CUTTING edge radiotherapy technology is enabling some cancer patients in the west of Scotland to dramatically cut their radiation exposure in a move that clinicians believe will lead to better survival rates.
The Beatson cancer centre in Glasgow is the first in the world to prepare highly complex radiotherapy treatment plans for patients in a matter of minutes using new software, called multi-criteria optimisation (MCO).
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Previously, it would take physicians more than a day to draw up a single plan manually, but as many as 50 individualised plans can now be generated in minutes.
Garry Currie, head of radiotherapy physics at NHS Greater Glasgow and Clyde, said this would have been "unthinkable" a few years ago.
He said: “I didn’t expect us to reach this stage during my career. Our work never stands still; however this is a real game changer.
“As recently as 2010, staff would start work on just one treatment plan and come back in the next day – including weekends – to finish the calculations."
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Around 200 patients a month are already benefitting from the new way of working, which also allows the medics to blast tumours with the highest possible dose of radiation within an incredibly tight margin of exposure, meaning that radiation to nearby healthy tissue by 20-30 per cent and more for organs further away.
In highly complex cases, such as patient requiring radiation to their entire central nervous system - from the brain to the base of the spine - the team have found that increasing radiation to the eye area by a harmless two per cent delivered a more than 50 per cent reduction in radiation to the heart, significantly cutting the patient's risk of cardiac arrest in future.
Mr Currie said: "A human being would never be able to achieve those sorts of calculations."
He said the team were amazed at the trade-offs in radiation available using the computer-generated plans.
He said: "Where we are treating a patient with a tumour in the pancreas, we can instantly assess the impact the plan would have on the dose delivered to either kidney and select the optimal balance in dose for that patient.
“We’re at the forefront of this work; however the results will continue to improve as more cancer centres start working in the same way and more and more collaborations take place.”
This new system works in combination with US-developed artificial intelligence software called RapidPlan and HyperArc, which the Beatson first deployed in September 2017.
They use mathematical algorithms weigh up the risks of various treatment options and sift through a vast amount of complex data much faster than the human brain ever could.
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HyperArc - which is only available in a handful of cancer centres worldwide - designs radio-surgery for patients with brain tumours.
As well as helping to deliver precision radiation to lesions with minimal damage to healthy brain tissue, it dramatically cuts the treatment time from 90 minutes to four minutes.
A Phase 2 clinical trial in Japan has just reported a 60 per cent increase in life expectancy for patients treated using HyperArc. To date, 60 patients at the Beatson have benefitted.
The Beatson team are also keen to establish a clinical trial to assess the impact of RapidPlan-guided radiotherapy on patients with mesothelioma, a highly-deadly form of lung cancer linked to asbestos exposure.
Scotland has the highest incidence in the world, but the clinicians believe the new radiation technique could offer a cure for some patients.
Clinical scientific lead, Susie Currie, said: "Previously doses had to be limited because of the risk of harm to other organs in and around the chest cavity.
"Now, where one lung is very damaged it's possible to treat that with a very high dose with almost no radiation exposure to neighbouring lung or organs.
"That's where we're looking to see better survival, so we are looking at clinical trials for that."
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