Dose Painting Project (2015-2018)
The Bristol Dose Painting Study
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VMAT device and software used to calculate the dose to the
patient so the tumour gets the highest dose whilst limiting the
dose to the surrounding tissues |
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This figure shows the dose distribution around the tumours and
surrounding tissue. |
This study is a collaboration between Medical Physics and
Oncology staff at UHBW (University Hospitals Bristol and Weston NHS
Foundation Trust) and NBT (North Bristol NHS Trust), and CRIC
Bristol, with support from Above & Beyond.
This study is to determine if a technique known as dose
painting is feasible. Dose painting involves boosting the dose of
radiation to tumours presenting as isolated nodules without
increasing the dose to the surrounding healthy tissues, focusing on
the prostate. The study focusses on the prostate because prostate
tumours tend to be close to healthy tissues such as the bladder,
rectum and urethra, and if you increase the dose to the whole
prostate this leads to higher rates of toxicity in the normal
tissues, so if dose painting is a feasible technique we could
reduce reoccurrence rate without decreasing quality of
life.
20 patients participated in this study, and MRI scans were
obtained for 19 of them. Of these, 14 had these isolated nodules
and 6 of those were able to receive the elevated dose, whilst in 6
of the 8 remaining they received a limited elevated dose due to
their position close to the urethra. In the other 2 patients there
were registration issues due to changes in their internal
anatomy.
This study has been very helpful in identifying the issues
involved in implementing this technique and current results are
positive regarding the feasibility of using dose painting in
Bristol. In the future the plan is to enter a clinical trial
involving dose painting, as currently this study has successfully
delivered an elevated dose to the tumour with no difference in
toxicity and quality of life between standard treatment and using
dose painting.
For more information on the study click here.