I have designed and led institutional and national trials testing conformal radiotherapy (CFRT) and dose escalation with the Medical Research Council (MRC) resulting in NICE guidance (March 2008) recommending high dose CFRT as the national standard of care.
I am leading further studies supported by the DoH, CRUK and NCRI studying intensity modulated (IMRT) and image guided (IGRT) radiotherapy with hypofractionation which tests the fraction sensitivity of prostate cancer.
This study (CHHiP) will recruit 3,160 men and is the largest academically led prostate trial in the world. A positive result will benefit patient outcome and radiotherapy resource utilisation. Linked translational research relates toxicity and efficacy to physical (dose volume/surface histogram analysis), genetic (SNP and GWAS) and predictive biomarkers using tissue microarrays (TMA). I have established a national quality assurance programme to aid the generalisability of IMRT and now IGRT.
I am leading a CR-UK supported randomised controlled trial (RCT) to test and generalise high dose pelvic IMRT for high risk prostate cancer.
I am further developing IGRT linking functional imaging using magnetic resonance imaging (MRI), dynamic MRI (dMRI) and magnetic resonance spectroscopy (MRS) to ultra high dose boost treatments which will include further study of a patented localising rectal obturator (ProSpare).
I established three joint research programmes with National Cancer Research Network (NCRN) support. The first of these, on familial genetics of prostate cancer, has recently identified several polymorphisms which may lead to risk stratification and new treatment targets.
The second, concerning surveillance for early prostate cancer, aims to define parameters predicting low biological potential and need for treatment. The third is a 'survivorship' programme in testis cancer identifying the need for long term monitoring of treatment sequelae.