A pioneering radiotherapy machine, developed by the Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London, has treated its first patient in the UK.

The Magnetic Resonance Linear Accelerator (MR Linac) machine is the first to generate magnetic resonance images and deliver X-ray radiation beams simultaneously. This allows radiotherapy to be adjusted in real time and read more accurately and effectively than before, according to its developers.

The ability to target tumors with radiation beams in real time was said to be particularly effective for cancers that change position through breathing, bladder filling or bowel changes. It should also reduce the side-effects for the patient.

Target tumors with radiation beams

Tumors in the prostate, lung, bladder, and bowel can now be targeted in real time – allowing the radiation beams to be adjusted with more precision during treatment.

Professor Uwe Oelfke, Head of the Joint Department of Physics at The Institute of Cancer Research, London, and The Royal Marsden, who leads the joint MR Linac project, said: “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.

“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 in targeting cancer and avoiding healthy tissue, we need to be able to see a patient’s tumor while we deliver the radiation treatment. The MR Linac will make this possible.”

‘Unlock the potential of radiotherapy.’

The MR Linac machine was expected to enable “another step change” in improving cancer treatment, added Prof Oelfke. “This trial is for prostate cancer, but we anticipate the MR Linac will help us improve radiotherapy for a wide range of cancers, including hard-to-treat forms such as lung and pancreatic cancer.”

Joshua Freedman, a third-year Ph.D. student in the institute’s Division of Radiotherapy and Imaging who helped develop the machine, said it combines two technologies to tailor the shape of X-ray beams in real time and accurately deliver doses of radiation.

“Currently, the same radiotherapy treatment plan is used for all fractions treatment rounds, but this approach has setbacks: a patient’s anatomy might undergo slow changes between treatment fractions, for example, because of weight-loss or tumor shrinkage,” said Freedman in a blog post.

“Another issue is that conventional radiotherapy is not able to fully account for any rapid anatomical changes during treatment delivery, for example, as a result of breathing, or due to bladder filling,” said Freedman.