'More cures, fewer side-effects' with pioneering radiotherapy machine

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Barry Dolling is prepared for treatment in the MR Linac by therapeutic radiographers

The first patient in the UK has been treated with a pioneering new radiotherapy machine.

The MR Linac simultaneously scans tumours inside the body while delivering X-ray radiation beams.

It means clinicians can plan and adjust radiotherapy in real time, allowing it to be more accurate than ever before.

The team at the Institute of Cancer Research, external and the Royal Marsden Hospital, external in London describe the technology as "groundbreaking".

They hope it will lead to more patients being cured while experiencing fewer side-effects.

Barry Dolling, 65, who has prostate cancer, is the first patient in the UK to be treated.

He told me: "I feel privileged and excited to be part of this. I volunteered to be part of the Prism, external trial and feel my treatment and the research will help others diagnosed with prostate cancer in the future."

Pioneering

Prof Uwe Oelfke, who leads the joint MR Linac project at the ICR and Marsden, told me: "Ten years ago we did not think it would be possible to combine MRI and radiotherapy - this is a real step-change in technology."

The machine has been specially designed so that the magnetic coils of the MRI and the X-ray beam of the linear accelerator do not interfere with each other.

It will be especially useful in treating tumours that shift in size and shape in the body, such as in the lung, bladder and bowel.

Dr Alison Tree, consultant oncologist at the Royal Marsden, described the new technology as "a dream come true" that would enable clinicians to deliver more targeted, higher doses of radiation, sparing healthy tissue.

"In lung cancer, we would like to give higher doses of radiotherapy but are limited because the tumour is often close to other vital structures in the chest," she said.

"This allows us to see the cancer more clearly and make sure the radiation goes where it is needed and not where it can cause harm."

Single treatment

The ability to give higher doses of radiation will enable patients to complete their treatment more quickly.

Mr Dolling will have 20 sessions of radiotherapy in the MR Linac. But it's predicted that eventually it will be possible to cure some cancers in a single treatment.

The Royal Marsden will treat prostate, rectal, bowel, bladder, cervical and eventually lung cancer in the MR Linac.

The installation of the MR Linac was made possible by a £10m grant from the Medical Research Council, plus support from the Royal Marsden Cancer Charity, external.

A second machine, at the Christie in Manchester, will begin treating patients early next year.

Both hospitals are part of an international research consortium together with companies Elekta, , externalwhich makes the MR Linac, and Phillips.

So far, the only other cancer centres to treat patients with the MR Linac are in the Netherlands, in Utrecht and Amsterdam.

The prospect of more accurately targeted radiotherapy, with fewer side-effects, will inevitably mean there will be high demand for access to treatment in the MR Linac.

Dr Tree said there would be several clinical trials and priority would be given to research that yielded the most benefit to patients.

There have been significant improvements in radiotherapy treatment in recent years - it already contributes to 40% of all the cases of cancer that are cured.

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