This is a prospective pilot study to investigate the potential clinical value of oxygen-enhanced magnetic resonance (OE-MRI) biomarkers in head and neck radiotherapy.
This is a prospective pilot study funded by the NIHR. Healthy participants and patients will be recruited in The Christie NHS Foundation Trust and will be asked to undergo oxygen-enhanced magnetic resonance imaging (OE-MRI) and dynamic contrast-enhanced MRI (DCE-MRI). This study builds on the work recently been completed in lung cancer. Clinical data will be collected from patients notes. Tumour hypoxia is common in solid tumours and associated with poor response to radiotherapy, poor loco-regional control and survival outcomes in head and neck cancer. There is a need to develop non-invasive tests that can measure tumour hypoxia to improve radiotherapy for these patients. The study will involve 3 components: 1. Reproducibility and feasibility: The reproducibility of OE-MRI in head and neck cancer is unknown. Ten healthy participants will be asked to undergo two baseline OE-MRI scans with either nasal cannula or facial mask to breathe air and oxygen throughout. The order of which non-invasive breathing method will be used first will be randomized. Following this initial pilot OE-MRI will be tested in 30 patients with solid head and neck tumours. To assess reproducibility in patients 2 OE-MRI will be performed at baseline. 2. Effect of radiotherapy on tumour and normal tissue: OE-MRI and DCE-MRI signals will be measured at baseline before standard radiotherapy treatment begins and at the end of week 2 week and week 4 following the start of radiotherapy. Comparison of hypoxia measurements will be taken. 3. Biological validation: All 30 patients will undergo a diagnostic biopsy as standard of care at their local hospital. Tissue samples will be requested and multi-gene hypoxia signatures will be tested. OE-MRI signals will be compared with tissue sample from the same patient and the presence of changes in tumour known to be associated with hypoxia will be analysed.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
40
Additional imaging using MRI scan
Assessment of hypoxia in head and neck squamous cell cancer using oxygen enhanced Magnetic resonance imaging (using a range of different MR sequences)
Assessment of hypoxia in head and neck squamous cell cancer using oxygen enhanced Magnetic resonance imaging (using a range of different MR sequences)
Time frame: 3 years
Optimal MRI sequence to image participants with head and neck cancer, based on tumour and organ at risk visualisation.
Optimal MRI sequence to image participants with head and neck cancer, based on tumour and organ at risk visualisation.
Time frame: 3 years
Treatment response in a number of participants with head and neck cancer treated with radiotherapy +/- systemic therapy
Treatment response in a number of participants with head and neck cancer treated with radiotherapy +/- systemic therapy
Time frame: 3 years
Treatment related toxicities in a number of participants with head and neck cancer as assessed during and after treatment completion
Treatment related toxicities in a number of participants with head and neck cancer as assessed during and after treatment completion
Time frame: 3 years
Survival outcomes in a number of participants treated with radiotherapy +/- systemic therapy for head and neck cancer
Survival outcomes in a number of participants treated with radiotherapy +/- systemic therapy for head and neck cancer
Time frame: 3 years
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