) |
Organisation | European Society for Radiotherapy and Oncology (ESTRO) |
Country | Belgium |
Sector | Charity/Non Profit |
PI Contribution | The HERO project (Health Economics in Radiation Oncology) is developing a knowledge base and a cost accounting model estimating the national cost of radiotherapy (RT). The overall aim is to provide solid data to the RT community to engage with governments, funders and decision makers, and advocate for better funding for RT, better resource planning and ultimately better care for cancer patients. The project is carried out in close collaboration with the European national societies of radiation oncology. A task force has been formed, consisting of international specialists in the field, including myself since 2021. I provide medical physics expertise, especially around technical innovations in advanced practice of radiation oncology. |
Collaborator Contribution | Prof Lievens (Gent) leads this group of international expert. The group is developing a frameword which will enable the definition and classification of innovations in radiation oncology. |
Impact | please note that as of March 14th 2023, the webpage above was not updated (hence doesn't include the most recent members of the group,including myself). First output (in press in Radiotherapy and Oncology) Title A systematic literature review of definitions and classification systems for radiotherapy innovation: a first step towards building a value-based assessment tool for radiation oncology. Author names and affiliations Miet Vandemaelea, Marianne Aznarb, 1, Pierre Blanchardc, Josep M Borrasd, Michelle Leeche, Ajay Aggarwalf, 1, Yolande Lievensa, 1 |
Start Year | 2021 |
Description | ESTRO HERO (Health Economics in Radiation Oncology) |
Organisation | Ghent University Hospital |
Country | Belgium |
Sector | Hospitals |
PI Contribution | The HERO project (Health Economics in Radiation Oncology) is developing a knowledge base and a cost accounting model estimating the national cost of radiotherapy (RT). The overall aim is to provide solid data to the RT community to engage with governments, funders and decision makers, and advocate for better funding for RT, better resource planning and ultimately better care for cancer patients. The project is carried out in close collaboration with the European national societies of radiation oncology. A task force has been formed, consisting of international specialists in the field, including myself since 2021. I provide medical physics expertise, especially around technical innovations in advanced practice of radiation oncology. |
Collaborator Contribution | Prof Lievens (Gent) leads this group of international expert. The group is developing a frameword which will enable the definition and classification of innovations in radiation oncology. |
Impact | please note that as of March 14th 2023, the webpage above was not updated (hence doesn't include the most recent members of the group,including myself). First output (in press in Radiotherapy and Oncology) Title A systematic literature review of definitions and classification systems for radiotherapy innovation: a first step towards building a value-based assessment tool for radiation oncology. Author names and affiliations Miet Vandemaelea, Marianne Aznarb, 1, Pierre Blanchardc, Josep M Borrasd, Michelle Leeche, Ajay Aggarwalf, 1, Yolande Lievensa, 1 |
Start Year | 2021 |
Description | ESTRO HERO (Health Economics in Radiation Oncology) |
Organisation | Gustave-Roussy Institute |
Department | Gustave-Roussy Institute of Oncology |
Country | France |
Sector | Academic/University |
PI Contribution | The HERO project (Health Economics in Radiation Oncology) is developing a knowledge base and a cost accounting model estimating the national cost of radiotherapy (RT). The overall aim is to provide solid data to the RT community to engage with governments, funders and decision makers, and advocate for better funding for RT, better resource planning and ultimately better care for cancer patients. The project is carried out in close collaboration with the European national societies of radiation oncology. A task force has been formed, consisting of international specialists in the field, including myself since 2021. I provide medical physics expertise, especially around technical innovations in advanced practice of radiation oncology. |
Collaborator Contribution | Prof Lievens (Gent) leads this group of international expert. The group is developing a frameword which will enable the definition and classification of innovations in radiation oncology. |
Impact | please note that as of March 14th 2023, the webpage above was not updated (hence doesn't include the most recent members of the group,including myself). First output (in press in Radiotherapy and Oncology) Title A systematic literature review of definitions and classification systems for radiotherapy innovation: a first step towards building a value-based assessment tool for radiation oncology. Author names and affiliations Miet Vandemaelea, Marianne Aznarb, 1, Pierre Blanchardc, Josep M Borrasd, Michelle Leeche, Ajay Aggarwalf, 1, Yolande Lievensa, 1 |
Start Year | 2021 |
Description | ESTRO HERO (Health Economics in Radiation Oncology) |
Organisation | London School of Hygiene and Tropical Medicine (LSHTM) |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | The HERO project (Health Economics in Radiation Oncology) is developing a knowledge base and a cost accounting model estimating the national cost of radiotherapy (RT). The overall aim is to provide solid data to the RT community to engage with governments, funders and decision makers, and advocate for better funding for RT, better resource planning and ultimately better care for cancer patients. The project is carried out in close collaboration with the European national societies of radiation oncology. A task force has been formed, consisting of international specialists in the field, including myself since 2021. I provide medical physics expertise, especially around technical innovations in advanced practice of radiation oncology. |
Collaborator Contribution | Prof Lievens (Gent) leads this group of international expert. The group is developing a frameword which will enable the definition and classification of innovations in radiation oncology. |
Impact | please note that as of March 14th 2023, the webpage above was not updated (hence doesn't include the most recent members of the group,including myself). First output (in press in Radiotherapy and Oncology) Title A systematic literature review of definitions and classification systems for radiotherapy innovation: a first step towards building a value-based assessment tool for radiation oncology. Author names and affiliations Miet Vandemaelea, Marianne Aznarb, 1, Pierre Blanchardc, Josep M Borrasd, Michelle Leeche, Ajay Aggarwalf, 1, Yolande Lievensa, 1 |
Start Year | 2021 |
Description | ESTRO HERO (Health Economics in Radiation Oncology) |
Organisation | Trinity St James’s Cancer Institute |
Country | Ireland |
Sector | Hospitals |
PI Contribution | The HERO project (Health Economics in Radiation Oncology) is developing a knowledge base and a cost accounting model estimating the national cost of radiotherapy (RT). The overall aim is to provide solid data to the RT community to engage with governments, funders and decision makers, and advocate for better funding for RT, better resource planning and ultimately better care for cancer patients. The project is carried out in close collaboration with the European national societies of radiation oncology. A task force has been formed, consisting of international specialists in the field, including myself since 2021. I provide medical physics expertise, especially around technical innovations in advanced practice of radiation oncology. |
Collaborator Contribution | Prof Lievens (Gent) leads this group of international expert. The group is developing a frameword which will enable the definition and classification of innovations in radiation oncology. |
Impact | please note that as of March 14th 2023, the webpage above was not updated (hence doesn't include the most recent members of the group,including myself). First output (in press in Radiotherapy and Oncology) Title A systematic literature review of definitions and classification systems for radiotherapy innovation: a first step towards building a value-based assessment tool for radiation oncology. Author names and affiliations Miet Vandemaelea, Marianne Aznarb, 1, Pierre Blanchardc, Josep M Borrasd, Michelle Leeche, Ajay Aggarwalf, 1, Yolande Lievensa, 1 |
Start Year | 2021 |
Description | European working group on dentofacial effects after radiotherapy for childhood cancer |
Organisation | European Society of Paediatric Oncology (SIOPE) |
Country | Belgium |
Sector | Charity/Non Profit |
PI Contribution | With Dr Shermaine Pan, clinical oncologist at the Christie NHS, I have co-funded a working group on dento-facial effects under the umbrella of SIOpe, the European Society of Paediatric Oncology. We distributed a survey to collect information on clinical practice and dose to dento-facial structures, receiving 60 responses from leading paeidiatric oncology centres in Europe, Australia and New Zealand. based on these replies, selected members will be invited to form the working group at the Pediatric Radiation ocnology Society meeting in Essen in June 2022. |
Collaborator Contribution | Access to the network of experts of SIOpe contribution to the design of the survey will co-author publication on survey outputs. |
Impact | Survey completed. Invited presentation at SIOP Europe Annual meeting (march 23 2022). SMILE international workshop (March 2023) |
Start Year | 2022 |
Description | European working group on dentofacial effects after radiotherapy for childhood cancer |
Organisation | Princess Máxima Center |
Country | Netherlands |
Sector | Hospitals |
PI Contribution | With Dr Shermaine Pan, clinical oncologist at the Christie NHS, I have co-funded a working group on dento-facial effects under the umbrella of SIOpe, the European Society of Paediatric Oncology. We distributed a survey to collect information on clinical practice and dose to dento-facial structures, receiving 60 responses from leading paeidiatric oncology centres in Europe, Australia and New Zealand. based on these replies, selected members will be invited to form the working group at the Pediatric Radiation ocnology Society meeting in Essen in June 2022. |
Collaborator Contribution | Access to the network of experts of SIOpe contribution to the design of the survey will co-author publication on survey outputs. |
Impact | Survey completed. Invited presentation at SIOP Europe Annual meeting (march 23 2022). SMILE international workshop (March 2023) |
Start Year | 2022 |
Description | Global Harmonisation Group on clinical trial QA |
Organisation | National Cancer Research Institute (NCRI) |
Department | NCRI Radiotherapy Trials Quality Assurance Team (RTTQA) |
Country | United Kingdom |
Sector | Charity/Non Profit |
PI Contribution | I provided expertise rearding the use of image guidance in clinical trials, especially for children. |
Collaborator Contribution | This work was led by MD Anderson, and identified some gaps in photon vs proton clinical trial QA. |
Impact | Paper published in Radiotherapy & Oncology doi: 10.1016/j.radonc.2023.109494. |
Start Year | 2022 |
Description | Global Harmonisation Group on clinical trial QA |
Organisation | University of Texas |
Department | M. D. Anderson Cancer Center |
Country | United States |
Sector | Academic/University |
PI Contribution | I provided expertise rearding the use of image guidance in clinical trials, especially for children. |
Collaborator Contribution | This work was led by MD Anderson, and identified some gaps in photon vs proton clinical trial QA. |
Impact | Paper published in Radiotherapy & Oncology doi: 10.1016/j.radonc.2023.109494. |
Start Year | 2022 |
Description | Joint grant application to Informatics Technology for Cancer Research with St Jude |
Organisation | St Jude Children's Hospital |
Country | United States |
Sector | Hospitals |
PI Contribution | Installation of the Image based data mining platform at St Jude. Leadership of the grant application. Co-investigator |
Collaborator Contribution | Lead investigators. |
Impact | Following the clinical collaboration of this award , I have developped a collaboration with teh technical radiotherapy leads at St Jude. This ITCR grant application will further develop the aims of this awards, but adds a platform for direct comparison with traditional dose-relationship methodologies. |
Start Year | 2022 |
Description | Leadership for women in medical physics |
Organisation | European Society for Radiotherapy and Oncology (ESTRO) |
Country | Belgium |
Sector | Charity/Non Profit |
PI Contribution | Dr Marianne Aznar obtained industry funding and directed 4 webinars on leadership for omen in medical physics (with ESTRO) |
Collaborator Contribution | NA |
Impact | 4 webinars directed on leadership for women in medical physics |
Start Year | 2023 |
Description | PTCOG base of skull sub-committee |
Organisation | Emory University |
Country | United States |
Sector | Academic/University |
PI Contribution | PSI, Emory and the Christie NHS are jointly leading an inter-observer study to quantify, and alter minimise (through guidelines) variations in the definition of base of skull tumours. They are providing their own clinical expertise, as well as access to an international network of experts who will participate in the study. |
Collaborator Contribution | I am providing technical expertise to enable the study, i.e. distributions of images, collection and analysis of data. |
Impact | Paper with recommendations for clinical practice. Less variations on tumour definition is expected to have direct impact on patient outcomes worldwide. |
Start Year | 2022 |
Description | PTCOG base of skull sub-committee |
Organisation | Paul Scherrer Institute |
Country | Switzerland |
Sector | Academic/University |
PI Contribution | PSI, Emory and the Christie NHS are jointly leading an inter-observer study to quantify, and alter minimise (through guidelines) variations in the definition of base of skull tumours. They are providing their own clinical expertise, as well as access to an international network of experts who will participate in the study. |
Collaborator Contribution | I am providing technical expertise to enable the study, i.e. distributions of images, collection and analysis of data. |
Impact | Paper with recommendations for clinical practice. Less variations on tumour definition is expected to have direct impact on patient outcomes worldwide. |
Start Year | 2022 |
Description | Patterns of pratice in image guidance for paediatric radiotherapy |
Organisation | Rigshospitalet |
Department | Department of Oncology |
Country | Denmark |
Sector | Hospitals |
PI Contribution | Dr Maja Maraldo from Copenhagen and myself are jointly leading this initiative to collect exact information on image guidance practice in children, define recommendations and encourage the proper use of images in children to maximise treatment accuracy with the lowest imaging burden. |
Collaborator Contribution | Dr Maja Maraldo from Copenhagen and myself are jointly leading this initiative to collect exact information on image guidance practice in children, define recommendations and encourage the proper use of images in children to maximise treatment accuracy with the lowest imaging burden. |
Impact | Outcomes will include: a paper outlining the results of a European survey; recommendations and guidelines. |
Start Year | 2021 |
Description | A talk at the "Womxn in Physics" conference, Kings College London 2022 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Talk at the "Womxn in Physics" conference held at Kings College London on the 17th February 2022. Talk titled Medical Physics in Cancer Research. The conferences aim is: To address issues surrounding the underrepresentation of womxn in Physics through a series of educational and social events. By providing a safe space for self-identifying womxn and non-binary individuals, we aim to promote gender equality and diversity by bringing womxn together to discuss their experience as a minority group and to combat isolation. Womxn are an underrepresented group in Physics particularly in academia therefore we aim to make everyone aware of gender biases in order to tackle gender stereotypes. Marianne discussed her role within the medical physics community. |
Year(s) Of Engagement Activity | 2022 |
URL | https://www.kclwomxninphysics.com/event-details/conference-2022 |
Description | AAPM GRSIC Webinar Series on Global Research Excellence and Rising Stars (2023) |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Participant in a webinar broadcast on February 23 2023 titled "Maximizing your Research Impact by Understanding the Scientific Publication Process". I was a member of a panel presenting including additional speakers John Boone and Qihui Lyu. The webinar is available online through the AAPM website. |
Year(s) Of Engagement Activity | 2023 |
URL | https://www.aapm.org/meetings/webinars/GRSICGRERSWebinarSeriesNo1.asp |
Description | CRUK Data Driven Conference poster |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Poster presentation at the CRUK Data Driven conference - "Towards automatic segmentation of dento-facial structures for paediatric head and neck cancers" |
Year(s) Of Engagement Activity | 2024 |
Description | ESTRO 2023 Conference Talk |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Estro 2023 oral presentation entitled: Automated analysis of internal facial asymmetry in children |
Year(s) Of Engagement Activity | 2023 |
Description | ESTRO Newsletter article |
Form Of Engagement Activity | A magazine, newsletter or online publication |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | ESTRO 2023 Physics Track Report - 'Big data, big headache' joint ESTRO-American Association of Physicists in Medicine session written by Angela Davey |
Year(s) Of Engagement Activity | 2023 |
URL | https://www.estro.org/About/Newsroom/Newsletter/Physics/ESTRO-2023-Physics-Track-Report-%E2%80%98Big... |
Description | ESTRO Physics workshop 2022 |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | ESTRO physics workshop on optimising image-guidance in Lisbon (Portugal) on October 7-8th 2022. I was part of the formal working group. |
Year(s) Of Engagement Activity | 2022 |
Description | Internal Christie Seminar on "current research in paediatric RT" |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Professional Practitioners |
Results and Impact | Dissemination of the aims of my EPSRC fellowship and description of the current paediatric radiotherapy landscape. |
Year(s) Of Engagement Activity | 2021 |
Description | Invited presentation at a joint workshop with St Jude's Children Research Hospital |
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 | Invited presentations at a joint St Jude's Research Hospital - University of Manchester workshop. Two members of the research team presented work entitled: Angela Davey - Temporal processes in paediatric outcomes research Edward Henderson - Deep learning for image segmentation and registration in radiotherapy - paediatric specific challenges and opportunities |
Year(s) Of Engagement Activity | 2023 |
Description | Invited talk at a UCL-UoM workshop |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Three members of the research group were invited to present at this cross-institutional brainstorming workshop. The presentations were entitled: Marianne Aznar - BRAINatomy: part 1 and part 2 Angela Davey - Temporal modelling of late effects post-radiotherapy in childhood cancer survivors Edward Henderson - Developing registration tools for image-based data mining in paediatric patients |
Year(s) Of Engagement Activity | 2024 |
Description | McMedHacks Webinar : "Data Mining in Radiotherapy: understanding the link between dose and late effects" |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Marianne gave a talk titled "Data mining in radiotherapy: understanding the link between dose and long-term side effects" as part of the McMedHacks - medical image analysis and deep learning in Python session in on July 24th 2021. The talk abstract is: As survival rates for cancer patients improve, late effects, such as second cancers or heart disease, are an increasing area of concern. In order to continuously improve radiation oncology treatments, it is crucial to understand the drivers of late toxicity, and the interaction between radiotherapy, other cancer treatments and co-morbidities. In this talk, we will review the limitations of current late effect research and explore the role of advanced methods such as data mining. We will also discuss uncertainties in outcome evaluation, and how machine learning approaches can help us evaluate, analyse and predict treatment-related toxicity. |
Year(s) Of Engagement Activity | 2021 |
URL | https://mcmedhacks.com/team/marianne-aznar/ |
Description | Mini-oral presentation at ISORED 2023 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Mini-oral presentation on: A descriptive analysis to aid discovery of relationships between radiotherapy for childhood cancer and neurocognitive outcomes. |
Year(s) Of Engagement Activity | 2023 |
Description | NIHR BRC Imaging Group meeting poster presentation |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | NIHR BRC Imaging Group Meeting poster presentation entitled, "Auto-contouring for children and young people requires suitable training data" |
Year(s) Of Engagement Activity | 2024 |
Description | Oral mini talk at ESTRO 2022 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Mini oral awarded based on submitted abstract at ESTRO 2022 from 6-10th May 2022. |
Year(s) Of Engagement Activity | 2022 |
Description | PPIE panel - Topic "Helping your friends better understand radiotherapy" |
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 | 6 teenagers/young adults who had previously received radiotherapy at the Christie Hospital were included in a patient panel to explore the topic: Helping your friends better understand radiotherapy through social media. The goal of the discussion was to help generate ideas for social media content (TikTok, Instagram) that young people undergoing radiotherapy can share with their friends, teachers, and wider support network. We used the session to begin these discussion and make a first capture of the information these teenages/young adults wished their friends knew during their treatment, in order to allow them to understand the journey they were going through and ensure these young people were able to access the support they needed. The group shared their experiences of radiotherapy and their views on using social media in this way. It was identified that the group would like their support network to better understand the differences between types of radiotherapy treatment (i.e. whole body irradiation vs breast), and help debunk some of the myths about radiotherapy. The group also wanted an easier way to access information about long and short-term side effects of radiotherapy that they were not informed about prior to treatment. We are planning a follow-up session for these participants to record their own messages for social media, and aim to connect with Teenager Cancer Trust who have a large social media presence (+40k followers on Instagram) to help promote this material. |
Year(s) Of Engagement Activity | 2022 |
Description | Presentation at ESTRO 2021 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Marianne Aznar spoke at ESTRO 2021 on August 30th on a talk entitled "Starting a networking group in a virtual environment". This was an invited presentation with the aim of mentoring fellow scientists. |
Year(s) Of Engagement Activity | 2021 |
URL | https://www.estro.org/Congresses/ESTRO-2021/576/makethebestuseofonlineresourcesandmeetingsforremot/2... |
Description | Presentation at the Christie Summer School 2021 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Presentation at the The 5th Christie Advanced Radiotherapy Summer School on 16th June 2021 entitled: "Big Data and late outcome analysis: late effects of cancer treatment". The event is attended by a radiographers, medical physicists, clinicians and academics and is a great way of networking with colleagues within the radiotherapy community. |
Year(s) Of Engagement Activity | 2021 |
URL | https://www.christie.nhs.uk/media/9693/adv-rt-summer-school-2021-agenda.pdf |
Description | Public engagement event at the University of Manchester community festival |
Form Of Engagement Activity | Participation in an open day or visit at my research institution |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Public/other audiences |
Results and Impact | We hosted a stall called "Treating cancer with radiation" at the 2023 UoM community festival, where a wide age-range of children were guided through several hands-on activities to gently introduce them and take them through the radiotherapy treatment process. |
Year(s) Of Engagement Activity | 2023 |
URL | https://www.socialresponsibility.manchester.ac.uk/public-engagement/spotlight-events/community-festi... |
Description | SIOP Conference Poster 2023 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Policymakers/politicians |
Results and Impact | SIOP Conference Poster entitled: EFFICIENT EVALUATION OF DOSE TO BRAIN STRUCTURES IN CHILDREN TREATED WITH RADIOTHERAPY FOR BRAIN TUMOURS |
Year(s) Of Engagement Activity | 2023 |
Description | SMILE workshop |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | A workshop was formed with a large multidisciplinary team, including oncologists who treat patients, radiologists experienced in follow-up imaging, surgeons who perform reconstructive surgery, dentists who routinely encounter dentofacial toxicities and physicists with technical expertise to perform dose-response investigation. The workshop examined the causes and treatment of facial asymmetry following radiotherapy in children. A parent also attended who described her daughters and families experience of dealing with long term side effects following radiotherapy for rhabdomyosarcoma in her cheek. The working group determined key actions for follow up to reduce future long term side-effects in childhood cancer survivors. |
Year(s) Of Engagement Activity | 2023,2024 |
Description | Speaker on the ESTRO debate "This house believes that in 10 years particle therapy will be in a better place than now" |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Speaker for a debate titled "This house believes that in 10 years particle therapy will be in a better place than now" as part of ESTRO 2022 conference held on 6-10th May 2022 |
Year(s) Of Engagement Activity | 2022 |
Description | The link between cognitive decline and radiation dose in children treated with brain tumours |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Talk delivered at CERRO (clinical and experimental research in radiation oncology) a conference strictly by invitation only. The meeting has been designed to provide an opportunity for oncologists, physicists, biologists, and radiation technologists to present work in progress in a format in which stimulates discussion and collaboration. |
Year(s) Of Engagement Activity | 2023 |