KAYAC+

Knowledge on outcome of adolescent and young adults with cancer

Project objectives and goals

Annually, cancer is diagnosed in 150.000 adolescents and young adults (AYAs) aged between 15 and 39 years in Europe and in 1.2 million AYA worldwide. Alarmingly, the age-standardized incidence was found to be highest in AYA in Western European countries. The malignancies encountered mostly originate from the breast (15%), thyroid (15%), cervix, testicles (8%), central nervous system 8%), bone or soft tissues (8%) as well as lymphoma (19%).
Many of those malignancies are treated with a combination of surgery, systemic therapy, and irradiation. Although a high cure rate is achieved, it is lower than for the paediatric counterparts. Of note, the risk of secondary tumours in survivors of AYA cancer 35 years after treatment ranges between 11.9% (breast cancer) and 26.6% (Hodgkin’s lymphoma) with an excess proportion of lung cancer [2]. In part, these secondary tumours may be caused by therapeutic interventions potentially affecting the DNA of cells in non-cancerous tissues. Novel radiation modalities are increasingly being utilised in European centres, facilitated by image-guidance and online-adaptive approaches. Particles, e.g. protons or carbon ions, are characterised by an energy-dependent point of maximum dose deposition, the so-called Bragg peak, followed by a sharp dose-gradient to zero dose. Also, the relative biological effectiveness of particles is higher compared to that of photons. Both characteristics enable sparing of normal tissues, thus reducing the incidence of side-effects and in theory of secondary tumours.
Within the pan-European KAYAC+ study, we will address various scientific questions of photon and particle therapy in AYA cancer patients. These include: differences in radiation treatment plans, dose from secondary particles and imaging, the induction of treatment-induced second tumours as well as the incidence of side-effects and their costs, and the contribution of radiation modalities, comorbidities, and lifestyle factors to secondary tumours. These questions will be assessed by two PhD students, one with a background in medicine or epidemiology, the other in the field of (medical) physics. The KAYAC+ database, which will be the nucleus for the pan-European database on particle therapy, will facilitate this project as well as future translational research.

 

Project coordinator

Esther G.C. Troost, TUD Dresden University of Technology, Faculty of Medicine, OncoRay - National Center for Radiation Research in Oncology, Germany