Assessment of New Radiation Oncology Technologies and Treatments

Study Protocol A: IMRT versus 3DCRT in Post-Prostatectomy Inclusion Criteria

All of the following must apply:

* Patient has provided written informed consent
* Prior RP for adenocarcinoma of the prostate.
* Histological confirmation of adenocarcinoma of the prostate with the Gleason score reported (RP specimen).
* Patients must have at least one of the following risk factors:
* Positive margins
* Extraprostatic extension (EPE) with or without seminal vesicle involvement (pT3a or pT3b)
* PSA nadir ≤ 1.0 ng/ml following RP
* Eastern Cooperative Oncology Group (ECOG) performance status 0 - 1
* Sufficient knowledge of English and adequate cognitive function to be able to complete the QoL and other questionnaires
* 18 years or older

Exclusion Criteria

None of the following must apply:

* Previous pelvic RT or surgery ie previous rectal or bladder resection
* Concurrent or previous malignancy within 5 years prior to registration (except non-melanomatous skin cancer)
* Androgen deprivation (AD) prior to or following RP as this will affect QoL
* Evidence of nodal or distant metastases
* Clinical or imaging evidence of local recurrence
* Planned adjuvant RT to cover pelvic lymph nodes
* PSA \>1.0 ng/ml
* Co-morbidities that would interfere with the completion of treatment
* Concurrent cytotoxic medication
* Hip prosthesis

Study Protocol B: IMRT versus 3DCRT in Anal Cancer Inclusion Criteria

All of the following must apply:

* Informed consent for prospective patients (QoL component)
* Age 18-80 years of age
* Sufficient knowledge of English and adequate cognitive function to be able to complete the QoL and other questionnaires
* Histological confirmation of squamous cell carcinoma or basaloid carcinoma
* T2-4N0, TanyN2 (ipsilateral groin nodes) and TanyN3 (bilateral groin nodes).
* Intention to elective irradiate all pelvic nodal groups up to L5-S1 interspace (including mesorectal, presacral, internal iliac, external iliac, ischiorectal fossa, obturator and inguinal groups).
* Planned for radical chemoradiation.

Exclusion Criteria

None of the following must apply:

* Evidence of metastatic disease
* Prior pelvic RT/ surgery (e.g. vaginal hysterectomy)
* Presence of hip prosthesis
* Acquired immunodeficiency syndrome (AIDS). HIV patients without AIDS eligible.
* Previous pelvic cancers

Study Protocol C: IMRT versus 3DCRT in Nasopharynx Inclusion Criteria

All of the following must apply:

* Informed consent for prospective patients (QoL component)
* Age \>18 years
* Sufficient knowledge of English and adequate cognitive function to be able to complete the QoL and other questionnaires
* Histologically confirmed carcinoma of the nasopharynx, types WHO1-111, Stage I-IVB
* Adequate staging of local disease (MRI of primary must be performed, imaging of neck nodes with CT with contrast and/or PET-CT) and exclusion of distant metastatic disease (to be confirmed by either whole body PET-CT or a chest CT, and upper abdominal CT or ultrasound scan for patients with abnormal liver function tests or a bone scan or FDG-PET for patients with bone pain).
* Disease must be considered potentially curable by chemoradiation
* Patients must be medically fit for cisplatin chemotherapy according to local practice (adequate renal, cardiac function, no significant neurological co-morbidities)
* Performance status ECOG 0, 1 or 2.

Exclusion Criteria

* Previous head and neck RT or major surgery
* Prior chemotherapy \< 6 months from study entry

Study Protocol C: IGRT versus non-IGRT in Intact Prostate Inclusion Criteria

* Patient has provided written informed consent
* Aged 18 years or older
* Sufficient knowledge of English and adequate cognitive function to be able to complete the QoL and other questionnaires
* Histological diagnosis of carcinoma of the prostate \< 6 months of entry without evidence of metastatic disease to the lymph nodes, bone or lung
* Intermediate risk prostate cancer (that is, T1-2a, Gleason score ≤ 6, PSA 10.1-20.0 ng/ml; T2b-c, Gleason ≤6, PSA ≤ 20.0 ng/ml; T1-2, Gleason 7, PSA ≤ 20.0 ng/ ml)

Exclusion Criteria

* Previous therapy for carcinoma of the prostate other than biopsy or transurethral resection.
* Previous pelvic RT or surgery (eg abdomino-perineal resection)
* Hip prosthesis
* Inflammatory bowel disease
* Previous or current use of AD