A head or neck cancer diagnosis is bad in itself, unfortunately even radiation treatment is not a certain cure, as it does not work for a large proportion of patients. Subsequent surgery after failure of radiotherapy becomes much more complicated for surgeons, as wounds in a previously irradiated person heal poorly. But what if it were possible to predict the effectiveness of radiotherapy before it started? The software that assists doctors and scientists in this endeavour was developed at the BUT in cooperation with the CAS and MU.
“DNA has two strands and when both break, the molecule breaks, which is one of the most serious types of damage that can be inflicted on this vital molecule. Ionising radiation is very effective in creating these double-strand DNA breaks, which is why it is used in radiotherapy, where it can effectively kill cancer cells. We can mark and image these DNA breaks under a microscope,” explains Martin Falk, the head of the Department of Cell Biology and Radiobiology at the Institute of Biophysics of the Czech Academy of Sciences. He also adds that cells have a variety of mechanisms and proteins involved that, when cells are irradiated, “rush” to the fracture areas to try to repair the damage as quickly as possible. Scientists can image these proteins using a fluorescent dye.
Although the team had to feed the software with training data for a year and a half, it is now functional and fully autonomous. Besides the two proteins studied so far, it even learned to analyse foci of other proteins on its own. Martin Falk of the CAS admits that humans are still more reliable in some respects: “When a person looks at the same images of damaged cells for 15 years, they are probably still more accurate than a piece of software. But when large amounts of data need to be analysed, manual analysis is virtually impossible, and especially in practice, the speed of obtaining results, which is enormous compared to a human, is important to us.”
And how much time will the program save for doctors? “We examine one sample manually for several days to a week; the machine can do it in about an hour. Moreover, it does not take people’s time and the calculation can run at night,” says Tomáš Vičar about one of the solution’s biggest advantages.
However, a more likely use is assessing the effectiveness of radiotherapy in cancer treatment. The software could examine both pre- and post-treatment patient samples. If the programme shows that the blood sample does not respond to radiation, doctors would not start radiotherapy and would not burden the patient with a treatment that would be useless in that patient’s case. On the contrary, they might start a more effective treatment strategy right away.
Experts have the opportunity to work with samples of real patients thanks to the inclusion of several institutions, which is ensured by Jaromír Gumulec from the Masaryk University, Faculty of Medicine: “We have been monitoring patients for about 6 years and therefore know how they responded to radiotherapy. Our question then is simple – does what we predicted using our software correspond to how patients responded to the actual treatment?”
(tk)