The Royal Marsden NHS Foundation Trust has achieved a UK first by delivering online adaptive radiotherapy (oART) on an Elekta linear accelerator (linac) using RaySearch’s advanced adaptive tools.
This type of radiotherapy allows for highly precise, targeted treatment. It can help to minimise damage to surrounding healthy tissue, and therefore reduce patient side effects.
Until now, the vast majority of oART treatments have been delivered on purpose-built, specialised machines, which are not commonplace. This achievement on an Elekta linac demonstrates that oART can be performed on machines that are already in use in the NHS, bringing this treatment to even more patients.
This latest success follows on from The Royal Marsden NHS Foundation Trust becoming the first hospital in the world to treat a patient using RaySearch’s advanced adaptive radiotherapy technology (known as Raystation, a treatment planning system) on an Accuray Radixact linear accelerator, both of which were funded by The Royal Marsden Cancer Charity.
That milestone has laid the foundation for being able to potentially extend adaptive workflows to more widely available linacs.
Traditionally, radiotherapy involves creating a treatment plan based on a planning CT scan of the patient’s anatomy, with clinicians outlining the treatment area and adding a margin of healthy tissue to accommodate anatomical changes. However, significant changes in the patient’s anatomy over the course of treatment can require a new plan. Online adaptive radiotherapy transforms this process. This adaptation takes place during the treatment session, accounting for even subtle changes, such as weight fluctuations and bladder filling.
This advanced approach not only enhances treatment accuracy but also has the potential to reduce the need for additional hospital visits and scans, easing patient anxiety and helping individuals return to their normal lives sooner.
Dr Shaista Hafeez, Consultant Clinical Oncologist at The Royal Marsden, said: “Online adaptive radiotherapy allows us to personalise treatment for each patient on a daily basis. By adapting the plan to the patient’s anatomy at every session, we can reduce treatment margins and hopefully minimise side effects, while maintaining excellent tumour coverage. Delivering oART on the Elekta linac is a significant step forward, and we are very grateful to The Royal Marsden Cancer Charity for funding this innovative technology, which we hope will be used at more centres to benefit patients across the UK.”
Antonia Dalmahoy, Managing Director of The Royal Marsden Cancer Charity, said: “We are delighted that the Charity’s support has enabled this exciting development, paving the way for more precise radiotherapy treatment with fewer side effects for a greater number of patients.”
The first patient to benefit from this innovative technique using an Elekta linac was Margaret Billington, 87, a bladder cancer patient.
Margaret said: “After my diagnosis, I was referred to The Royal Marsden to have six weeks of radiotherapy. The doctors and the rest of the team are lovely – they explained about this type of radiotherapy and its benefits. It’s marvellous that I’ve been able to have this as it’s very pioneering. Hopefully, it will make a difference to more patients in the future.”
Pictured: Elekta linear accelerator at The Royal Marsden
