Pioneering Radiotherapy Machine is a 'Dream Come True': 5 questions

Siobhan Harris


October 03, 2018

A ground-breaking new radiotherapy machine is being used in the UK.

The Magnetic Resonance Linear Accelerator (MR Linac) machine
scans tumours inside the body while delivering X-ray radiation beams at the same time.

The team behind it hopes it will lead to more patients being cured, with fewer treatment side-effects. 

A patient with prostate cancer was the first in the UK to receive treatment, at the Royal Marsden Hospital in London.

A team of clinical oncologists, therapeutic radiographers, and physicists, worked in collaboration for years to make this treatment available to patients.

Dr Alison Tree, consultant clinical oncologist at The Royal Marsden is leading the PRISM clinical trial and is team leader in Uro-oncology clinical trials at The Institute of Cancer Research (ICR).

Medscape UK asked her how the pioneering MR Linac will change the way we treat radiotherapy patients in the future.


Medscape UK: How does the new MR Linac radiotherapy machine operate and why is it ground-breaking?

Dr Tree: The MR Linac is the first technology in the world to simultaneously generate magnetic resonance images and deliver X-ray radiation beams — allowing radiotherapy to be adjusted in real time and delivered more accurately and effectively than ever before.

The MR Linac is a dream come true. If you were going to design radiotherapy from scratch, this is how you would do it. To be able to see the patient’s anatomy before you treat, to be able to change where you put the dose and treat with such accuracy is incredible.

Medscape UK: How exactly will it help clinicians?

Dr Tree: The ability to target tumours with radiation beams in real time will be particularly effective for cancers that change position through breathing, bladder filling or bowel changes and should reduce the side-effects for the patient.

For example, tumours in the prostate, lung, bladder, and bowel would be targeted in real time – allowing the radiation beams to be adjusted with enhanced precision during the course of treatment.

Medscape UK: How will it help patients?

Dr Tree: Prostate cancer responds most effectively to large doses of radiation delivered over a short period. However, because the prostate lies close to the rectum, high doses risk damaging the rectum and increasing side-effects.

With the MR Linac we can better target the prostate while avoiding the rectum, which we hope will minimise side effects. It is possible that this ground-breaking precision will one day make it possible for us to cure prostate cancer in a single treatment.

Medscape UK: How many other MR Linac machines are there globally to treat cancer?

Dr Tree: The Royal Marsden and ICR are the third cancer centre in the world to use the MR Linac and the first in the UK.

They formed an international consortium led by a team at Utrecht Medical Centre and the company Elekta, which makes the MR Linac, and MR partner Phillips and six other cancer centres. There are several other machines, spread across the world, which will become operational in the next year.

Medscape UK: How was it funded and looking into the future do you think the MR Linac will be more widely used?

Dr Tree: The installation of the MR Linac was made possible by a £10m grant from the Medical Research Council to The Institute of Cancer Research, with additional support from The Royal Marsden Cancer Charity.

At the moment we only have one machine, and the treatments take around 45 minutes per day, so we are limited by capacity. It is therefore very important that we focus on clinical trials to research which patients have most to gain from this machine, so they can be prioritised for treatment.


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