The Department of Radiation Oncology has an active research program that includes both basic (laboratory) and clinical research. Our research often involves collaboration with other departments as we strive to better identify and treat cancer, and to develop ways to deliver higher doses of radiation to the tumor area while reducing the effects to the surrounding healthy tissue.
Areas of concentration include:
The group's participation in national and local cancer trials makes it possible for patients to receive cutting-edge therapies. Our principal research interest is the use of radiation therapy in breast cancer treatment. In particular, we are involved in improving breast-conserving therapy for patients with invasive breast cancer and ductal carcinoma in situ.
This work has involved a series of collaborative studies with radiation oncologists, surgeons, pathologists, radiologists, medical oncologists and medical geneticists to define the optimal use of a variety of modalities, including radiation therapy. Studies have also included evaluations of radiation therapy after mastectomy to improve survival, and collaborative work with investigators in medical physics to ensure the safest and most effective techniques.
Central nervous system cancers
Our research focuses on improvements in radiotherapy for cancers of the central nervous system, using combination therapy with targeted radiosensitizing agents. In order to increase the control of malignant primary tumors and brain metastases, we design and participate in a variety of protocols that use targeted biological drugs or chemotherapy to sensitize tumors to radiation.
As part of the Harvard Gastrointestinal Cancer Center, we participate in a large number of clinical trials with the goal of improving outcomes for patients with cancers of the gastrointestinal tract. Many of these trials combine new types of chemotherapy and/or biological therapy with radiation. Available technologies include intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT). Currently active protocols involve a variety of innovative approaches, including improved cancer imaging, identifying new ways to predict and minimize the risk of long-term radiation complications, shorter courses of treatment for selected patients with rectal and pancreatic cancer, and novel treatments for liver cancer.
Our research focus is on improving curability and quality of life for patients with cancers of the urinary tract and male genital tract. Current treatment protocols include a randomized trial evaluating the role of chemotherapy (Taxotere) with radiation and androgen ablation in patients with high-risk prostate cancer; a study of MR/TRUS image-guided brachytherapy for patients with newly diagnosed prostate cancer; brachytherapy for men who have had a cancer recurrence after prior radiation; investigating a new form of radiation therapy (RapidArc™) in men with prostate cancer; determining the cardiovascular side effects of androgen deprivation therapy; and defining genetic-based markers of prostate-cancer progression.
In the area of translational science, we are working to develop molecular signatures of prostate tumors that can be used to design more individual therapies for men diagnosed with prostate cancer.
We have a strong interest in the care and medical management of men with testicular cancer. We are investigating new strategies that decrease their exposure to potentially unnecessary computerized axial tomography (CAT) scans as well as potentially unnecessary radiation and chemotherapy. We are working with the Adult Survivorship Program to create a treatment summary for all testicular cancer patients which will include the patient’s diagnosis, prognosis and potential for late effects of therapy. This document will be sent to primary care doctors with recommendations for future testing, such as early testing of cholesterol or more rigorous evaluation for hypertension. We are interested in the genetic predictors of treatment-related morbidity and in the quality of life for men with testicular cancer following diagnosis and treatment.
Current treatment protocols examine the use of MR-guidance and other 3D imaging approaches during brachytherapy, in order to improve imaging and reduce the risk of radiation damage to adjacent normal tissues. Other research studies focus on the epidemiology of endometrial cancer, the effects of radiation therapy on gynecologic malignancies, and quality-of-life improvements through novel techniques in gynecologic radiation oncology.
Head and neck cancers
In collaboration with our colleagues in medical and surgical oncology, we are investigating the use of systemic therapy in combination with radiation for patients with advanced disease. Systemic therapy includes standard chemotherapy agents as well as targeted agents and investigational treatments. All of our studies use state-of-the-art, intensity-modulated radiation therapy (IMRT).
Our group maintains one of the largest databases in the country on more than 2,000 patients treated for Hodgkin lymphoma in the last 40 years. The database provides valuable information on the efficacy of different treatment approaches and the various late effects of treatment. In addition, we are dedicated to optimizing treatment for patients with newly diagnosed disease and the follow-up care of survivors of lymphoma. Studies included examination of the role of radiation therapy for specific lymphoma types, optimal radiation dose and fields, novel techniques such as 4-dimensional treatment planning that may improve treatment outcome, and prospective screening trials for second malignancies and cardiac disease in lymphoma survivors
Soft tissue and bone sarcomas
The Sarcoma Program is internationally recognized for research in sarcoma in terms of basic science, laboratory investigation, and clinical trials, offering many new drugs and approaches to patients. We work closely with our colleagues in surgical and medical oncology to define the optimal role of radiation therapy as part of patient management (pre-operative vs. post-operative radiotherapy, intra-operative radiotherapy implants, or no radiotherapy). The unique expertise in our department positions us to offer innovative treatment techniques such as IMRT (intensity modulated radiation therapy), RapidArc™ therapy, brachytherapy, surface applicator therapy, and stereotactic body radiotherapy in addition to 3D-conformal therapy. Projects in development include the optimization of radiation techniques and doses for the treatment of retroperitoneal sarcoma, the development of strategies to minimize the risk of wound complications, definition of clinical characteristics and patterns of failure for specific histologic sub-types of sarcoma, and optimal integration of radiation therapy and systemic sarcoma treatment.
Our primary research goal is to improve radiation treatment and outcomes for patients with thoracic cancers. Current clinical studies involve new treatment techniques, such as stereotactic body radiotherapy, for delivering high radiation doses to tumors in the lung while sparing normal tissues. In addition, we are investigating advanced imaging technologies to improve the precision of radiation therapy planning and delivery to tumors with motion. Other ongoing research includes laboratory-based and translational studies to identify targeted drug treatments that may improve the effectiveness of radiation therapy for lung cancer, as well as population-based studies to study variations in the use of radiation therapy and outcomes among lung cancer patients.