Advanced Radiotherapy Network + (ARN+) extension

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

Abstract

In the UK, one in two people will be diagnosed with cancer during their lifetime and of those who survive, 41% can attribute their cure to a treatment including radiotherapy. Radiotherapy is very cost effective, accounting for only 6% of the total cost of cancer care in the UK.
In radiotherapy the way the radiation dose is delivered and conformed to the tumour uses a treatment plan, which is based around a CT scan of the patient and their tumour. The treatment plan uses beams of radiation at different angles, to maximise the dose (and damage) to the tumour and to minimise the damage to the surrounding healthy tissue. Constraints are also applied for "organs at risk" which are often more sensitive to radiation and so require the dose to be as low as possible. Radiotherapy is normally delivered in fractions, with a fraction being typically 1-2 Gy. A course of radiotherapy is typically 1 fraction every week-day over a period of 4-6 weeks.

Radiotherapy seeks to maximise the damage to the tumour (to sterilise it) while minimising the damage to the surrounding healthy tissue (to reduce side effects). In recent years radiotherapy has developed rapidly with the development of new machines and methodologies. These in turn, have resulted in better imaging, treatment planning and dosimetry, which enable the dose to be more accurately delivered and conformed to the tumour. This has resulted in better cancer survival and reduced side effects for patients. However, to maintain this rate of advancement and deliver even better treatments for patients we require innovation and solutions to the challenges, which still confront advanced RT.

This is exactly where the STFC community can make an enormous impact, working in partnership with the clinical community, as they together they have exactly the skill set which is needed to effectively tackle these new challenges as they arise. In addition, the latest developments in radiotherapy - such as MR-linacs and proton therapy - evidence the need for the STFC community to work in partnership with the clinical community and commercial partners. If the UK is to remain competitive and deliver even better treatments for patients, and produce income and impact for the UK economy, it can no longer rely on serendipitous partnerships. This is what this Advanced Radiotherapy Network + (ARN+) seeks to address. Working actively with the clinical community through the National Cancer Research Institute (NCRI) Clinical and Translational working group on Radiotherapy (CTRad) it has been able to establish a new community drawn from across STFC with clinicians and clinical scientists from the NHS.

This application is an extension of an existing successful ARN + and is aimed at both consolidating the success of the ARN+ and taking it one step further by developing a global dimension for its activities by working with the IAEA. It also seeks to showcase its activities to industry and develop a pipeline of innovation to the clinic. Finally it looks to work with STFC within the framework of UK Research and Innovation to build a national consensus, research roadmap and funding strategy in the field of Advanced Radiotherapy.

Planned Impact

The Advanced Radiotherapy Network (ARN+) was designed to bring the clinical radiotherapy and STFC communities together and to develop synergies and research collaboration between them. ARN+ has been successful and now seeks to build on this success and translate its research for patient benefit by actively working with industry and the NHS. In this extension to ARN+ it seeks to further engage with industry to take the research initiated in ARN+ up the technology readiness levels.
Global Impact In ARN+ extension, ARN+ also seeks to work with the IAEA to expand the international scope of its activities and to work together with the developing world to come up with solutions to some of the problems they currently face. Key to this approach is listening and testing understanding, so that the solutions proposed are fit for purpose. We will also work with industry to ensure that the work of ARN+ both complements what is already available and has a route for exploitation.
Academic impact arising from ARN+ activities and pump-priming projects will be realised through joint grant applications (across the Research Councils and Innovate UK) and will be fostered by the work, which will be done with STFC on providing a framework and roadmap for radiotherapy research. Research outputs will be another output as will the 3 PhD students, who are 50% funded through ARN+, and who will submit and graduate during ARN+ extension.
Economic Impact will arise from translating ARN+ activities up the technology readiness levels and engaging stakeholders from public and private sectors in ARN+ Showcase events. The Knowledge Hub on the new ARN+ web site will be designed so that it takes potential industrial partners quickly to the information they need and will also highlight where ARN+ has already been successful in industrial collaborations. Knowledge Exchange will be facilitated by a number of the ARN+ activities. ARN + will work closely with the Innovations Directorate, the Innovation Partnership Scheme (IPS) Fellows and STFC Innovations Ltd (based in Harwell). The Impact Sandpit (in Jan 2019) carried out through the existing ARN+ will also provide a forum for highlighting ARN+ research and the opportunities for its translation up the technology readiness levels.
Societal Impact will arise from continuing to have patient and carer representation on ARN+ through close collaboration with NCRI CTRad. From the outset ARN+ has tried to ensure that the patient voice and their views are central to ARN+ and this will continue in ARN+ extension. The ARN+ Knowledge Hub will also provide information for patents and carers, which has been generated by working closely with focus groups (of patients and carers) and Charities.
Policy Makers: The ARN+ extension will allow ARN+ in partnership with NCRI CTRad to work with STFC within the framework of UK Research and Innovation to build a national consensus, research roadmap and funding strategy in the field of Advanced Radiotherapy. This will involve working with key stakeholders including government, NHS, UK Research and Innovation, industry and Charities. In this way ARN+ can impact on national policy and use its Knowledge Hub to promote its activities and outcomes to the wider community.

Publications

10 25 50