A5033108955- Bladder and Urothelial Cancer Treatments
- Advanced Radiotherapy Techniques
- Urinary and Genital Oncology Studies
- Radiomics and Machine Learning in Medical Imaging
- Prostate Cancer Diagnosis and Treatment
- Lung Cancer Diagnosis and Treatment
- MRI in cancer diagnosis
- Medical Imaging Techniques and Applications
- Prostate Cancer Treatment and Research
- Advances in Oncology and Radiotherapy
- Hepatocellular Carcinoma Treatment and Prognosis
- Urological Disorders and Treatments
- Esophageal Cancer Research and Treatment
- Cancer Diagnosis and Treatment
- Cancer Immunotherapy and Biomarkers
- Radiation Therapy and Dosimetry
- Advanced MRI Techniques and Applications
- Renal cell carcinoma treatment
- Radiation Dose and Imaging
- Effects of Radiation Exposure
- Cancer Research and Treatments
- Urinary Bladder and Prostate Research
- Radiopharmaceutical Chemistry and Applications
- Pneumocystis jirovecii pneumonia detection and treatment
- Colorectal Cancer Surgical Treatments
Royal Marsden NHS Foundation Trust
2015-2025
Institute of Cancer Research
2015-2024
Royal Marsden Hospital
2011-2023
National Health Service
2016-2022
Sutton Hospital
2020
National Institute for Health Research
2020
NIHR Biomedical Research Centre at The Royal Marsden and the ICR
2020
Institute of Cancer Research
2017
The Maria Sklodowska-Curie National Research Institute of Oncology
2015
Sindh Institute of Urology and Transplantation
2001-2003
Purpose: MR-guided Radiation Therapy (MRgRT) allows for high-precision radiotherapy under real-time MR visualization. This enables margin reduction and subsequent dose escalation which may lead to higher tumor control less toxicity. The Unity MR-linac (Elekta AB, Stockholm, Sweden) integrates a linear accelerator with 1.5T diagnostic quality MRI an online adaptive workflow. A prospective international registry was established facilitate the evidence-based implementation of into clinical...
There is currently significant interest in the potential benefits of combining radiation and immune checkpoint blockade (ICB) to stimulate both regional distant abscopal responses. In melanoma lung cancer, patients who have received therapy during ICB appear prolonged survival. The PLUMMB trial (Pembrolizumab Muscle-invasive/Metastatic Bladder cancer) (NCT02560636) a phase I study test tolerability combination weekly with pembrolizumab metastatic or locally advanced urothelial cancer...
Technological advancement has facilitated patient-specific radiotherapy in bladder cancer. This been made possible by developments image-guided (IGRT). Particularly transformative the integration of volumetric imaging into workflow. The ability to visualise target using cone beam computed tomography and magnetic resonance initially assisted with determining magnitude inter- intra-fraction change. It led greater confidence ascertaining true anatomy at each fraction. increased certainty dose...
Purpose and ObjectivesWe report on the clinical outcomes of a phase 2 study assessing image guided hypofractionated weekly radiation therapy in bladder cancer patients unsuitable for radical treatment.Methods MaterialsFifty-five with T2-T4aNx-2M0-1 not suitable cystectomy or daily treatment were recruited. A "plan day" approach was used, treating whole (empty) to 36 Gy 6 fractions. Acute toxicity assessed during therapy, at 12 weeks using Common Terminology Criteria Adverse Events version...
Image guided adaptive radiation therapy offers individualized solutions to improve target coverage and reduce normal tissue irradiation, allowing the opportunity increase tumor dose spare bladder tissue.
Background Ultra-hypofractionated radiotherapy (UHRT) is an effective treatment for localised prostate cancer with acceptable toxicity profile; boosting the visible intraprostatic tumour has been shown to improve biochemical disease-free survival no significant impact on genitourinary and gastrointestinal toxicity1,2. Methods HERMES a single centre non-comparative randomised phase II trial in men intermediate or lower high risk cancer. Patients were allocated (1:1) 36.25 Gray (Gy) 5...
In 2018, the first online adaptive magnetic resonance (MR)-guided radiotherapy (MRgRT) system using a 1.5-T MR-equipped linear accelerator (1.5-T MR-Linac) was clinically introduced. This enables radiotherapy, in which radiation plan is adapted to size and shape changes of targets at each treatment session based on daily MR-visualized anatomy.
Delivering radiotherapy to the bladder is challenging as it a mobile, deformable structure. Dose-escalated adaptive image-guided could improve outcomes. RAIDER aimed demonstrate safety of such schedule.
756 Background: The objective of the PLUMMB trial (NCT02560636) was to assess safety, tolerability and efficacy addition anti-PD1 antibody Pembrolizumab with hypofractionated weekly bladder radiotherapy (RT) in patients advanced/metastatic cancer. We present final results, subject database lock statistical QC. Methods: aimed recruit 28 planned for RT a dose escalation phase (modified 3+3) 7 cohorts determine primary endpoint maximum tolerated (MTD), expansion answer secondary endpoints:...
Objective: The implementation of plan the day selection for patients receiving radiotherapy (RT) bladder cancer requires efficient and confident decision-making. This article describes development a training programme maintenance competency. Methods: Cone beam CT (CBCT) images acquired on RT were assessed to establish baseline competency needs. A was implemented, observers asked select planning target volumes (PTVs) two groups 20 patients' images. After clinical implementation, PTVs chosen...
Whole bladder magnetic resonance image-guided radiotherapy using the 1.5 Telsa MR-linac is feasible. Full online adaptive planning workflow based on anatomy seen at each fraction was performed. This delivered within 45 min. Intra-fraction filling did not compromise target coverage. Patients reported acceptable tolerance of treatment.
<h3>Purpose</h3> Hypofractionated radiation therapy can be used to treat patients with muscle-invasive bladder cancer unable have radical therapy. Toxicity is a key concern, but adaptive plan-of the day (POD) image-guided delivery could improve outcomes by minimizing volume of normal tissue irradiated. The HYBRID trial assessed multicenter implementation, safety, and efficacy this strategy. <h3>Methods</h3> Phase II randomized that was conducted at 14 UK hospitals. Patients T2-T4aN0M0...
Abstract Background: Radiotherapy for muscle invasive bladder cancer (MIBC) aims to offer organ preservation without oncological compromise. Neo-adjuvant chemotherapy provides survival advantage; response may guide patient selection and identify those most likely have favourable result with radiotherapy. Methods: Ninety-four successive patients T2-T4aN0M0 treated between January 2000 June 2011 were analysed at the Royal Marsden Hospital. Patients received platinum-based following...
Introduction Daily radiotherapy delivered with radiosensitisation offers patients muscle invasive bladder cancer (MIBC) comparable outcomes to cystectomy functional organ preservation. Most recurrences following occur within the bladder. Increasing dose tumour may further improve local control. Developments in image-guided have allowed tumour-focused ‘plan of day’ delivery. We aim test a randomised multicentre phase II trial whether this technique will enable escalation acceptable rates...
Introduction Patients with muscle invasive bladder cancer (MIBC) who are unfit and unsuitable for standard radical treatment cystectomy or daily radiotherapy present a large unmet clinical need. Untreated, they suffer high specific mortality risk significant disease-related local symptoms. Hypofractionated (delivering higher doses in fewer fractions/visits) is potential solution but could be compromised by the mobile nature of bladder, resulting target misses proportion fractions. Adaptive...