Clinical research fellowships

Brachytherapy (AFC) fellowship

Supervisors:
Dr. Gerard Morton
Dr. Eric Leung

The AFC Brachytherapy Program is accredited by the Royal College of Physicians and Surgeons of Canada. Upon completion of the training program, an AFC fellow will be able to function as a competent specialist in brachytherapy, capable of an enhanced practice in this area of focused competence within the scope of radiation oncology. The brachytherapy AFC trainee will acquire a working knowledge of the theoretical and practical basis of brachytherapy, including its foundations in science and research as it applies to medical practice. The trainee will be able to apply to the Royal College to be awarded a diploma (DRCPSC) in brachytherapy.

Breast cancer clinical research fellowship

Supervisors:
Dr. Gregory Czarnota
Dr. Hanbo Chen
Dr. Edward Chow
Dr. Eric Leung
Dr. Irene Karam
Dr. Eileen Rakovitch
Dr. Hany Soliman
Dr. Ewa Szumacher
Dr. Danny Vesprini

The Odette Cancer Centre at Sunnybrook is one of the largest programs in the country. It has unique, specialized programs in locally advanced cancer and immediate reconstruction, and a dedicated program for young women facing breast cancer. Fellows will gain clinical experience in the multidisciplinary management of breast cancer with specific expertise in the use of novel radiotherapy techniques to treat the disease. ​

Research areas include quantitative ultrasounds and novel imaging methods for tumour response prediction and monitoring, such as quantitative ultrasound, photoacoustics, optical measures and novel MRI methods. Research opportunities in breast SBRT and MR-Linac are also available. Fellows will be able to learn about and participate in conducting clinical trials and clinical epidemiological research, including health services, population-based research.

Central nervous system (CNS) clinical research fellowship

Supervisors:
Dr. Hanbo Chen
Dr. Jay Detsky
Dr. Sten Myrehaug
Dr. Arjun Sahgal
Dr. Hany Soliman
Dr. Chia-Lin (Eric) Tseng

This fellowship is a one-year clinical and research fellowship. Clinically the focus is on central nervous system (CNS) cancer radiotherapy, including Gamma Knife radiosurgery, spine SBRT and primary brain tumour radiation. You will have extensive exposure to MR linear accelerator treatment for CNS tumours.

Research opportunities include MR-Linac applications for CNS tumours; brain and spine radiosurgery outcomes; and potential involvement in clinical trials. There are multiple research projects and platforms to be engaged in, and most fellows finish two or three manuscripts by year’s end.

Gastrointestinal (GI) cancer clinical research fellowship

Supervisors:
Dr. William Chu
Dr. Hans Chung
Dr. Sten Myrehaug
Dr. Sylvia Ng
Dr. Amandeep Taggar
Dr. Yee Ung
Dr. Shun Wong

The GI site group at Odette Cancer Centre at Sunnybrook has an active treatment program inclusive of all GI malignancies. There is an emphasis on delivery of SBRT for localized and metastatic disease when appropriate, with an active program treating liver metastases, pancreatic cancer and abdominal metastases. In addition, there is an increased utilization of brachytherapy for both upper and lower GI malignancies.

In addition, Sunnybrook is a founding member of, and active contributor to the Atlantic consortium evaluating MR-Linac technology, with a local interest in pancreatic malignancies.

Clinical fellows will gain experience in comprehensive GI malignancy treatments, with a focus on SBRT indications and techniques.

Clinical areas of interest within the department include SBRT outcome assessment, imaging/protocol development on the MR-Linac, and metabolomics to establish treatment response.

Genitourinary (GU) cancer clinical research fellowship

The fellow will gain extensive clinical experience with:

1. workup of prostate cancer patients pre-diagnosis including MRI-screening and MR-guided transperineal biopsies;
2. management of patients on active surveillance including MR-staging and genomic classification;
3. decision-making and treatment of patients with SABR (including inserting fiducial markers), brachytherapy +/- androgen deprivation therapy;
4. management of salvage patients using postoperative RT, salvage HDR, salvage SABR (with SpaceOAR insertion) and ADT;
5. management of metastatic hormone sensitive (mHSPC) and castrate resistant prostate cancer (mCRPC) using abiraterone, enzalutamide, apalutamide, darolutamide and radium including SABR for oligometastases.

From a research perspective, the fellow will have the opportunity to design and conduct clinical trials and analyze results of ongoing mature studies. Previous fellows have been co-PIs on peer-reviewed grants, first author on numerous publications and been able to present at international conferences.

Gynecologic (GYNE) cancer clinical research fellowship

The fellow will gain extensive multidisciplinary clinical experience with workup of gynecological cancer patients; decision-making and treatment of patients with radiation, chemoradiation and brachytherapy; management of patients treated with MRI-guided brachytherapy and interstitial brachytherapy; and management and treatment of patients treated with stereotactic ablative radiotherapy (SABR) for gynecologic cancers.

The Odette Cancer Centre at Sunnybrook has one of the highest-volume gynecologic cancer brachytherapy and interstitial programs in the country. The centre also has a unique brachytherapy suite with MRI in the room, so that procedures can be done directly on the MRI bed while also functioning as a treatment bunker. The fellow will have the opportunity to gain expertise in MRI-guided brachytherapy and interstitial brachytherapy with perineal template applicators and hybrid applicators. Novel techniques such as real-time guidance with MRI and transrectal ultrasound will also be developed.

From a research perspective, the fellow will have the opportunity to develop research programs on MRI-guided brachytherapy, including MRI planning and functional imaging, interstitial brachytherapy and real-time guidance of interstitial brachytherapy. The fellow will also have an opportunity to design and conduct clinical trials and analyze results of ongoing mature studies, which include areas ranging from translational research to imaging trials. Novel research projects on SABR and MR-Linac for gynecologic cancers can also be developed during the fellowship.

Head and neck (H&N) cancer clinical research fellowship

The primary objective of this one-year clinical and research fellowship is to provide clinical expertise and research opportunities in the multi-disciplinary management of head and neck oncology.

It is expected the fellow will be involved in research during their time. Active areas of investigation include MR-Linac-based therapy for head and neck cancer, head and neck SBRT, as well as quality improvement projects within the head and neck oncology space.

The head and neck clinical program at the Odette Cancer Centre is a vibrant, high-volume program with approximately 750 new patients seen each year.

Thoracic (Lung) cancer clinical research fellowship

The fellow will gain further experience (beyond what a typical radiation oncology residency provides) in the multi-disciplinary management of thoracic malignancies, including non-small cell lung cancer, small cell lung cancer, esophagus cancer, and pulmonary/hilar/mediastinal metastases. The fellow will learn how we employ high- precision radiotherapy techniques (IMRT/VMAT/SBRT) in the treatment of thoracic tumours. Within lung cancer, there will be a focus on the importance of biomarker-based decision making, and its impact on systemic therapy and radiotherapy decision-making. Dr. Alexander Louie will be the overall supervisor, but the fellow will rotate with several members of the Thoracic Radiation Oncology team to get the broadest possible experience during a one-year time period.

Potential research projects will revolve around evaluating clinical/technical/epidemiological outcomes of patients with thoracic malignancies treated with radiotherapy. This could include retrospective clinical studies, development of prospective trials, technical research in collaboration with our medical physicists, or database outcomes research.

Multi-site stereotactic body radiation therapy (SBRT) clinical research fellowship

The fellow will gain further experience (beyond what a typical radiation oncology residency provides) in the use of SBRT in various body sites. In addition to consolidating his/her experience in the use of SBRT in established sites such as lung and liver, the fellow will gain expertise in the delivery of SBRT to other body sites, including kidney/adrenal, pancreas, non-spine bone, and axillary/mediastinal/abdominal/pelvic lymphadenopathy. More importantly, the fellow will appreciate and understand better the established and emerging indications of using SBRT in the setting of localized and metastatic cancer, including oligometastases and oligoprogression. Block rotations and/or supervision under various radiation oncologists is possible to tailor the SBRT experience towards the fellow’s interests in a one-year period.

Potential research projects will revolve around evaluating clinical/technical/epidemiological outcomes of patients treated with SBRT. This could include retrospective clinical studies, development of prospective trials, technical/dosimetric research in collaboration with our medical physicists, or database outcomes research.

Optimizing safety is a core theme, particularly with SBRT for oligometastatic and oligoprogressive cancers and the potential for interaction with the rapidly evolving systemic therapy landscape. Prior fellows have gone on to establish or strengthen SBRT programs as staff physicians.

Fellows have the option to apply and work towards a graduate degree at the University of Toronto, if a more prolonged two-year fellowship is desired.