Magnetic Resonance Radiation Therapy With Elekta Unity
By Warren Miller. 2nd October 2018
Radiation therapy is an established type of cancer treatment. Where appropriate, consultants and radiologists who specialise in the treatment of Mesothelioma, use external beam radiation in aggressive treatment plans.
However, there is a safety issue in this treatment as the Mesothelioma tumours are often close to the heart, liver, intestines and kidneys. The tumors may also move when the patient breathes or their abdominal organs shift because of digestion.
So there is a trade off between the safety concerns and the effectiveness of the treatment to destroy the cancer cells.
A higher dose of radiation will kill more cancer cells, but it could also cause severe complications if it hits healthy cells by mistake. Modern technologies such as intensity-modulated radiation therapy and proton therapy can target areas in the body much more selectively. Even so, these therapy techniques are only as good as the imaging scans that guide them. This is where the emerging techniques of image-guided radiation therapy (IGRT) come in.
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.
For the first time, the worlds of advanced radiotherapy and high-field quality Magnetic Resonance imaging have been brought together to create Elekta's MR-linac – the first platform to enable MR/RT. It was developed in collaboration with seven world-leading cancer centers and 200 scientists and enables clinicians to confidently see and track difficult to visualise soft-tissue anatomies.
The Elekta Unity system received its CE mark in June 2018, clearing the technology for commercial sales and clinical implementation in Europe. It combines high-field Magnetic Resonance Imaging, precision radiation therapy and intelligent software to deliver Magnetic Resonance (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. ”
Cancer Test Case at The Royal Marsden
The patient at The Royal Marsden 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.
Alison Tree, who is leading the PRISM trial stated:
“ Tumour shape and position relative to healthy tissue evolve over the course of treatment and can change during an individual treatment session. 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. ”
Uwe Oelfke, head of Physics continues . . .
“ 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, 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 technology of radiation therapy is constantly improving - this can only benefit victims of cancer including mesothelioma patients. There is still no cure for mesothelioma, but with a combination of therapies, the prognosis for mesothelioma is slowly improving.
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