How is Research Changing Radiotherapy Care in Denmark? Q&A with Professor Grau | Varian

How is Research Changing Radiotherapy Care in Denmark? Q&A with Professor Grau

How is Research Changing Radiotherapy Care in Denmark? Q&A with Professor Grau

A: I was drawn to the field of proton therapy because it has great potential to significantly improve the outcome of cancer treatment. I’ve dedicated the last 15 years to developing and introducing novel technology in radiotherapy, with a focus on improving tumor control and reducing side effects. That’s why I’m delighted to help establish a Danish national center for proton therapy at Aarhus, which is currently under construction. The center will include Varian’s ProBeam® system, with three 360 degree rotational gantry rooms, and a research room with a horizontal beam. Once its doors open, the DCPT will treat up to 1,200 patients annually.  


Q: What triggered your research interest in proton therapy?
A: The physical advantages of the proton beam hold great potential for improving the therapeutic ratio, but there are insufficient clinical outcome data for many of the potential indications. My attraction to clinical proton therapy research grew out of this dilemma, which is both a great challenge and opportunity. Denmark has a unique opportunity to perform clinical research in proton therapy because we have a national referral base, and the treatment will be free of charge for patients. In addition, we have well-functioning multidisciplinary cancer groups that collaborate nationally and internationally.


Q: Are there any personal experiences that might have influenced your interest? 
A: I think the changes I’ve seen over the last 15 years have greatly influenced my interest in proton therapy research. As an active participant in the major growth of radiation oncology in Denmark, I’ve seen radiation oncology change from a field with outdated equipment and long waiting lists to a state-of-the-art treatment method with the most advanced technology and no waiting lists, due to a greater investment in and political focus on radiation oncology. As president of the Danish Society for Clinical Oncology, I had the opportunity to work with the administrative system in Denmark and to help advocate for this change in radiation oncology. Drawing on my experience as Director of the National Center for Interventional Research in Radiation Oncology (CIRRO), I have also learned how important it is to collaborate across disciplines, specialties, and departments to further proton therapy research.


Q: What makes your approach to proton therapy research unique?
A: The unique feature of the Danish Center for Particle Therapy is that it will be a public, national research center, offering proton therapy free of charge to all relevant Danish patients. We will have the unique opportunity to treat the majority of patients in clinical trials, which will help us create the evidence-base needed for new proton therapy indications. We will select the most appropriate patients based on a systematic comparison of photon vs. proton dose planning and risk of morbidity. Current clinical research activities are focused on collecting and analyzing the dose-volume relationships for conventional photon-based radiotherapy, including patient reported outcomes (PROM), in the national collaborative tumor groups. This data will subsequently be used for large-scale comparative dose planning studies, so we can select the right patients for proton therapy trials.  


Q: What makes proton therapy research exciting today?
A: Proton therapy is a cutting-edge technology with a clear potential to significantly improve the outcome of cancer treatment, but there are so many unsolved questions waiting to be addressed in a translational and clinical research setting. With the opening of the Danish Center for Particle Therapy, we look forward to solving many of these questions through research focused on areas such as the details of the relative biological effectiveness (RBE), motion mitigation strategies as well as image guidance, adaptation, and automation. By bringing technical innovation to proton therapy, we anticipate greatly improving radiotherapy care in Denmark.