A pioneering new type of radiotherapy machine opened by Mayor of London, Sadiq Khan, has the potential to transform the care of cancer patients by directing radiation even at tumours that move during treatment.
The MR Linac machine is the first technology to simultaneously generate magnetic resonance images and deliver X-rays, allowing radiotherapy to be adjusted in real time and delivered more accurately and effectively than ever before.
The Royal Marsden and the Institute of Cancer Research (ICR) are the first institutions in the UK to install an MR Linac machine, with the first patients due to be treated in the second half of 2017, initially through clinical studies in hard-to-treat cancer types.
The technology is set to make radiotherapy more effective and reduce its side-effects by tailoring the radiation beam precisely to the patient’s anatomy during treatment. It could be especially effective for cancers such as lung, cervical, prostate, bowel and bladder, which move during radiotherapy or change position between scanning and treatment due to breathing, bladder filling or bowel changes.
The installation of the MR Linac was made possible by a £10m grant from the Medical Research Council to the ICR, with additional support from The Royal Marsden Cancer Charity.
Physicists at the ICR and The Royal Marsden have been actively developing the technology for several years as part of an international consortium led by a team at Utrecht Medical Centre and the company Elekta, which makes the MR Linac, and MR partner Phillips.
The UK team’s initial findings, published in the journal Radiotherapy and Oncology, have shown that it is possible to target radiation precisely at lung tumours with the MR Linac using real-time imaging. The research shows that the system can be calibrated to deliver X-rays accurately in the presence of the distorting magnetic field used to generate MRI images, overcoming a key scientific challenge.
The purpose-built treatment suite containing the MR Linac, based in the Radiotherapy department at The Royal Marsden, will continue to be used to develop the technology ahead of the first clinical studies later next year.
As well as the MRC funding for the MR Linac project, scientists were also funded by Cancer Research UK for much of the preparatory research.
Mayor of London Sadiq Khan said: “It’s a great honour to be involved in officially opening the MR Linac radiotherapy system. This truly groundbreaking device is the first of its kind anywhere in the UK and has the potential to transform the care that cancer patients receive. The MR Linac will give patients access to the most cutting-edge treatment available, which could help to save lives.
“The fact that the Institute of Cancer Research and The Royal Marsden are among a select group of international centres developing this pioneering technology really underlines the fact that London is at the forefront of advances in medical research and innovation.”
Professor Uwe Oelfke, Head of the Joint Department of Physics at the ICR and The Royal Marsden said: “Combining the excellent soft-tissue contrast of MRI scanning with precision radiotherapy in a single treatment technology has been one of the major challenges of modern radiotherapy research. The launch of our new system is an important step towards finally making this state-of-the-art treatment available for patients in the UK, with our first clinical trials due to begin in about a year’s time.
“By doing accurate patient imaging at the same time as delivery of radiotherapy – rather than as separate steps – we aim to significantly improve treatment for patients with hard-to-treat cancers including lung cancer.”
Dr Nick Van As, Medical Director at The Royal Marsden, said: “The MR Linac will give us the opportunity to realise our vision for radiotherapy of the future. Tumours and organs can move and change shape while we deliver radiotherapy, which means we have to irradiate a safety margin to ensure we hit the target every time.
“The superior imaging of the MR Linac will allow us to treat with a greater level of accuracy and to adapt our radiotherapy treatment on a daily basis, meaning less normal tissue is irradiated. This will minimise damage to the normal tissues and safely give us capacity to prescribe higher radiation doses to the tumour, hopefully leading to more effective treatment.”