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Radiotherapy

Radiotherapy

First UK radiation treatment using MR-guided linac

25 Sep 2018 Tami Freeman
MR-linac team
The Elekta Unity treatment team at The Royal Marsden and the Institute of Cancer Research, London. (Courtesy: Elekta)

The Royal Marsden and the Institute of Cancer Research (ICR) in London have performed the first treatment in the UK using an MR-linac – the Elekta Unity system.

The Elekta Unity, which received its CE mark in June 2018 and is being clinically implemented in European cancer centres, combines high-field (1.5 T) MR imaging, precision radiation therapy and intelligent software to deliver MR-guided radiotherapy.

“It’s hugely exciting to be able to trial this technology here at the ICR and The Royal Marsden,” says Uwe Oelfke, head of the Joint Department of Physics. “Together we’ve made world-leading advances in radiotherapy through our research and we expect Elekta Unity to allow us to make another step change in improving cancer treatment. This trial is for prostate cancer, but we anticipate Elekta Unity will help us improve radiotherapy for a wide range of cancers, including hard-to-treat forms such as lung and pancreatic cancer.”

The patient received treatment as part of the PRISM clinical trial, which will assess the feasibility of delivering radical radiotherapy for prostate cancer using the MR-linac. The patient had a localized prostate cancer and started hormone treatment in May 2018. His PSA (prostate-specific antigen) level indicated that he was ready to start radiotherapy and he was offered treatment on the Elekta Unity.

“Tumour shape and position relative to healthy tissue evolve over the course of treatment and can change during an individual treatment session,” explains Alison Tree, who is leading the PRISM trial. “The ability to detect those changes and adapt therapy in real time allows us to improve the precision of radiation therapy, more effectively treating the tumour while preserving healthy tissue.”

Tree notes that the Elekta Unity will also enable radiation treatment of patients who would not be candidates using more traditional radiation delivery systems.

“For decades, the radiation oncology community has dreamed of the day when we could see what we treat in real time just as our surgical colleagues do, and we are excited that this day has arrived,” says Oelfke. “Radiotherapy is important to the treatment of around 40% of the people who are cured of cancer. But if we want to fully unlock the potential of radiotherapy by making it even more precise, we need to be able to see a patient’s tumour while we deliver the radiation treatment. The MR-linac will make this possible.”

The Royal Marsden and the ICR are founding members of Elekta’s MR-linac Consortium, a collaborative industrial–academic partnership that Elekta founded with seven centres and technology partner, Philips, in 2012.

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