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ARCHERY: a prospective observational study of artificial intelligence-based radiotherapy treatment planning for cervical, head and neck and prostate cancer - study protocol

Aggarwal A 1 , Court LE 2 , Hoskin P 3 , Jacques I 4 , Kroiss M 5 , Laskar S 6 Show all authors , Lievens Y 7 , Mallick I 8 , Abdul Malik R 9 , Miles E 5 , Mohamad I 10 , Murphy C 4 , Nankivell M 4 , Parkes J 11 , Parmar M 4 , Roach C 4 , Simonds H 12 , Torode J 13 , Vanderstraeten B 7 , Langley R 4

Affiliations 

  • 1 Institute of Clinical Trials and Methodology - MRC CTU at UCL, University College London, London, UK [email protected]
  • 2 MD Anderson Cancer Center, University of Texas, Houston, Texas, USA
  • 3 Department of Oncology, The Christie NHS Foundation Trust, Manchester, UK
  • 4 Institute of Clinical Trials and Methodology - MRC CTU at UCL, University College London, London, UK
  • 5 National Radiotherapy Trials Quality Assurance Group, Mount Vernon Hospital, Northwood, UK
  • 6 Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
  • 7 Ghent University Hospital, Gent, Belgium
  • 8 Department of Radiation Oncology, Tata Memorial Center, Kolkata, West Bengal, India
  • 9 University of Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  • 10 King Hussein Cancer Center, Amman, Jordan
  • 11 University of Cape Town, Rondebosch, South Africa
  • 12 Stellenbosch University, Stellenbosch, Western Cape, South Africa
  • 13 King's College London, London, UK
BMJ Open, 2023 Dec 07;13(12):e077253.
PMID: 38149419 DOI: 10.1136/bmjopen-2023-077253

Abstract

INTRODUCTION: Fifty per cent of patients with cancer require radiotherapy during their disease course, however, only 10%-40% of patients in low-income and middle-income countries (LMICs) have access to it. A shortfall in specialised workforce has been identified as the most significant barrier to expanding radiotherapy capacity. Artificial intelligence (AI)-based software has been developed to automate both the delineation of anatomical target structures and the definition of the position, size and shape of the radiation beams. Proposed advantages include improved treatment accuracy, as well as a reduction in the time (from weeks to minutes) and human resources needed to deliver radiotherapy.

METHODS: ARCHERY is a non-randomised prospective study to evaluate the quality and economic impact of AI-based automated radiotherapy treatment planning for cervical, head and neck, and prostate cancers, which are endemic in LMICs, and for which radiotherapy is the primary curative treatment modality. The sample size of 990 patients (330 for each cancer type) has been calculated based on an estimated 95% treatment plan acceptability rate. Time and cost savings will be analysed as secondary outcome measures using the time-driven activity-based costing model. The 48-month study will take place in six public sector cancer hospitals in India (n=2), Jordan (n=1), Malaysia (n=1) and South Africa (n=2) to support implementation of the software in LMICs.

ETHICS AND DISSEMINATION: The study has received ethical approval from University College London (UCL) and each of the six study sites. If the study objectives are met, the AI-based software will be offered as a not-for-profit web service to public sector state hospitals in LMICs to support expansion of high quality radiotherapy capacity, improving access to and affordability of this key modality of cancer cure and control. Public and policy engagement plans will involve patients as key partners.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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