Assessment of the benefits and risks of cancer treatments
Lead Research Organisation:
Medical Research Council
Abstract
Most people who get cancer now survive and this is in large part due to the effectiveness of treatments, such as chemotherapy and radiotherapy, and in the UK alone there are estimated to be over 2 million people who are cancer survivors. While the short term side effects of such treatments are well known, the long term health effects of these treatments were largely unknown. Our programme of research has previously demonstrated that radiotherapy treatment increases the long-term risk of heart disease in cancer patients and this has resulted in changes in clinical practice, such as taking measures to minimise the exposure of the heart to radiotherapy during treatment and also treating with lower doses of radiotherapy. This research allows clinicians to individualise the dose of radiotherapy given to each patient to maximise the benefit and minimise the long-term risk of heart disease. Our current research is looking in more detail at these risks from radiotherapy as well as collaborating with many other scientists worldwide to better understand the risks of various other treatments, such as anthracyclines. We are also carrying out research to better understand the long-term risks, particularly from heart disease, of cancer treatments in children, teenagers and young adults.
Technical Summary
The programme will continue a long-running area of research to produce uniquely reliable answer to important clinical questions concerned with the benefits and the main risks of treatments for various cancers, which includes breast cancer, lymphomas and all cancers diagnosed in children, teenagers and young adults. All currently available treatments have both short term side-effects, which are generally well documented, as well as less well studied long-term hazards. For example, our previous research has developed a dose-response relationship for use by clinicians to predict the radiation-related ischaemic heart disease risk for individual women irradiated for breast cancer, based on their cardiac radiation dose and their pre-existing risk factors. Our future work will further develop these risk/benefit prediction models to include valvular heart disease and pericarditis in breast cancer radiotherapy and for ischaemic heart disease, valvular heart disease, and heart failure in Hodgkin lymphoma radiotherapy. In addition, we will bring together the results from a number of treatment trials of anthracyclines for various cancers to reliably determine the risks of cardiovascular disease from these therapies. We will also analyse several large cohorts to more precisely determine the risk of cardiovascular disease from various cancer treatments using data from cancer registries that include around 2 million women with breast cancer and also determine these risks in children, teenagers and young adults using UK data on around 250,000 cancer survivors.
Organisations
- Medical Research Council (Lead Research Organisation)
- Leeds Teaching Hospitals NHS Trust, Leeds (Collaboration)
- Public Health England, Salisbury (Collaboration)
- Proton Therapy Center Czech Ltd (Collaboration)
- University of Florida, United States (Collaboration)
- German Medical Group (Collaboration)
- Derby Teaching Hospitals NHS Foundation Trust (Collaboration)
- European Society of Therapeutic and Radiation Oncology (Collaboration)
- Hospital Saint-Louis (Collaboration)
- Independent Cancer Patients' Voice (Collaboration)
- University of Toronto (Collaboration)
- University of Cambridge (Collaboration)
- University of Southern Denmark, Denmark (Collaboration)
- St Jude Children's Hospital (Collaboration)
- Netherlands Cancer Institute (Collaboration)
- Korean Radiation Oncology Group (Collaboration)
- San Raffaele Hospital (Collaboration)
- University of Oxford, United Kingdom (Collaboration)
- Coventry University, United Kingdom (Collaboration)
- McMaster University, Canada (Collaboration)
- Curie Institute Paris (Institut Curie) (Collaboration)
- Karolinska Institute, Sweden (Collaboration)
- University of Texas at San Antonio, United States (Collaboration)
- Center Hospital Lyon Sud (Collaboration)
- University of Birmingham, United Kingdom (Collaboration)
- Guy's and St Thomas' NHS Foundation Trust, London (Collaboration)
- Danish Breast Cancer Cooperative Group (DBCG) (Collaboration)
- Oxford University Hospitals NHS Foundation Trust (Collaboration)
Publications

Aleman BM
(2014)
Cardiovascular disease after cancer therapy.
in EJC supplements : EJC : official journal of EORTC, European Organization for Research and Treatment of Cancer ... [et al.]

Amoroso V
(2015)
International Expert Consensus on Primary Systemic Therapy in the Management of Early Breast Cancer: Highlights of the Fifth Symposium on Primary Systemic Therapy in the Management of Operable Breast Cancer, Cremona, Italy (2013).
in Journal of the National Cancer Institute. Monographs

Anastasi G
(2020)
Patterns of practice for adaptive and real-time radiation therapy (POP-ART RT) part I: Intra-fraction breathing motion management.
in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

Arriagada R
(2009)
OECI Workshop on late side-effects of cancer treatments.
in European journal of cancer (Oxford, England : 1990)

Asselain B
(2018)
Long-term outcomes for neoadjuvant versus adjuvant chemotherapy in early breast cancer: meta-analysis of individual patient data from ten randomised trials
in The Lancet Oncology

Aznar M
(2016)
Cumulative burden of disease: a relevant measure of the late side-effects of cancer treatment
in The Lancet Oncology

Aznar M
(2017)
The role of technology in clinical trials using stereotactic body radiotherapy.
in The British journal of radiology

Aznar M
(2021)
Radiation oncology in the new virtual and digital era
in Radiotherapy and Oncology

Aznar M. C.
(2016)
Exposure of the Lungs in Breast Cancer Radiation Therapy: A Systematic Review of Lung Doses Published Between 2010 and 2015
in INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS

Aznar MC
(2017)
"To clip or not to clip. That is no question!"
in European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
Description | 'Mind the gap' between the development of therapeutic innovations and the clinical practice in oncology: A proposal of the European Organisation for Research and Treatment of Cancer (EORTC) to optimise cancer clinical research |
Geographic Reach | Europe |
Policy Influence Type | Citation in other policy documents |
URL | https://www.sciencedirect.com/science/article/pii/S0959804917312534 |
Guideline Title | Cardoso F, Kyriakides S, Ohno S, et al. Early breast cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Annal Oncol 2019; 30: 1194-220. |
Description | 20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years |
Geographic Reach | Europe |
Policy Influence Type | Citation in clinical guidelines |
Guideline Title | Cardoso F, Kyriakides S, Ohno S, et al. Early breast cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Annal Oncol 2019; 30: 1194-220. |
Description | 20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years. NEJM 2017; 377: 1836-46 |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in clinical guidelines |
Impact | The absolute risks of breast cancer recurrence in this study are being used to inform clinical guidelines. See, for example: Cardoso F, Kyriakides S, Ohno S, et al. Early breast cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Annal Oncol 2019; 30: 1194-220. |
Guideline Title | 30-day mortality following chemotherapy |
Description | 30-day mortality following chemotherapy |
Geographic Reach | National |
Policy Influence Type | Citation in clinical guidelines |
Guideline Title | 30-day mortality following chemotherapy |
Description | 30-day mortality following chemotherapy |
Geographic Reach | National |
Policy Influence Type | Citation in clinical guidelines |
Description | ?????????? ???????????? ??????????? ???????????: ????????? ?????? ????????? (Management of toxicity of inhibitors of angiogenesis. Resolution of the board of Experts) |
Geographic Reach | Europe |
Policy Influence Type | Citation in other policy documents |
URL | https://cyberleninka.ru/article/n/upravlenie-toksichnostyu-ingibitorov-angiogeneza-rezolyutsiya-sove... |
Description | Association of sleep duration and quality with blood lipids: a systematic review and meta-analysis of prospective studies |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in systematic reviews |
URL | http://bmjopen.bmj.com/content/7/12/e018585 |
Guideline Title | Recommendations for the follow-up care of female breast cancer survivors |
Description | Breast cancer follow up guidelines in Spain |
Geographic Reach | National |
Policy Influence Type | Citation in clinical guidelines |
Impact | These results were used to inform breast cancer follow-up guidelines in Spain |
URL | https://link.springer.com/article/10.1007/s12094-017-1801-4 |
Guideline Title | Up to Date |
Description | Cancer survivorship: Cardiovascular and respiratory issues |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in clinical guidelines |
URL | https://www.uptodate.com/contents/cancer-survivorship-cardiovascular-and-respiratory-issues |
Guideline Title | Royal College of Radiologists guidelines |
Description | Cardiac side-effects from breast cancer radiotherapy |
Geographic Reach | National |
Policy Influence Type | Citation in clinical guidelines |
Description | Cardio-Onco-Hematología en la práctica clínica. Documento de consenso y recomendaciones (Cardio-Onco-Hematology in clinical practice. Consensus document and recommendations) |
Geographic Reach | Europe |
Policy Influence Type | Citation in other policy documents |
URL | http://www.revespcardiol.org/es/cardio-onco-hematologia-practica-clinica-documento-deconsenso/articu... |
Description | Cardiotoxicity of radiation therapy for Hodgkin lymphoma and pediatric malignancies |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in other policy documents |
URL | https://www.uptodate.com/contents/cardiotoxicity-of-radiation-therapy-for-hodgkin-lymphoma-and-pedia... |
Description | Cardiovascular Adverse Events in Patients With Cancer Treated With Bevacizumab: A Meta-Analysis of More Than 20 000 Patients |
Geographic Reach | North America |
Policy Influence Type | Citation in other policy documents |
URL | http://jaha.ahajournals.org/content/6/8/e006278 |
Description | Cardiovascular Complications of Cancer Therapy: Best Practices in Diagnosis, Prevention, and Management: Part 1 |
Geographic Reach | North America |
Policy Influence Type | Citation in systematic reviews |
URL | https://www.sciencedirect.com/science/article/pii/S0735109717409971 |
Description | Cardiovascular Complications of Cancer Therapy: Best Practices in Diagnosis, Prevention, and Management: Part 2 |
Geographic Reach | North America |
Policy Influence Type | Citation in systematic reviews |
URL | https://www.sciencedirect.com/science/article/pii/S073510971740996X |
Guideline Title | Cardiovascular Disease and Breast Cancer: Where These Entities Intersect: A Scientific Statement From the American Heart Association |
Description | Cardiovascular Disease and Breast Cancer: Where These Entities Intersect: A Scientific Statement From the American Heart Association |
Geographic Reach | North America |
Policy Influence Type | Citation in clinical guidelines |
URL | http://circ.ahajournals.org/content/early/2018/01/31/CIR.0000000000000556.short |
Description | Cardiovascular diseases in patients receiving small molecules with anti-vascular endothelial growth factor activity: A meta-analysis of approximately 29,000 cancer patients |
Geographic Reach | Europe |
Policy Influence Type | Citation in other policy documents |
URL | http://journals.sagepub.com/doi/abs/10.1177/2047487318755193 |
Description | Citation in European Society of Cardiology |
Geographic Reach | Europe |
Policy Influence Type | Citation in other policy documents |
Impact | Our work on the cardiovascular risks of radiotherapy for breast cancer have provided quantitative information that has been used in this position paper from the European Society of Cardiology |
URL | https://academic.oup.com/eurheartj/article-abstract/37/36/2768/2197413/2016-ESC-Position-Paper-on-ca... |
Guideline Title | Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: a position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society European Journal of Heart FailureVolume 22, Issue 11, November 2020, Pages 1945-1960 |
Description | Citation in National Clinical Practice Guidelines in Cardio-Oncology 2020 |
Geographic Reach | Europe |
Policy Influence Type | Citation in clinical guidelines |
Guideline Title | Stratification and management of cardiovascular risk in cancer patients. A consensus document of the SEC, FEC, SEOM, SEOR, SEHH, SEMG, AEEMT, AEEC, and AECC Revista Espanola de Cardiologia 2021 in press |
Description | Citation in National Clinical Practice Guidelines in Cardiology 2020 |
Geographic Reach | National |
Policy Influence Type | Citation in clinical guidelines |
Guideline Title | Invasive Breast Cancer Version 1.2016, NCCN Clinical Practice Guidelines in Oncology |
Description | Citation in National Clinical Practice Guidelines in Oncology 2016 |
Geographic Reach | North America |
Policy Influence Type | Citation in clinical guidelines |
URL | http://www.jnccn.org/content/14/3/324.short |
Guideline Title | 4th Hungarian breast cancer consensus conference - radiotherapy guidelines Magyar Onkologia Volume 64, Issue 4, 2020, Pages 371-383 |
Description | Citation in National Clinical Practice Guidelines in Oncology 2020 |
Geographic Reach | Europe |
Policy Influence Type | Citation in clinical guidelines |
Guideline Title | 4th Hungarian breast cancer consensus conference - radiotherapy guidelines Magyar Onkologia Volume 64, Issue 4, 2020, Pages 371-383 |
Description | Citation in National Clinical Practice Guidelines in Oncology 2020 |
Geographic Reach | Europe |
Policy Influence Type | Citation in clinical guidelines |
Guideline Title | 4th hungarian breast cancer consensus conference - radiotherapy guidelines Magyar Onkologia Volume 64, Issue 4, 2020, Pages 371-383 |
Description | Citation in National Clinical Practice Guidelines in Oncology 2020 |
Geographic Reach | Europe |
Policy Influence Type | Citation in clinical guidelines |
Guideline Title | The Japanese Breast Cancer Society Clinical Practice Guideline for radiation treatment of breast cancer, 2018 edition Breast CancerVolume 27, Issue 1, 1 January 2020, Pages 9-16 |
Description | Citation in National Clinical Practice Guidelines in Oncology 2020 |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in clinical guidelines |
Guideline Title | ESO-ESMO 4th International Consensus Guidelines for Breast Cancer in Young Women (BCY4) |
Description | Citation in National Clinical Practice Guidelines in Oncology 2020 |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in clinical guidelines |
Guideline Title | Postmastectomy Radiation Therapy Planning After Immediate Implant-based Reconstruction Using the European Society for Radiotherapy and Oncology-Advisory Committee in Radiation Oncology Practice Consensus Guidelines for Target Volume Delineation Clinical Oncology Volume 33, Issue 1, January 2021, Pages 20-29 |
Description | Citation in National Clinical Practice Guidelines in Oncology 2020 |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in clinical guidelines |
Guideline Title | ESO-ESMO 4th International Consensus Guidelines for Breast Cancer in Young Women (BCY4) Annals of OncologyVolume 31, Issue 6, June 2020, Pages 674-696 |
Description | Citation in National Clinical Practice Guidelines in Oncology 2020(2) |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in clinical guidelines |
Guideline Title | The Japanese Breast Cancer Society Clinical Practice Guideline for radiation treatment of breast cancer, 2018 edition Breast Cancer Volume 27, Issue 1, 1 January 2020, Pages 9-16 |
Description | Citation in National Clinical Practice Guidelines in Oncology 2020(3) |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in clinical guidelines |
Guideline Title | Postmastectomy Radiotherapy: An American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology Focused Guideline Update |
Description | Citation in a Guideline Update from the American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in clinical guidelines |
Impact | Our research has influenced which women receive radiotherapy following mastectomy for an invasive breast cancer |
URL | https://link.springer.com/article/10.1245/s10434-016-5558-8 |
Guideline Title | Clinical use of biomarkers in breast cancer: Updated guidelines from the European Group on Tumor Markers (EGTM) |
Description | Clinical use of biomarkers in breast cancer: Updated guidelines from the European Group on Tumor Markers (EGTM) |
Geographic Reach | Europe |
Policy Influence Type | Citation in clinical guidelines |
Impact | This article has clarified the importance of obtaining information on the hormonal receptor status for women with breast cancer before deciding on the best course of treatment for them |
URL | http://www.ejcancer.com/article/S0959-8049(17)30075-8/abstract |
Description | Coffee Decreases the Risk of Endometrial Cancer: A Dose-Response Meta-Analysis of Prospective Cohort Studies |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in other policy documents |
URL | http://www.mdpi.com/2072-6643/9/11/1223 |
Description | Comprehensive review of cardiovascular toxicity of drugs and related agents |
Geographic Reach | Europe |
Policy Influence Type | Citation in other policy documents |
URL | http://onlinelibrary.wiley.com/doi/10.1002/med.21476/full |
Description | Consensus paper on the "executive summary of the international conference on Mediterranean diet and health: a lifelong approach", an Italian initiative supported by the Mediterranean diet foundation and menarini foundation |
Geographic Reach | Europe |
Policy Influence Type | Citation in other policy documents |
URL | https://www.sciencedirect.com/science/article/pii/S0899900718300121 |
Description | Coronary heart disease and risk for cognitive impairment or dementia: Systematic review and meta-analysis |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in systematic reviews |
URL | http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0184244 |
Description | Current recommendations for diagnostic echocardiography in cancer patients |
Geographic Reach | Europe |
Policy Influence Type | Citation in other policy documents |
URL | https://link.springer.com/article/10.1007/s00059-017-4542-9 |
Guideline Title | DEGRO practical guidelines for radiotherapy of breast cancer VI: therapy of locoregional breast cancer recurrences |
Description | DEGRO (ie German Association for Radiation Oncology) practical guidelines for radiotherapy of breast cancer VI: therapy of locoregional breast cancer recurrences |
Geographic Reach | Europe |
Policy Influence Type | Citation in clinical guidelines |
Impact | Our article provided quantitative information regarding the beneficial effect of radiotherapy following surgery for early breast cancer. |
URL | https://link.springer.com/article/10.1007/s00066-015-0939-7 |
Guideline Title | DEGRO practical guidelines for radiotherapy of breast cancer VI: therapy of locoregional breast cancer recurrences |
Description | DEGRO practical guidelines for radiotherapy of breast cancer VI: therapy of locoregional breast cancer recurrences |
Geographic Reach | Europe |
Policy Influence Type | Citation in clinical guidelines |
Impact | Our article provided quantitative information on the benefits of radiotherapy for women with early breast cancer |
URL | https://link.springer.com/article/10.1007/s00066-015-0939-7 |
Description | Diagnostic protocol for cardiomyopathy secondary to cancer treatments |
Geographic Reach | Europe |
Policy Influence Type | Citation in other policy documents |
URL | https://www.sciencedirect.com/science/article/pii/S0304541217302706 |
Description | Documento di consenso ANMCO/AICO/AIOM: Snodi clinico-gestionali in ambito cardioncologico (Consensus documanet ANMCO / AICO / AIOM: Clinical -management in the field of cardiooncology) |
Geographic Reach | Europe |
Policy Influence Type | Citation in other policy documents |
URL | https://www.researchgate.net/profile/Luigi_Tarantini/publication/313860736_Documento_di_consenso_ANM... |
Guideline Title | ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC) |
Description | ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC) |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in clinical guidelines |
URL | https://www.romanianjournalcardiology.ro/wp-content/uploads/2017/10/ghid.pdf |
Description | Effect of long-term nutraceutical and dietary supplement use on cognition in the elderly: a 10-year systematic review of randomised controlled trials |
Geographic Reach | Europe |
Policy Influence Type | Citation in systematic reviews |
URL | https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/effect-of-longterm-nutr... |
Description | Effects of neighbourhood and household sanitation conditions on diarrhea morbidity: Systematic review and meta-analysis |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in systematic reviews |
URL | http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0173808 |
Guideline Title | Cardiotoxicity of chemotherapeutic agents and radiotherapy-related heart disease: ESMO clinical practice guidelines |
Description | Estimating cardiac exposure from breast cancer radiotherapy in clinical practice |
Geographic Reach | Europe |
Policy Influence Type | Citation in clinical guidelines |
Impact | Results were used to inform the following clinical practice guidelines: Cardiotoxicity of chemotherapeutic agents and radiotherapy-related heart disease: ESMO clinical practice guidelines. Ann Oncol 2010; 21 (Suppl 5) v277-v282. |
Description | Evidence-based Review on the Use of Proton Therapy in Lymphoma From the Particle Therapy Cooperative Group (PTCOG) Lymphoma Subcommittee |
Geographic Reach | Europe |
Policy Influence Type | Citation in systematic reviews |
URL | http://www.redjournal.org/article/S0360-3016(17)30901-X/fulltext |
Guideline Title | Interdisziplinäre Früherkennung, Diagnostik, Therapie und Nachsorge des Mammakarzinoms. Leitlinie der DGGG und DKG (S3-Level, AWMF-Registernummer 032/045OL, Dezember 2017) - Teil 2 mit Empfehlungen zur Therapie des primären, rezidivierten und fortgeschrittenen Mammakarzinoms |
Description | German Breast Cancer Treatment Guidelines |
Geographic Reach | National |
Policy Influence Type | Citation in clinical guidelines |
Impact | The results of this meta analysis were used to inform German breast cancer treatment guidelines |
URL | https://www.thieme-connect.com/products/ejournals/html/10.1055/a-0646-4630 |
Description | Individualization of post-mastectomy radiotherapy and regional nodal irradiation based on treatment response after neoadjuvant chemotherapy for breast cancer |
Geographic Reach | Europe |
Policy Influence Type | Citation in systematic reviews |
URL | https://link.springer.com/article/10.1007/s00066-018-1270-x |
Description | Inferring the effects of cancer treatment: Divergent results from Early Breast Cancer Trialists' Collaborative Group meta-analyses of randomized trials and observational data from SEER registries |
Geographic Reach | National |
Policy Influence Type | Citation in clinical reviews |
Guideline Title | The Japanese Breast Cancer Society Clinical Practice Guideline for radiation treatment of breast cancer, 2015 edition |
Description | Influence on Japanese |
Geographic Reach | Asia |
Policy Influence Type | Citation in clinical guidelines |
Impact | Our article provided quantitative information on the benefits and risks of radiotherapy for women with breast cancer |
URL | https://link.springer.com/article/10.1007/s12282-016-0672-9 |
Description | Influenced design of HeartSpare 1A clinical study |
Geographic Reach | National |
Policy Influence Type | Influenced training of practitioners or researchers |
Impact | Clinical Study HeartSpare 1A Phase 3 randomised trial of voluntary deep-inspiratory breast hold versus active breathing control deep-inspiration breath hold with active breathing control. Recruitment completed and results published Bartlett FR, Colgan RM, Carr K, et al. The UK HeartSpare study: Randomised evaluation of voluntary deep-inspiratory breath-hold in women undergoing breast radiotherapy. Radioth Oncol 2013; 108: 242-7. Research paper from our team used in study design Darby SC, McGale P, Taylor CW, Peto R. Long-term mortality from heart disease and lung cancer after radiotherapy for early breast cancer: prospective cohort study of about 300 000 women in US SEER cancer registries. Lancet Oncol 2005;6:557-565. Impact of research Our work on heart disease after breast cancer radiotherapy highlighted the need for breast cancer radiotherapy that avoided the heart. |
Description | Influenced design of HeartSpare 1B clinical study |
Geographic Reach | National |
Policy Influence Type | Influenced training of practitioners or researchers |
Impact | HeartSpare 1B Phase 3 randomised trial of voluntary breath-hold technique and prone radiotherapy. Recruitment completed and results published Bartlett FR, Colgan RM, Donovan EM, et al. The UK HeartSpare study (Stage 1B): Randomised comparison of voluntary breath-hold technique and prone radiotherapy after breast conserving surgery. Radioth Oncol 2015; 114: 66-72. Darby SD, Ewertz M, McGale P, Bennet AM, Blom-Goldman U, Brønnum D, Correa C, Cutter D, Gagliardi G, Gigante B, Jensen MB, Nisbet A, Peto R, Rahimi K, Taylor C, Hall P. Risk of ischemic heart disease in women irradiated for breast cancer. New England Journal of Medicine 2013;368:987-998 Our dose-response relationship for ischaemic heart disease after radiotherapy showed there was no evidence of a threshold heart dose below which there was no risk. The study was set up to investigate ways of reducing heart dose as much as possible in left breast radiotherapy. |
Description | Influenced design of HeartSpare 2 clinical study |
Geographic Reach | National |
Policy Influence Type | Influenced training of practitioners or researchers |
Impact | HeartSpare 2 The aim of this study was to make heart-sparing breast radiotherapy available to all suitable patients across the NHS. Recruitment completed. Results not yet published Darby SD, Ewertz M, McGale P, Bennet AM, Blom-Goldman U, Brønnum D, Correa C, Cutter D, Gagliardi G, Gigante B, Jensen MB, Nisbet A, Peto R, Rahimi K, Taylor C, Hall P. Risk of ischemic heart disease in women irradiated for breast cancer. New England Journal of Medicine 2013;368:987-998 Our dose-response relationship for ischaemic heart disease after radiotherapy showed there was no evidence of a threshold heart dose below which there was no risk. The study was set up to reduce heart dose from left breast radiotherapy throughout the UK. |
Description | Influenced design of HeartSpare-plus clinical study |
Geographic Reach | National |
Policy Influence Type | Influenced training of practitioners or researchers |
Impact | HeartSpare-plus This study aims to identify optimal radiotherapy techniques for treating locoregional lymph nodes in women whilst limiting the dose to normal tissues, in order to reduce the risks of radiation-induced heart disease and second cancers. Darby SD, Ewertz M, McGale P, Bennet AM, Blom-Goldman U, Brønnum D, Correa C, Cutter D, Gagliardi G, Gigante B, Jensen MB, Nisbet A, Peto R, Rahimi K, Taylor C, Hall P. Risk of ischemic heart disease in women irradiated for breast cancer. New England Journal of Medicine 2013;368:987-998 Our dose-response relationship for ischaemic heart disease after radiotherapy showed there was no evidence of a threshold heart dose below which there was no risk. The study was set up to reduce heart dose from left regional node irradiation. |
Description | Influenced design of proton beam therapy in breast cancer study |
Geographic Reach | National |
Policy Influence Type | Influenced training of practitioners or researchers |
Impact | Proton beam therapy in breast cancer clinical study Study being designed. Darby SD, Ewertz M, McGale P, Bennet AM, Blom-Goldman U, Brønnum D, Correa C, Cutter D, Gagliardi G, Gigante B, Jensen MB, Nisbet A, Peto R, Rahimi K, Taylor C, Hall P. Risk of ischemic heart disease in women irradiated for breast cancer. New England Journal of Medicine 2013;368:987-998 The design of this study requires absolute estimates of the likely cardiac risks of breast cancer radiotherapy for included women. These will be calculated using Darby 2013. It also requires estimates of the risks for young women, and for women who also receive cardiotoxic chemotherapy, which will be informed by our other projects. |
Description | Inform radiotherapy guidelines in UK |
Geographic Reach | National |
Policy Influence Type | Influenced training of practitioners or researchers |
Impact | Duane F, McGale P, Teoh S, Mortimer C, Broggio J, Darby SC, Dodwell D, Lavery B, Oliveros S, Vallis KA, Taylor CW. International variation in criteria for internal mammary chain radiotherapy. Clin Oncol 2019; 31: 453-461. Listed as "Editor's choice" This study of worldwide guidelines in internal mammary chain radiotherapy is being used to inform radiotherapy guidelines in the UK. Its results were presented and discussed at a meeting of the UK Breast Cancer Group in November 2019. |
Guideline Title | International Lymphoma Radiation Oncology Group guidelines |
Description | International Lymphoma Radiation Oncology Group guidelines |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in clinical guidelines |
URL | http://www.bloodjournal.org/content/132/16/1635.abstract?sso-checked=true |
Description | LA FIBRILLAZIONE ATRIALE NEL PAZIENTE ONCOLOGICO |
Geographic Reach | Europe |
Policy Influence Type | Citation in other policy documents |
URL | http://www.anmco.it/uploads/u_cms/media/2018/1/14404d1d8c23eb76b57f6d3ccf069d31.pdf |
Guideline Title | London Cancer Alliance |
Description | Long-term mortality from heart disease and lung cancer after radiotherapy for early breast cancer: prospective cohort study of about 300 000 women in US SEER cancer registries |
Geographic Reach | National |
Policy Influence Type | Citation in clinical guidelines |
Impact | Our dose-response relationship, and our work on the relationship between maximum heart distance and mean heart dose were used to inform the London Cancer Alliance guidelines for heart sparing breast cancer radiotherapy (10th July 2014). |
Description | Lycopene and tomato and risk of cardiovascular diseases: A systematic review and meta-analysis of epidemiological evidence |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in systematic reviews |
URL | http://www.tandfonline.com/doi/abs/10.1080/10408398.2017.1362630 |
Guideline Title | NCCN guidelines for survivorship |
Description | NCCN guidelines for survivorship |
Geographic Reach | National |
Policy Influence Type | Citation in clinical guidelines |
URL | http://www.jnccn.org/content/16/10/1216.short |
Guideline Title | NICE Breast Cancer Radiotherapy Guidance |
Description | NICE Breast Cancer Radiotherapy Guidance |
Geographic Reach | Europe |
Policy Influence Type | Citation in clinical guidelines |
Impact | The results of this meta analysis informed the 2018 NICE breast cancer radiotherapy guidance. |
URL | https://www.nice.org.uk/guidance/ng101/documents/evidence-summary-9 |
Description | Our systematic review of heart doses in breast cancer was quoted by: Sardar, P 2016. "Long-term cardiovascular mortality after radiotherapy for breast cancer: A systematic review and meta-analysis". DOI: 10.1002/clc.22631 |
Geographic Reach | North America |
Policy Influence Type | Citation in systematic reviews |
URL | http://onlinelibrary.wiley.com/doi/10.1002/clc.22631/full |
Description | Our work on the main risks of breast cancer radiotherapy (second cancer and heart disease) was used by the Clinical Translational Radiotherapy working group (CTRad) to inform the UK internal mammary chain research agenda. |
Geographic Reach | Local/Municipal/Regional |
Policy Influence Type | Participation in a national consultation |
Guideline Title | Follow-up after treatment for breast cancer Practical guide to survivorship care for family physicians |
Description | Our work was used to assess the risk of heart disease after radiotherapy in "Follow-up after treatment for breast cancer Practical guide to survivorship care for family physicians" |
Geographic Reach | North America |
Policy Influence Type | Citation in clinical guidelines |
URL | http://www.cfp.ca/content/62/10/805.short |
Guideline Title | Prevention and Monitoring of Cardiac Dysfunction in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline |
Description | Our work was used to assess the risk of heart disease after radiotherapy in "Prevention and Monitoring of Cardiac Dysfunction in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline" |
Geographic Reach | North America |
Policy Influence Type | Citation in clinical guidelines |
URL | http://ascopubs.org/doi/abs/10.1200/JCO.2016.70.5400 |
Description | Partial breast radiotherspy |
Geographic Reach | National |
Policy Influence Type | Influenced training of practitioners or researchers |
Impact | Taylor CW, Dodwell D, Darby SC, Broggio J, McGale P. Eligibility for partial breast radiotherapy in England. Clinical Oncology. 2020 Apr 1;32(4):217-20 We performed this study in response to a request from breast cancer researchers in the UK. They plan to use our analyses to compare the number women in England who are eligible for partial breast radiotherapy with the number of women who actually receive it. |
Guideline Title | 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC) |
Description | Practice guidelines for European Society of Cardiology |
Geographic Reach | Europe |
Policy Influence Type | Citation in clinical guidelines |
URL | https://www.ncbi.nlm.nih.gov/pubmed/27567406 |
Guideline Title | Prevention and Monitoring of Cardiac Dysfunction in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guidelines |
Description | Prevention and Monitoring of Cardiac Dysfunction in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guidelines |
Geographic Reach | North America |
Policy Influence Type | Citation in clinical guidelines |
URL | http://ascopubs.org/doi/abs/10.1200/JCO.2016.70.5400 |
Description | Proton therapy for locally advanced breast cancer: a systematic review of the literature |
Geographic Reach | Europe |
Policy Influence Type | Citation in systematic reviews |
URL | https://www.sciencedirect.com/science/article/pii/S0305737217301986 |
Description | Publication: Risk of ischemic heart disease in women irradiated for breast cancer. New England Journal of Medicine 2013;368:987-998 |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Influenced training of practitioners or researchers |
Impact | Darby SD, Ewertz M, McGale P, Bennet AM, Blom-Goldman U, Brønnum D, Correa C, Cutter D, Gagliardi G, Gigante B, Jensen MB, Nisbet A, Peto R, Rahimi K, Taylor C, Hall P. Risk of ischemic heart disease in women irradiated for breast cancer. New England Journal of Medicine 2013;368:987-998 Results continue to inform education and training. For example, results have been presented annually at the European Society of Therapeutic Radiation Oncology teaching courses since 2013, and were presented in 2015 at the 4-yearly National Cancer Institute Radiation Epidemiology Dosimetry course. This publication has resulted in the introduction of heart-sparing radiotherapy in the UK, and in other developed countries. Reductions in heart dose from breast cancer radiotherapy since 2013 were recently demonstrated by a worldwide systematic review Average mean heart dose in left breast radiotherapy reduced from 4.6 Gy in 2014 to 2.6 Gy in 2017. Reference: Drost L, Yee C, Lam H, et al. A systematic review of heart dose in breast radiotherapy. Clin Breast Cancer 2018; 18: e819-24.) In the USA, heart-sparing breast cancer radiotherapy has increased, with >80% of radiation oncologists using heart-sparing techniques. Reference: Desai N, Currey A, Kelly T, Bergom C. Nationwide trends in heart-sparing techniques utilized in radiation therapy for breast cancer. Adv Radiat Oncol 2019; 4: 246-52 |
Description | Recommendations for the follow-up care of female breast cancer survivors: a guideline of the Spanish Society of Medical Oncology (SEOM), Spanish Society of General Medicine (SEMERGEN), Spanish Society for Family and Community Medicine (SEMFYC), Spanish Society for General and Family Physicians (SEMG), Spanish Society of Obstetrics and Gynecology (SEGO), Spanish Society of Radiation Oncology (SEOR), Spanish Society of Senology and Breast Pathology (SESPM), and Spanish Society of Cardiology (SEC) |
Geographic Reach | Europe |
Policy Influence Type | Citation in other policy documents |
URL | https://link.springer.com/article/10.1007/s12094-017-1801-4 |
Guideline Title | Expert Consensus for Multi-Modality Imaging Evaluation of Cardiovascular Complications of Radiotherapy in Adults: A Report from the European Association of Cardiovascular Imaging and the American Society of Echocardiography . Journal of the American Society of Echocardiography 2013; 26: 1013-1032 |
Description | Risk of ischemic heart disease in women irradiated for breast cancer |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in clinical guidelines |
Guideline Title | Risk of ischemic heart disease in women irradiated for breast cancer |
Description | Risk of ischemic heart disease in women irradiated for breast cancer II |
Geographic Reach | National |
Policy Influence Type | Citation in clinical guidelines |
Impact | Results were used to inform the DEGRO (German society of radiation oncology) guidelines 2014 and 2015. DEGRO practical guidelines: radiotherapy of breast cancer III - radiotherapy of lymphatic pathways Strahlenther Onkol 2014; 190: 342-352. DEGRO practical guidelines for radiotherapy of breast cancer V - therapy for locally advanced and inflammatory breast cancer Strahlenther Onkol 2015; 191: 623-33. |
Description | Smoking cessation in cancer patients |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Influenced training of practitioners or researchers |
Impact | Early Breast Cancer Trialists' Collaborative Group. (Writing committee: Taylor CW, Correa C, Duane F, Aznar MC, Anderson SJ, Bergh J, Dodwell D, Ewertz M, Gray R, Jagsi R, Pierce L, Pritchard KI, Swain S, Wang Z, Wang Y, Whelan T, Peto R, McGale P.) Estimating the risks of breast cancer radiotherapy: Evidence from modern radiation doses to the lungs and heart and from previous randomised trials. J Clin Oncol 2017;35:1641-9. The results of this study are being used to promote smoking cessation in cancer patients See, for example: https://www.breastcancer.org/research-news/rads-risks-much-higher-for-smokers |
URL | https://www.breastcancer.org/research-news/rads-risks-much-higher-for-smokers |
Description | Symptom practice guide for telephone assessment of patients with cancer treatment-related cardiotoxic dyspnea: Adaptation and evaluation of acceptability |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in other policy documents |
URL | https://cardiooncologyjournal.biomedcentral.com/articles/10.1186/s40959-017-0026-6 |
Description | TUMORE DEL RENE TERAPIA ONCOLOGICA E CARDIOTOSSICITA |
Geographic Reach | Europe |
Policy Influence Type | Citation in other policy documents |
URL | http://www.anmco.it/uploads/u_cms/media/2018/1/14404d1d8c23eb76b57f6d3ccf069d31.pdf |
Guideline Title | The diagnosis and management of non-alcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases |
Description | The diagnosis and management of non-alcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases |
Geographic Reach | North America |
Policy Influence Type | Citation in clinical guidelines |
URL | http://onlinelibrary.wiley.com/doi/10.1002/hep.29367/abstract;jsessionid=BFA49C715E6F589D30513A958D4... |
Description | The nature and efficacy of culturally-adapted psychosocial interventions for schizophrenia: a systematic review and meta-analysis |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in systematic reviews |
URL | https://www.cambridge.org/core/journals/psychological-medicine/article/nature-and-efficacy-of-cultur... |
Description | Balancing the Benefits and Risks of Radiotherapy for Lymphoma |
Amount | £389,443 (GBP) |
Funding ID | NIHR300740 |
Organisation | National Institute for Health Research |
Sector | Public |
Country | United Kingdom |
Start | 03/2020 |
End | 03/2023 |
Description | CRUK Programme Grant Award |
Amount | £3,207,423 (GBP) |
Organisation | Cancer Research UK |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 03/2016 |
End | 03/2021 |
Description | Cancer Innovation & Career Development Award |
Amount | £14,000 (GBP) |
Organisation | King’s Health Partners |
Sector | Academic/University |
Country | United Kingdom |
Start | 08/2020 |
Description | Choosing breast cancer radiotherapy that improves survival. |
Amount | £384,045 (GBP) |
Funding ID | NIHR300676 |
Organisation | National Institute for Health Research |
Sector | Public |
Country | United Kingdom |
Start | 03/2020 |
End | 03/2023 |
Description | Clinical Research Training |
Amount | £187,000 (GBP) |
Organisation | British Heart Foundation (BHF) |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 03/2009 |
End | 08/2012 |
Description | Early Career Travel Fellowship |
Amount | $2,500 (USD) |
Organisation | National Institutes of Health (NIH) |
Department | National Cancer Institute (NCI) |
Sector | Public |
Country | United States |
Start | 02/2020 |
End | 01/2021 |
Description | Non-Clinical Training |
Amount | £71,000 (GBP) |
Organisation | Cancer Research UK |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 09/2012 |
End | 09/2016 |
Description | Pump-Priming Funding Award for Medical Scanning Costs |
Amount | £16,000 (GBP) |
Organisation | Wellcome / EPSRC Centre for Medical Engineering |
Sector | Public |
Country | United Kingdom |
Start | 03/2020 |
Description | Research Excellence Award |
Amount | £49,000 (GBP) |
Organisation | British Heart Foundation (BHF) |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 04/2009 |
End | 03/2014 |
Description | Research grant |
Amount | £382,000 (GBP) |
Organisation | Department of Health (DH) |
Sector | Public |
Country | United Kingdom |
Start | 12/2012 |
End | 11/2015 |
Description | Research grant |
Amount | £80,000 (GBP) |
Organisation | Cancer Research UK |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 03/2010 |
End | 02/2011 |
Description | Research grant |
Amount | £449,000 (GBP) |
Organisation | Department of Health (DH) |
Sector | Public |
Country | United Kingdom |
Start | 01/2007 |
End | 12/2009 |
Description | Research grant (RACE) |
Amount | £258,000 (GBP) |
Organisation | European Commission |
Sector | Public |
Country | European Union (EU) |
Start | 07/2005 |
End | 10/2009 |
Title | Cardiac Contouring Atlas |
Description | This cardiac atlas enables reproducible contouring of segments of the left ventricle and main coronary arteries to facilitate future studies relating cardiac radiation doses to clinical outcomes. |
Type Of Material | Physiological assessment or outcome measure |
Year Produced | 2017 |
Provided To Others? | Yes |
Impact | The heart is a complex anatomical organ and contouring the cardiac substructures is challenging. We have provided a reproducible method for contouring left ventricular and coronary arterial segments on radiotherapy CT-planning scans. |
URL | http://www.thegreenjournal.com/article/S0167-8140(17)30030-0/abstract |
Description | Academic Collaborators |
Organisation | Danish Breast Cancer Cooperative Group (DBCG) |
Country | Denmark |
Sector | Charity/Non Profit |
PI Contribution | CTSU co-ordinates data collection from a number of national and international partners, including other academic institutions and cancer registries. This disparate data is then cleaned, entered into a study database in order to undergo statistical analysis. |
Collaborator Contribution | Academic partners provide various datasets for our analyses and help to formulate and develop future research questions. |
Impact | Our research is making a significant contribution to the development of several clinical tools used by oncologists to predict the absolute benefits of various breast cancer treatments. |
Start Year | 2006 |
Description | Academic Collaborators |
Organisation | Netherlands Cancer Institute (NKI) |
Country | Netherlands |
Sector | Academic/University |
PI Contribution | CTSU co-ordinates data collection from a number of national and international partners, including other academic institutions and cancer registries. This disparate data is then cleaned, entered into a study database in order to undergo statistical analysis. |
Collaborator Contribution | Academic partners provide various datasets for our analyses and help to formulate and develop future research questions. |
Impact | Our research is making a significant contribution to the development of several clinical tools used by oncologists to predict the absolute benefits of various breast cancer treatments. |
Start Year | 2006 |
Description | Academic Collaborators |
Organisation | Oxford University Hospitals NHS Foundation Trust |
Department | Radiotherapy Physics |
Country | United Kingdom |
Sector | Charity/Non Profit |
PI Contribution | CTSU co-ordinates data collection from a number of national and international partners, including other academic institutions and cancer registries. This disparate data is then cleaned, entered into a study database in order to undergo statistical analysis. |
Collaborator Contribution | Academic partners provide various datasets for our analyses and help to formulate and develop future research questions. |
Impact | Our research is making a significant contribution to the development of several clinical tools used by oncologists to predict the absolute benefits of various breast cancer treatments. |
Start Year | 2006 |
Description | Academic Collaborators |
Organisation | University of Birmingham |
Department | Centre for Childhood Cancer Survivor Studies |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | CTSU co-ordinates data collection from a number of national and international partners, including other academic institutions and cancer registries. This disparate data is then cleaned, entered into a study database in order to undergo statistical analysis. |
Collaborator Contribution | Academic partners provide various datasets for our analyses and help to formulate and develop future research questions. |
Impact | Our research is making a significant contribution to the development of several clinical tools used by oncologists to predict the absolute benefits of various breast cancer treatments. |
Start Year | 2006 |
Description | Academic Collaborators |
Organisation | University of Oxford |
Department | CRUK/MRC Oxford Institute for Radiation Oncology |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | CTSU co-ordinates data collection from a number of national and international partners, including other academic institutions and cancer registries. This disparate data is then cleaned, entered into a study database in order to undergo statistical analysis. |
Collaborator Contribution | Academic partners provide various datasets for our analyses and help to formulate and develop future research questions. |
Impact | Our research is making a significant contribution to the development of several clinical tools used by oncologists to predict the absolute benefits of various breast cancer treatments. |
Start Year | 2006 |
Description | Academic Collaborators |
Organisation | University of Oxford |
Department | Department of Oncology |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | CTSU co-ordinates data collection from a number of national and international partners, including other academic institutions and cancer registries. This disparate data is then cleaned, entered into a study database in order to undergo statistical analysis. |
Collaborator Contribution | Academic partners provide various datasets for our analyses and help to formulate and develop future research questions. |
Impact | Our research is making a significant contribution to the development of several clinical tools used by oncologists to predict the absolute benefits of various breast cancer treatments. |
Start Year | 2006 |
Description | Academic Collaborators |
Organisation | University of Southern Denmark |
Department | Department of Oncology |
Country | Denmark |
Sector | Academic/University |
PI Contribution | CTSU co-ordinates data collection from a number of national and international partners, including other academic institutions and cancer registries. This disparate data is then cleaned, entered into a study database in order to undergo statistical analysis. |
Collaborator Contribution | Academic partners provide various datasets for our analyses and help to formulate and develop future research questions. |
Impact | Our research is making a significant contribution to the development of several clinical tools used by oncologists to predict the absolute benefits of various breast cancer treatments. |
Start Year | 2006 |
Description | Big data in populations of cancer patients |
Organisation | Public Health England |
Country | United Kingdom |
Sector | Public |
PI Contribution | We are developing models to predict the benefits and risks from the various different options available for treating women who have been diagnosed with breast cancer. During the course of this we are also helping Public Health England to improve the quality of their routine data. |
Collaborator Contribution | Public Health England have provided us with data on all 600,000 women diagnosed with breast cancer in England during 1997-2014. Items included are patient and tumour characteristics and, for those who have died, the date and cause of death. |
Impact | None so far |
Start Year | 2016 |
Description | Clinical Collaborations within Oxford |
Organisation | Oxford University Hospitals NHS Foundation Trust |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Dr Carolyn Taylor and Dr Frances Duane are collaborating with other breast oncologists to develop internal mammary nodal radiotherapy Dr David Cutter is collaborating with lymphoma oncologists to improve lymphoma radiotherapy Dr Marianne Aznar collaborates with radiotherapy physicists Mr Gurdeep Mannu collaborates with breast surgeons All four individuals are involved in teaching in Oxford University Hospitals NHS Trust |
Collaborator Contribution | Collaboration with oncologists, radiographers, physicists and surgeons has enabled the team to ensure that their research programme answers clinically relevant question, and remains up to date |
Impact | The collaboration involves oncologists, physicists, surgeons and radiographers. Outputs from these collaborations include: Audit of Cardiac dose from tangential breast cancer radiotherapy in the year 2010 C.W. Taylor (2010) Lorenzen EL, Taylor CW, Maraldo M, Nielsen MH, Offersen BV, Andersen MR, O'Dwyer D, Larsen L, Duxbury S, Jhitta B, Darby SC, Ewertz M, Brink C. Inter-observer variation in delineation of the heart and left anterior descending coronary artery in radiotherapy for breast cancer: A multi-centre study from Denmark and the UK. Radioth Oncol 2013;108:254-258. Taylor CW, Wang Z, Macaulay E, Jagsi R, Darby SC. Exposure of the heart in breast cancer radiotherapy: A systematic review of heart doses published during 2003-2013. Int J Radiat Oncol Biol Phys 2015;93:845-853. |
Start Year | 2010 |
Description | Collaboration with Netherlands Cancer Institute to study the risks of colorectal cancer and stroke after radiotherapy for Hodgkin lymphoma |
Organisation | Netherlands Cancer Institute (NKI) |
Department | Molecular Pathology Division |
Country | Netherlands |
Sector | Hospitals |
PI Contribution | We have provided expertise in dosimetry and in statistical analysis |
Collaborator Contribution | NKI staff have obtained information regarding patients treated at the NKI and other hospitals in the Netherlands, obtaining information on treatments received, risk factors for colon cancer and stroke and outcomes |
Impact | doi: https://doi.org/10.1182/blood-2016-09-740332 |
Start Year | 2016 |
Description | Coventry University |
Organisation | Coventry University |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Supplied biological sample for microRNA analysis |
Collaborator Contribution | analysis is currently underway |
Impact | none yet |
Start Year | 2016 |
Description | ESTRO course on Multidisciplinary Management of Breast Cancer |
Organisation | European Society of Therapeutic and Radiation Oncology |
Country | Belgium |
Sector | Charity/Non Profit |
PI Contribution | Marianne Aznar and Sarah Darby are faculty members of the ESTRO (the European Society of Therapeutic and Radiation Oncology) course on the Multidisciplinary Management of Breast Cancer. Marianne covers aspects related to medical physics, while Sarah handles epidemiology and the effects of radiotherapy. This year the 3-day course was held in Dublin and attracted over 100 participants, most of whom were young radiation oncologists from around Europe who have recently started to specialise in breast cancer. |
Collaborator Contribution | event hosts |
Impact | ESTRO course provision |
Start Year | 2017 |
Description | Excess Mortality Risk Analysis of Proton Beam versus Optimal Photon Radiotherapy for Mediastinal Hodgkin Lymphoma: Who May Benefit Most? |
Organisation | Guy's and St Thomas' NHS Foundation Trust |
Country | United Kingdom |
Sector | Public |
PI Contribution | Academic partnership |
Collaborator Contribution | Expertise in Butterfly VMAT radiotherapy, Prof Mikhaeel reviewed our treatment plans and provide clinical expertise. Also GSTT provided a dosimetrist to help planning 60 additional patients with BVMAT. |
Impact | Prestigious ASTRO oral presentation and winner of BestofASTRO abstract recognition. Publication in preparation |
Start Year | 2018 |
Description | Independent Cancer Patients Voice |
Organisation | Independent Cancer Patients' Voice |
Country | United Kingdom |
Sector | Charity/Non Profit |
PI Contribution | Discussions to ascertain views of patients on our decision aids |
Collaborator Contribution | Two representatives provide consumer/patient input to our work on decision aids |
Impact | Ongoing |
Start Year | 2015 |
Description | Partial breast radiotherapy trialists |
Organisation | University of Oxford |
Department | Early Breast Cancer Trialists Collaborative Group Writing Committee |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Overall leadership |
Collaborator Contribution | Input to data analysis plan, and to planning of meta analysis. Provision of their data, help liaising with other Trialists, clinical advice |
Impact | Planning of meta-analysis is underway |
Start Year | 2019 |
Description | Pathological study of DCiS |
Organisation | Netherlands Cancer Institute (NKI) |
Department | Molecular Pathology Division |
Country | Netherlands |
Sector | Hospitals |
PI Contribution | Study design, statistical analysis |
Collaborator Contribution | Data regarding women diagnosed with DCIS at the NKI and other hospitals in the Netherlands, including pathological and radiological information. |
Impact | None as yet |
Start Year | 2016 |
Description | Proton Therapy Centre, Prague |
Organisation | Proton Therapy Center Czech Ltd |
Country | Czech Republic |
Sector | Hospitals |
PI Contribution | We have provided expert review of contouring and developed methods to predict late effects of radiation. |
Collaborator Contribution | PTC Prague contributed radiotherapy data for analysis |
Impact | • G. Ntentas, K. Dedeckova, M. Andrilik, M.C. Aznar, B. George, S. Darby, D. Cutter. Predicted Cardiac and Second Cancer Risks in Hodgkin Lymphoma Patients Treated with Advanced Proton Beam Therapy Compared to Photon Radiotherapy. ICML-14, Lugano, Switzerland. Haematological Oncology 35 (S2); June 2017; P173 • G. Ntentas, K. Dedeckova, M. Andrilik, M.C. Aznar, B. George, S. Darby, D. Cutter. Predicted Cardiac and Second Cancer Risks in Hodgkin Lymphoma Patients Treated With Advanced Proton Beam Therapy Compared to Photon Radiation Therapy. ASTRO 59 (2017), San Diego, USA. Vol. 99, Issue 2, S181 |
Start Year | 2016 |
Description | Radiation Dose and Outcomes in Breast Cancer |
Organisation | Curie Institute Paris (Institut Curie) |
Country | France |
Sector | Academic/University |
PI Contribution | Intellectual input to study relating radiation doses to breast cancer outcomes in two randomised trials |
Collaborator Contribution | data provision |
Impact | n/a |
Start Year | 2017 |
Description | Radiation Dose and Outcomes in Breast Cancer |
Organisation | Korean Radiation Oncology Group |
Country | Korea, Republic of |
Sector | Learned Society |
PI Contribution | Intellectual input to study relating radiation doses to breast cancer outcomes in two randomised trials |
Collaborator Contribution | data provision |
Impact | n/a |
Start Year | 2017 |
Description | Radiation Dose and Outcomes in Breast Cancer |
Organisation | Leeds Teaching Hospitals NHS Trust |
Country | United Kingdom |
Sector | Public |
PI Contribution | Intellectual input to study relating radiation doses to breast cancer outcomes in two randomised trials |
Collaborator Contribution | data provision |
Impact | n/a |
Start Year | 2017 |
Description | Regional Nodal Radiotherapy Early Breast Cancer Trialists Collaborative Group writing committee |
Organisation | Center Hospital Lyon Sud |
Country | France |
Sector | Hospitals |
PI Contribution | Statistical Analysis. Preparation of Report |
Collaborator Contribution | Individual patient data meta analysis of regional nodal breast cancer |
Impact | n/a |
Start Year | 2016 |
Description | Regional Nodal Radiotherapy Early Breast Cancer Trialists Collaborative Group writing committee |
Organisation | Curie Institute Paris (Institut Curie) |
Country | France |
Sector | Academic/University |
PI Contribution | Statistical Analysis. Preparation of Report |
Collaborator Contribution | Individual patient data meta analysis of regional nodal breast cancer |
Impact | n/a |
Start Year | 2016 |
Description | Regional Nodal Radiotherapy Early Breast Cancer Trialists Collaborative Group writing committee |
Organisation | Danish Breast Cancer Cooperative Group (DBCG) |
Country | Denmark |
Sector | Charity/Non Profit |
PI Contribution | Statistical Analysis. Preparation of Report |
Collaborator Contribution | Individual patient data meta analysis of regional nodal breast cancer |
Impact | n/a |
Start Year | 2016 |
Description | Regional Nodal Radiotherapy Early Breast Cancer Trialists Collaborative Group writing committee |
Organisation | Hospital Saint-Louis |
Country | France |
Sector | Hospitals |
PI Contribution | Statistical Analysis. Preparation of Report |
Collaborator Contribution | Individual patient data meta analysis of regional nodal breast cancer |
Impact | n/a |
Start Year | 2016 |
Description | Regional Nodal Radiotherapy Early Breast Cancer Trialists Collaborative Group writing committee |
Organisation | Leeds Teaching Hospitals NHS Trust |
Country | United Kingdom |
Sector | Public |
PI Contribution | Statistical Analysis. Preparation of Report |
Collaborator Contribution | Individual patient data meta analysis of regional nodal breast cancer |
Impact | n/a |
Start Year | 2016 |
Description | Regional Nodal Radiotherapy Early Breast Cancer Trialists Collaborative Group writing committee |
Organisation | McMaster University |
Country | Canada |
Sector | Academic/University |
PI Contribution | Statistical Analysis. Preparation of Report |
Collaborator Contribution | Individual patient data meta analysis of regional nodal breast cancer |
Impact | n/a |
Start Year | 2016 |
Description | Regional Nodal Radiotherapy Early Breast Cancer Trialists Collaborative Group writing committee |
Organisation | University of Cambridge |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Statistical Analysis. Preparation of Report |
Collaborator Contribution | Individual patient data meta analysis of regional nodal breast cancer |
Impact | n/a |
Start Year | 2016 |
Description | Review of Stratified screening for breast cancer |
Organisation | University of Oxford |
Department | Nuffield Department of Primary Care Health Sciences |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | David Dodwell provides informal advice on breast cancer care and outcomes and NHS current screening strategy |
Collaborator Contribution | Academic partnership |
Impact | n/a |
Start Year | 2020 |
Description | Sentinel Node Biopsy Early Breast Cancer Trialists |
Organisation | University of Oxford |
Department | Early Breast Cancer Trialists Collaborative Group Writing Committee |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Statistical analysis. Preparartion of report |
Collaborator Contribution | Individual patient data meta-analysis |
Impact | none yet |
Start Year | 2016 |
Description | Sentinel Node Breast Cancer Trialists |
Organisation | Derby Teaching Hospitals NHS Foundation Trust |
Country | United Kingdom |
Sector | Public |
PI Contribution | None yet |
Collaborator Contribution | The trialists in the collaboration will provide data as part of an EBCTCG meta-analysis |
Impact | n/a |
Start Year | 2017 |
Description | Sentinel Node Breast Cancer Trialists |
Organisation | German Medical Group |
Country | Germany |
Sector | Private |
PI Contribution | None yet |
Collaborator Contribution | The trialists in the collaboration will provide data as part of an EBCTCG meta-analysis |
Impact | n/a |
Start Year | 2017 |
Description | Sentinel Node Breast Cancer Trialists |
Organisation | Karolinska Institute |
Country | Sweden |
Sector | Academic/University |
PI Contribution | None yet |
Collaborator Contribution | The trialists in the collaboration will provide data as part of an EBCTCG meta-analysis |
Impact | n/a |
Start Year | 2017 |
Description | Sentinel Node Breast Cancer Trialists |
Organisation | Leeds Teaching Hospitals NHS Trust |
Country | United Kingdom |
Sector | Public |
PI Contribution | None yet |
Collaborator Contribution | The trialists in the collaboration will provide data as part of an EBCTCG meta-analysis |
Impact | n/a |
Start Year | 2017 |
Description | Sentinel Node Breast Cancer Trialists |
Organisation | San Raffaele Hospital |
Country | Italy |
Sector | Hospitals |
PI Contribution | None yet |
Collaborator Contribution | The trialists in the collaboration will provide data as part of an EBCTCG meta-analysis |
Impact | n/a |
Start Year | 2017 |
Description | St Jude's Children Research Hospital |
Organisation | St Jude Children's Hospital |
Country | United States |
Sector | Hospitals |
PI Contribution | academic collaboration |
Collaborator Contribution | Development of joint projects on the late effects of cancer treatment in children, These projects form the basis of a fellowship application for Marianne Aznar and contribute to her development as an established scientist |
Impact | none yet |
Start Year | 2020 |
Description | University of Florida |
Organisation | University of Florida |
Country | United States |
Sector | Academic/University |
PI Contribution | We have provided expert review of contouring and developed methods to predict late effects of radiation. |
Collaborator Contribution | UFTPI contributed radiotherapy for data analysis |
Impact | none yet |
Start Year | 2015 |
Description | University of Texas |
Organisation | University of Texas |
Department | M. D. Anderson Cancer Center |
Country | United States |
Sector | Academic/University |
PI Contribution | academic collaboration |
Collaborator Contribution | provision of retrospective dosimetry and provide doses for case/cohort studies involving over 300 survivors of Hodgkin Lymphoma |
Impact | Dose-Response Relationships for Radiation-Related Heart Disease: Impact of Uncertainties in Cardiac Dose Reconstruction Authors Georgios Ntentas, Sarah C Darby, Marianne C Aznar, David C Hodgson, Rebecca M Howell, Maja V Maraldo, Sameera Ahmed, Angela Ng, Berthe MP Aleman, David J Cutter Radiotherapy and Oncology, Volume 153, December 2020, Pages 155-162 |
Start Year | 2017 |
Description | University of Toronto |
Organisation | University of Toronto |
Country | Canada |
Sector | Academic/University |
PI Contribution | Analysed the data |
Collaborator Contribution | PMCC contributed radiotherapy data for analysis. |
Impact | G. Ntentas, M.C. Aznar, D. Hodgson, S.C. Darby, S. Ahmed, A. Ng, D. Cutter. Cardiac Radiation Dose Reconstruction in the Study of Late Effects: A Comparison of Different Methods. ASTRO 59 (September 2017), San Diego, USA. IJROBP Vol. 99, Issue 2, E635 G. Ntentas, M.C. Aznar, D. Hodgson, S.C. Darby, S. Ahmed, A. Ng, D. Cutter. Cardiac Radiation Dose Reconstruction in the Study of Late Effects: A Comparison of Different Methods ESTRO 37 (April 2018), Barcelona, Spain. EP-2004. Clinical intensity-modulated proton therapy for Hodgkin lymphoma: which patients benefit the most? Ntentas G, Dedeckova K, Andrlik M, Aznar MC, George B, Kubeš J, Darby SC, Cutter DJ. Pract Radiat Oncol. 2019 May;9(3):179-187 Dose-Response Relationships for Radiation-Related Heart Disease: Impact of Uncertainties in Cardiac Dose Reconstruction Authors Georgios Ntentas, Sarah C Darby, Marianne C Aznar, David C Hodgson, Rebecca M Howell, Maja V Maraldo, Sameera Ahmed, Angela Ng, Berthe MP Aleman, David J Cutter Radiotherapy and Oncology, Volume 153, December 2020, Pages 155-162 |
Start Year | 2016 |
Description | Annual National Oncology Team of the Year |
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 | David Dodwell is a judge for the Annual National Oncology team of the year award sponsored by the British Medical Organisation. (May 2018 - ongoing) |
Year(s) Of Engagement Activity | 2018 |
Description | British Breast Group |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Carolyn Taylor is a member of this group which meets twice per year to exchange breast cancer research ideas. 2015-present |
Year(s) Of Engagement Activity | 2015 |
Description | Council of Cardio-Oncology of the European Society of Cardiology |
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 | Marianne Aznar and Sarah Darby became members of the European Society of Cardiology's Council of Cardio-Oncology. This group, which was founded in August 2018 as a multidisciplinary constituent body to encourage the prevention, early diagnosis and management of cancer therapy-related cardiovascular diseases. Its aims are to bring together European & non-European specialists in the field and specialists from Oncology, Hematology, Radiotherapy and related disciplines to enhance the knowledge and the standard of care for Cardio-Oncology patients. |
Year(s) Of Engagement Activity | 2018 |
Description | Council of the International Lymphoma Radiation Oncology Group |
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 | Marianne Aznar became a member of the Council for this Group in 2018. |
Year(s) Of Engagement Activity | 2018 |
Description | Europa Donna |
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 | International. European Breast Cancer Coalition involving 47 member countries. Regular meetings with Elizabeth Bersten Nordstrom and Tanja Spanic. Elizabeth was previously president and Tanja is now current president of Europa Donna. They provide patient input to our ongoing research. |
Year(s) Of Engagement Activity | 2017 |
URL | https://www.europadonna.org/ |
Description | European Organisation for Research and Treatment of Cancer (EORTC) Radiotherapy Quality Assurance (RT-QA) group. |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Marianne Aznar became a member of the EORTC RT-QA group in 2018. Its purpose is to develop guidelines for quality assurance in clinical oncology trials, especially those involving new technologies such as proton therapy and the MR-linac. |
Year(s) Of Engagement Activity | 2018 |
Description | In2ScienceUK |
Form Of Engagement Activity | A broadcast e.g. TV/radio/film/podcast (other than news/press) |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | Rebecca Shakir mentored on the In2scienceUK programme, August 2020 |
Year(s) Of Engagement Activity | 2020 |
Description | Independent Cancer Patients' Voice |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | Regular meetings with patient representatives from the organisation Independent Cancer Patients' Voice who provide consumer input to our ongoing research. |
Year(s) Of Engagement Activity | 2018 |
Description | Media coverage following NEJM publication: increase in heart disease risk following radiotherapy treatment for cancer |
Form Of Engagement Activity | A magazine, newsletter or online publication |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Media (as a channel to the public) |
Results and Impact | US CBS news website: http://www.cbsnews.com/news/radiation-for-breast-cancer-may-raise-heart-disease-risk-for-women/ Increased awareness amongst patients and oncologists of the increased risk of heart disease in cancer patients who receive radiotherapy. |
Year(s) Of Engagement Activity | 2013 |
Description | Media interview, BBC Radio4 |
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 | Public/other audiences |
Results and Impact | July 17 Carolyn Taylor. Interview on BBC 4 "Inside Health" on "Radiotherapy and smoking". |
Year(s) Of Engagement Activity | 2017 |
URL | http://www.bbc.co.uk/programmes/b08yp16p |
Description | National Audit of Breast Cancer in Older Patients [NABCOP]. |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | David Dodwell is the lead oncologist on NABCOP. NABCOP is a national clinical audit commissioned by the Healthcare Quality Improvement Partnership (HQIP) to support NHS providers to improve the quality of hospital care for older patients with breast cancer. This has been achieved by publishing information about the care provided by all NHS hospitals that deliver breast cancer care in England and Wales and addressing treatment variation. Date 2018-ongoing |
Year(s) Of Engagement Activity | 2018 |
Description | National Cancer Research Institute Breast cancer Clinical Studies Group |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Carolyn Taylor is a member of this multidisciplinary group of ~40 breast cancer professionals which meets three times per year to coordinate UK trials in breast cancer and to inform priorities, funding and education. 2015-present |
Year(s) Of Engagement Activity | 2015 |
Description | Pennsylvania Breast Cancer Coalition |
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 | Regular meetings with Pat Halpin-Murphy, President of the Pennsylvania Breast Cancer Coalition who provides patient input to our ongoing research. |
Year(s) Of Engagement Activity | 2019 |
URL | https://www.pabreastcancer.org/ |
Description | Radiotherapy Information Strategy Group and the Clinical Working Group |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | David Cutter became a member - and the CTRad Representative - of this group which has been formed to improve the routine collection of radiotherapy data and to facilitate its use in improving services, clinical outcomes and research. Date 2018- |
Year(s) Of Engagement Activity | 2018 |
Description | Secretariat of the Early Breast Cancer Trialists' Collaborative Group |
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 | The EBCTCG is based in the Nuffield Department of Population Health. It brings together the worldwide randomised data in early breast cancer. The resulting analyses influence breast cancer guidelines worldwide. Carolyn Taylor and David Dodwell are leading on clinical input in meta-analyses of treatments for DCIS, axillary management, radiotherapy fractionation partial breast radiotherapy, sequencing of radiotherapy and chemotherapy and regional nodal irradiation. 2004-present These outputs are being developed. |
Year(s) Of Engagement Activity | Pre-2006,2006 |
Description | Survivors Day, Guy's Cancer Charity |
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 | Public/other audiences |
Results and Impact | Georgios Ntentas volunteered to explain to patients how Radiotherapy works with interactive workshops and tours of the department |
Year(s) Of Engagement Activity | 2020 |
Description | Twitter journal club |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Other audiences |
Results and Impact | The following publication was the subject of a twitter journal club on 24th January 2016. Taylor, CW, Kirby AM. Cardiac side-effects from breast cancer radiotherapy. Clin Oncol 2015;27:621-9. It had participation from the USA, Canada, Australia, Singapore, Saudi, UK and Spain During the day there 465,000 page impressions (ie delivered tweets). Over the week that we first mentioned the journal club there were 1.6 million page impressions with 616 tweets from 180 participants with a big surge over Sunday 24th January |
Year(s) Of Engagement Activity | 2014 |
Description | UK Breast Cancer Group |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Carolyn Taylor is a member of this national group of breast oncologists which meets annually for breast cancer research updates, and to discuss guidelines. 2015-present |
Year(s) Of Engagement Activity | 2015 |
Description | Visit from Independent Cancer Patients' Voice |
Form Of Engagement Activity | Participation in an open day or visit at my research institution |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Patients, carers and/or patient groups |
Results and Impact | Visit from Independent Cancer Patients' Voice representatives to the unit Monday 9th October. Ongoing intellectual input from them in meetings and teleconferences. |
Year(s) Of Engagement Activity | 2017 |