Christie researchers hope to ‘transform the landscape’ of children’s cancer treatment with groundbreaking radiotherapy project

News story published 21 January 2025

Radiotherapy is a very safe and effective way to treat and cure brain tumours in children and young people.* However, this doesn’t mean that the treatment doesn’t come with long-term side effects, such as poor memory or hormonal problems, that can affect quality of life.

The question that researchers must answer is how to effectively kill the tumour while avoiding the brain regions that are most sensitive to radiotherapy and cause these side effects.

A photo of a child patient being treated with radiotherapy by 2 radiographers.

This is exactly what researchers at The Christie NHS Foundation Trust, a specialist cancer centre in Manchester, and The University of Manchester are doing properly for the very first time. Although this is an area that’s been researched more generally, the team are the first to use using scans and treatment plans (including cognitive tests that assess important areas like memory and processing speed) from 139 patients to properly get an answer that could change clinical practice.

They have identified a radiation-sensitive region at the front of the brain that’s associated with cognition and hormone production and will now validate the results. They hope that, by the end of 2028, their findings will be used to guide treatment plans for patients having radiotherapy and proton beam therapy as standard of care in the NHS.

“We did not expect this frontal region to be as important as it is,” comments Professor Marianne Aznar, Professor of Radiation Oncology Physics at The Christie and The University of Manchester. “We thought it would be the hippocampus as it’s a well-defined structure that’s very well known to be associated with memory, so to see that the grey matter at the front of the brain is so important, was really surprising.

“The initial work was done using the information from St. Jude’s Children’s Research Hospital in the US and we’ll now validate it using the scans and treatment plans of children who have had proton beam therapy at The Christie. In 4 years’ time, we hope to give clinicians what we’re calling a ‘brain atlas’, a detailed plan of areas to avoid. This project truly has the potential to really improve patient outcomes and transform the landscape of paediatric brain tumour treatments,” she continues. 

How did they do it?

Identifying the areas in the brain that are sensitive to radiotherapy in an unbiased and rigorous ways is easier said than done, especially as the extent to which people are affected differs a lot.

The team used a technique called image-based data mining to do this. In essence, this is an advanced computer programme that helps turn a large collection of images – in this case, data from nearly 140 patients – into something that’s not only very detailed, because it retains all the individual patient information, but also organized, searchable, and understandable. This makes it easier to spot patterns.

A truly collaborative approach

To be able to get this far needed a truly collaborative approach. The team comprises experts from diverse fields spanning pre-clinical science, oncology, neurology, paediatrics, physics and patient advocacy.

The project is truly international in its approach. The Manchester team, lead by Dr. Martin McCabe, a paediatric oncologist at The Christie, is working closely with St Jude Children’s Research Hospital in the US and the University of Groningen in the Netherlands. The project is supported by Stand Up To Cancer® (SU2C) and Cancer Research UK, who have just given the researchers a $5 million USD (just under £4.1m) grant to finalise the research. Professor Aznar’s physics work is funded by the Engineering and Physical Sciences Research Council (ESPC) 

Putting patients first

 People had radiotherapy as children are also being involved, helping the team understand how to communicate the information going forward. 

One of these people is Kat Watson-Wood. Now in her 30s, Kat had radiotherapy for a brain tumour when she was just 3. She lives with some side effects because the tumour was on the part of the brain that plays a role in motor movement regulation and balance control. As a result, she walks with a crutch. She also has some problems with her memory.

A photo of Christie patient Kat Watson-Wood and her partner.

Kat attends the team’s meetings every month and has given the team a lot of important insight. “Cancer treatment is constantly evolving and that’s only possible because of research. I’m so happy to be involved if it can improve things for people like me in the future,” says Kat.

Last updated: January 2025