Exploring novel solutions of radiotherapy delivery and using biology, imaging, new fractionations and radiobiological models to improve TCP/NTCP ratio

如果不能进行手术，上消化道（食道、胰腺）的癌症预后较差。根治性放疗联合化疗是治疗的标准，然而，大量患者在放疗领域出现肿瘤复发。在过去，增加放射治疗剂量会引起严重的毒性。现在，放射治疗的一些技术进步允许使用功能成像（如MRI和PET）进一步个性化治疗，以指导需要更多放射治疗的区域或集中放射治疗（如立体定向消融放射治疗）该研究的目的是进一步个性化放射治疗的方式，使用个人特有的特征，患者和/或肿瘤。在实验室中已被证明可以增强辐射的新药将与辐射结合，以进一步增强肿瘤杀伤力。在临床实践中的最终影响将是改善局部肿瘤控制和减少辐射引起的毒性。

Cancers of the upper gastro-intestinal tract (oesophagus, pancreas) have a poor outcome if surgery cannot be undertaken. Radical radiotherapy combined with chemotherapy are the standard of care, however a significant number of patients have tumour recurrence in the radiotherapy field. In the past increasing radiotherapy dose caused severe toxicity. There are now several technological advances in radiotherapy that permits further individualization of treatment using either functional imaging such as MRI and PET to guide the areas that need more radiotherapy or focused radiotherapy (such as Stereotactic ablative radiotherapy) to areas of tumour that cannot be removed by surgery.The aim of the research is to further personalise the way radiotherapy is delivered using characteristics specific to an individual patient and/or tumour. Novel drugs that have been shown in laboratory to enhance radiation will be combined with the radiation to further enhance tumour kill. The ultimate impact in clinical practice would be improvement in local tumour control and reduction in toxicity caused by radiation.