However, it is well known that these aspects may be the cause for treatment failure for a considerable fraction of the non-responding patients, as the standard dose prescription does not ensure curative doses to counteract the radiation resistance of the tumour. Among these adverse factors one has to take into account the variations in cellular density from tumour to tumour and the distinct microenvironmental characteristics of the tumours.

The progress in imaging methods during the last decade has significantly improved cancer diagnosis and prognosis by increasing the accuracy of delineating target structures on a background of normal tissue anatomy, which has formed the foundation for 3D- and 4D-based radiation treatment methods. Among the imaging techniques, positron emission tomography (PET) has the advantage of being almost non-invasive since it uses tracers that are usually metabolic substitutes, versatile, as several tracers are already available for investigating various processes and quite sensitive since relatively low concentrations of tracers could be imaged.

The general aim of this research project is to use information from morphological and functional imaging methods in order to individualise the radiation dose delivery with high accuracy using advanced treatment planning techniques such as biologically optimized intensity-modulated radiotherapy alone or in combination with chemotherapy or surgery.

The specific aims of this project are the determination of the critical radiobiological parameters before and during the treatment, such as tumour metabolism, hypoxia, proliferation and density of clonogenic cells, influencing the radiation sensitivity of individual tumours based on PET-CT imaging using suitable tracers, the inclusion of this biological information into the treatment planning and the adaptation of the treatment based on the assessment of the tumour responsiveness.

The project relies on radiobiological modelling of the influence of the tumour microenvironment on the treatment outcome implemented in the clinical context.

The present research project contributes to optimising the efficiency of treatment by selecting patients in need of more aggressive treatment approaches than standard radiation therapy, improve quality of life both in responders to standard treatment by preventing unnecessary dose escalations and in non-responders by referring them to more effective treatments and also decrease hospital and community costs by recommending expensive treatments only for those patients who will benefit the most from them.

This research project is carried out in close collaboration with the industry, namely with RaySearch Laboratories AB (Stockholm, Sweden), one of the leading companies in the production and development of treatment planning systems for radiation therapy.

For more information contact Iuliana Toma-Dasu