ARCHERY

A new study testing an innovative approach to radiotherapy treatment planning, the ARCHERY study, is evaluating the use of artificial intelligence (AI) to automate several steps in the radiotherapy treatment pathway. It will assess both its quality, time and cost savings compared to the standard manual approach.

Radiotherapy is an effective treatment for many cancers. But planning a treatment that can deliver radiation to the tumour, while avoiding damage to healthy organs nearby, is a labour-intensive and highly skilled process. It requires input from expert clinicians and physicists or radiographers. This process is particularly challenging in low and middle-income countries, where there are not enough people with the necessary training and skills.

ARCHERY will test whether AI can be used to:

• Target and ‘contour’ organs which need to be treated and others that need to be avoided
• Plan how to arrange the beams of radiation to deliver an effective dose to the target, while not exposing normal tissue to harmful amounts

ARCHERY will compare the quality of plans prepared using AI with current standards of care that use manual approaches. It will also gather data on the time and cost involved, to allow evaluation of the health-economic impact of this approach.

If successful, the approach could transform radiotherapy treatment planning, speeding up the process from weeks to minutes, reducing costs and allowing more patients who need treatment to be treated. It could also help improve the consistency and quality of treatment as well as enable more complex techniques to be adopted.

The AI software being used in ARCHERY has been developed by the MD Anderson Cancer Center. If found it be effective, it will be made available as a web-based not-for-profit service for public-sector and non-profit hospitals in low- and middle-income countries

ARCHERY is the first study of its kind. It will look at treatments for three high burden tumours in a global setting: over 1000 patients with head and neck cancer, cervical cancer or prostate cancer will be enrolled in hospitals in India, South Africa, Jordan and Malaysia.

The ARCHERY study, led by Dr Ajay Aggarwal, Consultant Clinical Oncologist at Guy’s Cancer Centre/LSHTM and coordinated by the MRC Clinical Trials Unit at UCL, is funded by the US National Institute for Health and the Rising Tide Foundation for Clinical Cancer Research (RTFCCR).

RTFCCR supports the prostate cancer arm of the study. This high burden cancer is the most frequently diagnosed in men. In low-and-middle income countries radiotherapy is the major treatment modality for it, given the paucity of urological services and the consequent predominance of advanced cancers. In addition, poor quality radiotherapy planning is directly linked to an increased risk of cancer recurrence and functional morbidity for patients, such as bladder and bowel toxicity and sexual dysfunction. For these reasons, the ARCHERY study represents a great opportunity for enabling implementation of cheaper, easier and more effective radiotherapy practice also for prostate cancer treatment in low- and medium-income countries.

Collaborating centres and partners

• MD Anderson Cancer Center (USA), Dr Laurence Court
• Ghent University Hospital (Belgium)
• UK Radiotherapy Trials Quality Assurance group
• Cape Town University (South Africa), Prof. Parkes and Prof. Simonds
• Tata Memorial Centre (India), Prof. Ghosh-Laskar
• Tata Memorial Hospital (India), Dr Mallick
• King Hussein Cancer Centre (Jordan), Dr Mohamad
• University of Malaya (Malaysia), Prof. Malik
• Stellenbosch University (South Africa)