CUH

Radiotherapy physics

Medical physics

Box: 152

Cambridge University Hospitals NHS Foundation Trust

Hills Road,

Cambridge,

CB2 0QQ

 

Enquiries: 01223 216 472

Fax: 01223 257 137

 

Radiotherapy physics provides a comprehensive physics service to the Addenbrooke’s radiotherapy centre ensuring the safe and accurate use of high dose ionising radiation to treat patients with cancer, whilst maintaining a safe environment for other patients, visitors and staff.

 

Physicists, technicians and radiographers work closely with oncology staff to provide a wide range of scientific and technical advice and support for all radiotherapy treatments. Routine clinical work includes radiotherapy treatment planning and related dosimetry the provision of brachytherapy, and the manufacture of  immobilisation and shielding equipment for patients. Extensive support is provided to radiotherapy equipment. This incorporates the design of facilities; the management of computer systems, the design and management of software; and the commissioning, servicing and quality control of linear accelerators, orthovoltage  units, brachytherapy units and CT scanners.  All our work and related dosimetry are monitored and assured to nationally and internationally agreed specifications and legal requirements.

 

We are involved in research and development in radiotherapy physics, and have PhD students from the University of Cambridge based in our department.

 

We are also responsible for providing radiotherapy physics advice and support to two University Departments (Veterinary Medicine and Pathology). 

 

 

Addenbrooke’s

Linacs:

  • 1 Elekta Synergy (6MV + electrons )
  • 2 TomoTherapy Hi-Arts
  • 2 Siemens Oncor (6MV and 15MV, plus electrons 6MeV – 21MeV)
  • 2 Siemens Primus (6MV and 15MV, plus electrons 6MeV – 21MeV)
  • 1 Siemens Primus (single energy 6MV)

Other equipment:

  • Nucletron HDR brachytherapy
  • Nucletron Seed Selectron
  • Pantak DXT300
  • MOSAIQ (radiotherapy management system)

Elsewhere

  • Varian Clinac 1800C at Vet school

 

 

Planning systems

  • Pinnacle
  • CMS Xio
  • TomoTherapy
  • Addenbrooke’s Radiotherapy Planning System (ARPS)
  • ProSoma (outlining and virtual simulation)
  • Various Nucletron Brachy planning systems

 

 

Imaging systems

  • Toshiba Aquilon wide-bore CT scanner
  • GE Nxi CT scanner
  • Pips Pro
  • Acculoc (gold seed system)

 

 

Areas of interest

  • Benefits and detriments of Image Guided Radiotherapy.
  • Sources of Uncertainty in Radiotherapy.
  • Integration of 4DCT and PET-CT into treatment planning
  • Development of novel treatment planning techniques
  • Modelling of radiotherapy capacity and demand.
  • Proton therapy planning
  • Voxel tracking to investigate link between dose and toxicity.

 

 

Courses

 

Fundamentals of Radiotherapy Planning

 

This course has been run since 2000. The last one was run 21-23 November 2011. The next one is scheduled for 12-14 November 2012, at the Moller Centre in Cambridge. Further details, are on the RCR web site.

 

> RCR Events

 

 

Recent publications

Authors from Addenbrooke’s Radiotherapy physics are underlined

 

Published papers

Thomas SJ,  Eyre KR, Tudor GSJ and Fairfoul J.  Dose calculation software for helical tomotherapy, utilizing patient CT data to calculate an independent three dimensional dose cube. Medical physics 2012 Vol. 39, No. 1, 160-167

Thomas SJ and Cowley I. A comparison of four indices for combining distance and dose differences.. Int J Radiat Oncol Biol Phys. Epub Feb 2012 http://dx.doi.org/10.1016/j.ijrobp.2011.11.009

Tudor GSJ, Cowen M, Rimmer Y and Thomas SJ "Consideration of the likely benefit from implementation of prostate image-guided radiotherapy using current margin sizes - a radiobiological analysis" British Journal of Radiology 2012 (Published online before print February 14, 2012, doi:10.1259/bjr/27924223)

Barnett GC, Wilkinson JS, Moody AM, Wilson CB, Twyman N, Wishart GC, Burnet NG, Coles CE.  The Cambridge Breast Intensity-modulated Radiotherapy Trial: Patient- and Treatment-related Factors that Influence Late Toxicity.

Clin Oncol (R Coll Radiol). 2011 Dec;23(10):662-73.

Barnett GC, Wilkinson JS, Moody AM, Wilson CB, Twyman N, Wishart GC, Burnet NG, Coles CE Randomized Controlled Trial of Forward-Planned Intensity-Modulated Radiotherapy for Early Breast Cancer: Interim Results at 2 Years. Int J Radiat Oncol Biol Phys. Volume 82, Issue 2,  1 February 2012 , Pages 715-723

Coles CEHarris EJDonovan EMBliss PEvans PMFairfoul JMackenzie CRawlings CSyndikus ITwyman NVasconcelos JVowler SL,Wilkinson JSWilks RWishart GCYarnold J. Evaluation of implanted gold seeds for breast radiotherapy planning and on treatment verification: a feasibility study on behalf of the IMPORT trialists. Radiother Oncol. 2011 Aug;100(2):276-81.

Donovan EM, Cuirlionis L, Fairfoul J, James H, Mayles H, Manktelow S, Raj S, Tsang Y, Twyman N, Yarnold J, Coles C. Planning With Intensity-Modulated Radiotherapy and Tomotherapy to Modulate Dose Across Breast to Reflect Recurrence Risk (IMPORT High Trial). Int J Radiat Oncol Biol Phys. 2011 79(4) 1064-1072

Loo H, Fairfoul J, Chakrabarti A, Dean JC, Benson RJ, Jefferies SJ, Burnet NG.  Tumour Shrinkage and Contour Change during Radiotherapy Increase the Dose to Organs at Risk but not the Target Volumes for Head and Neck Cancer Patients Treated on the TomoTherapy HiArt(TM) System. Clin Oncol (R Coll Radiol). 2011 23 (1) 40-47

Thomas SJ, Vinall A, Poynter A, Routsis D.  A Multicentre Timing Study of Intensity-modulated Radiotherapy Planning and Delivery.  Clin Oncol (R Coll Radiol). 2010 Oct;22(8):658-65.

Estall V, Fairfoul J, Jena R, Jefferies SJ, Burton KE, Burnet NG. Skull base meningioma - comparison of intensity-modulated radiotherapy planning techniques using the moduleaf micro-multileaf collimator and helical tomotherapy. Clin Oncol (R Coll Radiol). 2010 Apr;22(3):179-84.

Eaton D, Twyman N, Thomas S Commissioning a miniature multileaf collimator for small field radiotherapy. Med Dosim. 2010 Spring;35(1):1-6.

Estall VJ, Eaton D, Burton KE, Jefferies SJ, Jena R, Burnet NG Intensity-modulated radiotherapy plan optimisation for skull base lesions: practical class solutions for dose escalation. Clin Oncol (R Coll Radiol). 2010 May;22(4):313-20

Burnet NG, Adams EJ, Fairfoul J, Tudor GS, Hoole AC, Routsis DS, Dean JC, Kirby RD, Cowen M, Russell SG, Rimmer YL, Thomas SJ. Practical aspects of implementation of helical tomotherapy for intensity-modulated and image-guided radiotherapy. Clin Oncol (R Coll Radiol). 2010 May;22(4):294-312

Williams MV, Hoole AC, Dean JC, Russell SG, Thomas SJ, Fairfoul J, Burnet NG. IMRT can be faster to deliver than conformal radiotherapy. Radiother Oncol. 2010 May;95(2):257-8.

Jena R, Kirkby NF , Burton KE, Hoole AC, Tan LT, Burnet NG. A novel algorithm for the morphometric assessment of radiotherapy treatment planning volumes. Br J Radiol. 2010 Jan;83(985):44-51.

Houghton F, Benson RJ, Tudor GS, Fairfoul J, Gemmill J, Dean JC, Routsis DS, Jefferies SJ, Burnet NG.

An assessment of action levels in imaging strategies in head and neck cancer using TomoTherapy. Are our margins adequate in the absence of image guidance? Clin Oncol (R Coll Radiol). 2009 Nov;21(9):720-7.

Clark CH, Hansen VN, Chantler H, Edwards C, James HV, Webster G, Miles EA, Guerrero Urbano MT, Bhide SA, Bidmead AM, Nutting CM; PARSPORT Trial Management Group. Dosimetry audit for a multi-centre IMRT head and neck trial. Radiother Oncol. 2009 Oct;93(1):102-8

Barnett GC, Wilkinson J, Moody AM, Wilson CB, Sharma R, Klager S, Hoole AC, Twyman N, Burnet NG, Coles CE.

A randomised controlled trial of forward-planned radiotherapy (IMRT) for early breast cancer: Baseline characteristics and dosimetry results. Radiother Oncol. 2009 Jul;92(1):34-41

Nguyen TB, HooleACF, Burnet NG and Thomas SJ The optimization of intensity modulated radiotherapy in cases where the planning target volume extends into the build-up region. Phys. Me d. Biol. 54 (2009) 2511-2525

Nguyen TB, HooleACF, Burnet NG and Thomas SJ. Dose–volume population histogram: a new tool for evaluating plans whilst considering geometrical uncertainties. Phys. Me d. Biol. 54 (2009) 935–947

Tan LT, Coles CE, Hart C, Tait E. Clinical Impact of Computed Tomography-based Image-guided Brachytherapy for Cervix Cancer using the Tandem-ring Applicator - the Addenbrooke's Experience. Clin Oncol (R Coll Radiol). 2009 Apr;21(3):175-82.

 

Presentations/Posters

D. Routsis, J. Dean,J. Fairfoul J  FEASIBILITY OF DOSE DIFFERENCE ASSESSMENTS FOR ADAPTIVE RADIOTHERAPY IN ROUTINE PRACTICE WITH TOMOTHERAPY  (ESTRO Conference London 2011) Radiotherapy and Oncology 99(sup1)S101

S. Thomas, K. Eyre, S. Tudor, J. Fairfoul AN INDEPENDENT DOSE CALCULATION PROGRAM FOR THE CHECKING OF TOMOTHERAPY PLANS (ESTRO Conference London 2011) Radiotherapy and Oncology 99(sup1)S152

K. Eyre, D. Whitney, H. Chantler, C. Coles, C. OPTIMISATION OF MAMMOSITE BRACHYTHERAPYWilson2 (ESTRO Conference London 2011) Radiotherapy and Oncology 99(sup1)S254

D. Gregory, L. T. Tan, C. Coles, S. Brooke, D. Whitney PRELIMINARY RESULTS OF MRI -BASED IMAGE-GUIDEDBRACHYTHERAPY FOR CERVIX CANCER – THE ADDENBROOKE’S EXPERIENCE

 (ESTRO Conference London 2011) Radiotherapy and Oncology 99(sup1)S267

S. Tudor, Y. Rimmer, M. Cowen, S. Thomas A RADIOBIOLOGICAL CONSIDERATION OF LIKELY BENEFIT FROM IMPLEMENTATION OF PROSTATE IGRT WITHOUT MARGIN REDUCTION  (ESTRO Conference London 2011) Radiotherapy and Oncology 99(sup1)S472

Chantler HJ, Benson RJ, Burnet NG, Dean JC, Jefferies SJ, Rimmer YL, Russell SG, Thomas SJ, Tudor GS. The Relationship between PTV Margin, Imaging Frequency and Confidence of Target Coverage, for Prostate, and Head and Neck Radiotherapy. Clinical Oncology 2011 Apr;23:S18

Aslam S, Jena R, Jefferies SJ, Hoole ACF, Dean J, Fairfoul J, Burnet NG. Positional Correction Data Prove the Absolute Necessity for Image Guidance in High Dose Radiotherapy for Spinal Chordoma. Clinical Oncology 2011 Apr;23:S28

Dean JC, Routsis DS, Loo SW, Horan G, Lenane M, Fairfoul J, Burnet NG, Williams MV. Developing a Supine Technique for Treating Cranial Spinal Axis on Tomotherapy. Clinical Oncology 2011 Apr;23:S35

Loo SW, Horan G, Lenane M, Dean JC, Fairfoul J, Cowen MA, Thomas SJ, Burnet NG, Williams MV. Craniospinal Irradiation using Helical Tomotherapy for Paediatric Metastatic Medulloblastoma. Clinical Oncology 2011 Apr;23:S44

Mukesh M, Cowen M, Horan G, Thomas SJ, Williams MV. Conformal Radiotherapy vs. IMRT in Paediatric Neuroblastoma: Balancing Dosimetric Advantages and Secondary Cancer Risks. Clinical Oncology 2011 Apr;23:S20.

Rahman F, Fairfoul J, Williams MV, Burnet NG. A Comparison of Radiotherapy Treatment Plans for Hodgkin Lymphoma using 3D Conformal and Helical Tomotherapy Methods. Clinical Oncology 2011 Apr;23:S49

D. O’Doherty, L. Tait and J. Fairfoul, Delta4 and Tomotherapy – Our Experience, presentation, IPEM Biennial Radiotherapy meeting, Cardiff July 2010

Barraclough, J.M., Chantler, H. J. & Geater, A. 2010, Dosimetric effects of high density valves in breast radiotherapy treatment planning, IPEM Annual Scientific Me eting, Cardiff, poster presentation

M Cowen, MV Williams, G Horan, M Mukesh and SJ Thomas “Potential benefits and risks in treating paediatric neuroblastoma patients with IMRT using helical tomotherapy”, ESTRO, Barcelona , September 2010 

S Loo, G Horan, J Fairfoul, S Tudor, M Lenane, J Dean, M Cowen, S Thomas, N Burnet and M Williams "Craniospinal radiotherapy using helical tomotherapy for paediatric medulloblastoma: developing dose constraints", ESTRO, Barcelona, September 2010 

Eyre K and  Thomas SJ. Comparison of image registration packages for use in radiotherapy planning. IPEM Biennial Radiotherapy meeting, Cardiff University , 6-7 July 2010

M Cowen and SJ Thomas Monte Carlo modelling the effect of translational shifts and rotations on prostate dose-population histograms - what margins are required for IGRT?” AAPM, Philadelphia , July 2010 

Chantler H. Advances in the radiotherapy of head & neck cancer: The Addenbrookes experience. Head & Neck cancer: advances in radiation treatment meeting, London , 30 April 2010

Tudor GS, Lane J, Thomas SJ, Tait EE, Chantler HJ, Barraclough J, Carroll HE 2009 “Effect of respiratory motion on tomotherapy, step-and-shoot IMRT and conformal radiotherapy treatments” Presented at IPEM meeting “Managing motion in radiotherapy”

Barraclough, J.M., Whitney, D. and Brooke, S. 2009, The Commissioning of 3D Image Guided Brachytherapy for Iridium Wire Treatments, IPEM Brachytherapy in the Modern Era, Manchester, poster presentation

Barraclough, J.M. 2009, The Commissioning of 3D Image Guided Brachytherapy for Iridium Wire Treatments, IPEM Annual Scientific Me eting, Liverpool, oral presentation

Cowen MA, Williams MV, Horan G and Thomas SJ. “Inclusion of predicted carcinogenic risks in treatment plan optimisation” IPEM MPEC, Liverpool September 2009, (abstract book ISBN 978-1-903613-37-5, p80) 

 

Invited presentations

Tudor GS, “Adaptive Planning – Role and Practical Solutions”, Tomotherapy Users Group Meeting, Cambridge 2011
Whitney DM, The Advantages of Image Guided Brachytherapy of the Cervix, Brit Institute of Radiol., London 13th Oct 2010
Whitney DM, Implementation of Oncentra GYN for 3D Image Guided Brachytherapy of the Cervix, Nucletron Brachytherapy User Meeting, Liverpool, 21st May 2010
Thomas SJ.  Impact of New Technologies on Bunker Design.  IPEM Meeting on “Current developments in the design of radiotherapy treatment room facilities” London 18th March 2009 .

 

PhD projects

Completed

 Ian Cowley

“New approaches to improving the accuracy and outcome of Intensity Modulated Radiotherapy.”

PhD awarded by the Open University 2006.

Supervisors: Simon Thomas, Philip Dendy, Sarah Brooke.

 

Thai-Binh Nguyen

“Method of IMRT optimization of shallow tumour cases where the PTV extends into the build-up region”.

PhD awarded by the University of Cambridge 2009.

Supervisors: Neil Burnet, Simon Thomas, Andrew Hoole

 

Mark Cowen

“Image Guided Radiotherapy Using Tomotherapy”.

PhD awarded by the University of Cambridge 2012

Funded by MRC studentship.

Supervisors Simon Thomas, Neil Burnet

 

Current

Sam Tudor - “Ensuring dosimetric coverage of radiotherapy treatment volumes”. 

Commenced October 2009.

Part time PhD, supported by East of England SHA.

University of Cambridge.. Supervisor: Simon Thomas

 

Stacey McGowen “Optimisation of Proton Radiotherapy Planning with regard to Range Uncertainties.”

Commenced January 2011.

Funded by MRC Studentship.

University of Cambridge.  Supervisors Neil Burnet, Simon Thomas, Raj Jena.

 

 

 

 

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