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Claire Fletcher

I am studying for a PhD part time while working in the Radiotherapy department for University Hospitals Coventry and Warwickshire NHS trust (UHCW).

PHD Project Title: Development of cone beam computed tomographic biomarkers for lung radiotherapy

Project Supervisors: Dr Jon Duffy and Dr Jane Rogers

Project Summary:

Radical radiotherapy is commonly used for inoperable, non-metastatic lung or oesophageal cancers, and radiation-induced lung damage is recognised as a complication. The radiotherapy treatment usually delivered in the UK consists of 55 Gy in 20 fractions. A cone beam CT (CBCT) is performed immediately prior to each treatment fraction to position the patient accurately. During the course of treatment, a variety of changes are frequently seen in the either the tumour or lung, but such changes do not usually lead to any adaptation of radiotherapy treatments at present

This project will use CBCT data of patients treated at University hospitals Coventry to correlate patient outcomes with changes in CBCT images during the treatment course.

The aim of the project is to determine parameters which can be further investigated clinically to potentially adapt radiotherapy during the course of patient treatments to reduce toxicities and/or increase tumour control.



Radiotherapy: The destruction of cancerous cells with high energy (megavoltage, MV) x-rays

Fractionation: Radiotherapy treatments are delivered in a number of small fractions in order to allow normal healthy tissues to recover while maximising destruction of cancerous cells

Planning CT: Before treatment by radiotherapy a patient will be given a planning CT scan in order that the treatment can be planned using computer software (a planning system)

Adaptive Radiotherapy: Patients can be re-planned based on changes occurring over treatment, for example tumour shrinkage

Cone Beam CT: CBCT uses a cone shaped kilovoltage (kV) x-ray beam and 2D detectors (instead of the usual fan shaped x-ray beam and 1D detectors used in conventional CT scans), this allows volume images to be acquired with just one rotation of the x-ray gantry