Introduction: Clinical and translational approaches to radiotherapy


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Gillie McKenna1
1Gray Institute for Radiation Oncology & Biology, University of Oxford, Oxford, UK

Abstract

Developments in radiotherapy, such as IMRT and IGRT, in the last twenty years have been driven by advances in imaging, but in current practice, the information from imaging is still largely anatomic rather than functional. However, while these methods give accurate information about the larger areas of tumour, they often fail to identify metastases, both distant and lymphatic. They also fail to provide any information about the biology or physiology of the tumour, the major determinants of treatment outcome. FDG-PET and a number of developments of MR, and ultrasound have begun to enable imaging to move beyond mere anatomical localization and give some information about tumour properties other than mass. In the next few years, imaging will continue to advance rapidly to enable assessment of metabolism, vascularity, microenvironment, host cell infiltration, proliferation, signalling, oxygenation, apoptosis, and molecular and genetic signatures. How we will incorporate such information in radiotherapy planning is far from clear. This session will cover three areas: developments in pre-clinical imaging that are likely to lead to new methods for interrogating tumours, the use of currently available techniques to plan radiotherapy treatment and the use of information from imaging to predict the outcome of therapy. As we move to more and more conformal methods of treatment, including particle therapy, the accuracy of the information we derive from imaging will become ever more vital to improving the outcome of radiotherapy. This session should give some insights into where the field is likely to go.