Johnson explains: "We already know that using imaging can help us to target cancers much more precisely and make radiotherapy treatment more effective.

"This study examines how small differences in how a patient is lying can affect survival, even when an imaging protocol is used. It tells us that even very small remaining errors can have a major impact on patients' survival chances, particularly when tumours are close to a vital organ like the heart.


"By imaging patients more frequently and by reducing the threshold on the accuracy of their position, we can help lower the dose of radiation that reaches the heart and avoid unnecessary damage."

Johnson and her colleagues are now looking at the data in more detail to see whether particular regions of the heart are more sensitive to radiation than others, and they hope to investigate the effect of differences in patient position in other types of cancer.

President of ESTRO, Professor Yolande Lievens, head of the department of radiation oncology at Ghent University Hospital, Belgium, said: "Radiotherapy treatments are given according to strict protocols to ensure that patients get the most effective treatment with the fewest possible side-effects. This research suggests that changes to lung and oesophageal cancer protocols could positively impact the overall survival of patients with these cancers, both of which have relatively high mortality rates."

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