PEARL

A PET-based Adaptive Radiotherapy Clinical Trial (PEARL).

Background

Radiotherapy, combined with chemotherapy, is the key curative treatment option for many patients with head and neck cancer. Patients who relapse are at risk of dying of their cancer. Relapses usually occur at the site of the original cancer, so an attractive option is to increase the radiation dose to more effectively treat the cancer.

Positron Emission Tomography (PET)

Centre for Trials Research will be collaborating with Velindre Cancer Centre and the PETIC centre (Positron Emission Tomography (PET) Imaging Centre) at Cardiff University to optimize the use of PET imaging for head and neck cancer radiotherapy planning. The PEARL trial aims to show that modern radiotherapy (IMRT) and imaging (PET-CT) techniques allow us to safely increase the dose to the part of the cancer that is most likely to relapse. This may lead to reduced toxicity and improved outcome for head and neck cancer patients having radiotherapy in future.

Novel system

We will also aim to validate the ability of our novel system, ATLAAS, to automatically outline the cancer using PET-CT scans, showing that it is as least as accurate and reproducible as experienced doctors. Biomarkers that predict the outcome of individual patients are required to guide future developments. We will study repeat PET-CTs and cell-free tumour DNA in patients before, during and after radiotherapy to see if they can identify patients at highest risk of relapse.