Developing a technique to measure levels of tumour hypoxia during proton beam therapy through gamma-ray spectroscopy

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Around 50% of patients receive radiotherapy as part of their cancer treatment. One of the most important factors influencing clinical outcome, following radiotherapy, is tumour hypoxia. Low oxygen levels (hypoxia), is a characteristic of the tumour microenvironment which drives increased metastatic potential and confers resistance to radiotherapy, decreasing overall survival. However, even with advances in radiotherapy, including a move towards proton beam therapy (PBT), hypoxia-mediated radio-resistance is a complexity that remains. This project aims to develop a technique to measure oxygen levels, and consequently hypoxia, in tumours treated with PBT in real time. During PBT, dose is deposited in tissue by both the ionisation of atomic electrons and proton interactions with the atomic nuclei. This project takes a multidisciplinary approach to harness the naturally produced radiation during PBT to measure hypoxia. Real time measurement of hypoxia during treatment will inform adaptive therapy where radiation dose can be escalated to overcome hypoxic radio-resistance during fractionated treatment planning.