Cancer treatment that takes days not weeks

Magnetic resonance image guided radiotherapy, or MRIgRT, is the most exciting development in advanced radiotherapy for years. By combining a linear accelerator with a high definition MR scanner, MRIdian allows clinicians to see as they treat – adjusting the beam to allow for movements and anatomical changes. It provides a step-change in accurate stereotactic ablative radiotherapy (SABR), bringing a new level of control and confidence with tumour targeting and sparing of normal tissue. MRIdian makes truly adaptive SABR possible for the first time.

GenesisCare is the first to introduce MRIdian technology to the UK at our Oxford centre – the first member of an emerging MRIgRT network that will put us at the forefront of exploring the possibilities of this innovative approach.

MRIdian 50/5 – our experience so far

The MRIdian MR linac is one of the most advanced forms of radiation therapy, demanding a high level of clinician input, a skilled team, a robust workflow and a completely new way of working.
MRIdian 50/5 chronicles our experience of how we overcame these challenges and we were able to set up a service in six months and treat our first 50 patients during the next five. In that time, the benefits to patients have been even greater than any of us imagined.
We want to share what we’ve learned so that other centres can replicate this service with the same efficiency and positive outcome. MRI-guided radiotherapy will play a major role in cancer care in the next five to ten years and will be adopted by many more healthcare organisations.

Inoperable pancreatic cancer is a new indication for high-dose SABR – it’s only possible because of MR linac Dr James Good, Clinical Director of Stereotactic Radiotherapy, GenesisCare UK

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Our centre in Oxford is rated ‘Good’ by the Care Quality Commission (CQC).

MRIdian specialists at GenesisCare

Patient care on the MRIdian is delivered by a team of specially trained consultant oncologists, selected on the basis of their clinical expertise. Collectively the team provide a comprehensive infrastructure for patient selection, peer review, and clinical governance for all referrals, and the credentialing of new clinicians in MRI-guided radiotherapy. We are excited to be partnering with the University of Oxford to build a body of evidence that will impact the lives of many patients.

Dr Ami Sabharwal

Urological cancer

Specialist interest in urological cancers

Dr Andy Gaya

Clinical Oncologist

Specialist interest in upper and lower GI and HPB cancers

Dr Philip Camilleri

Clinical Director, Urological Cancers

Specialist interest in urological cancers

Dr Carla Perna

Clinical Oncologist

Specialist interest in urological cancers

Dr James Good

Clinical Director, SABR, Birmingham & Oxford

Specialist interest in colorectal, HPB and head/neck cancers

Dr Nicola Dallas

Clinical Oncologist

Specialist interest in urological and head/neck cancers

Dr Veni Ezhil

Clinical Oncologist

Specialist interest in thoracic cancers and lymphoma

Dr Prantik Das, Nottingham

Clinical Oncologist

Specialist interest in urological cancers

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A new paradigm in radiation oncology

Real-time on-table adaptive radiotherapy brings a new level of confidence to SABR delivery.

Image: Mittauer, Cureus

Compassionate Access Programme

Cancers treated

With 10,000 patients treated to date worldwide, MRIdian has been widely used for gastrointestinal, lung and prostate cancer, and is increasingly recognised as a possible platform for partial breast treatments and safer re-irradiation. The possibility of incorporating on-table functional MRI into treatment pathways is just around the corner.

The evidence base for SABR is growing and there is currently a range of clinical scenarios into which it can be integrated. At GenesisCare, we currently offer SABR in the following situations:

  1. Localised prostate cancer, where hypofractionated treatment offers an alternative to conventional radiotherapy

  2. Early stage lung cancer

  3. Pelvic reirradiation

  4. Hepatobiliary cancer, including primary liver cancers and inoperable/recurrent pancreatic cancer

  5. Selected cases of oligo-metastatic and oligo-progressive cancers

  6. Renal cell carcinoma where surgery is not possible or not preferrable, and other treatments are not advisable (e.g. for larger tumours where risk of damage to surrounding organs is greater, or central kidney tumours where surgery is not possible and SABR would preserve greater renal function)  

References

  1. Bruynzeel, A et al. A Prospective Single-Arm Phase 2 Study of Stereotactic Magnetic Resonance Guided Adaptive Radiation Therapy for Prostate Cancer: Early Toxicity Results International Journal of Radiation Oncology, Biology, Physics.
  2. Rudra, S. et al. Using adaptive magnetic resonance image-guided radiation therapy for treatment of inoperable pancreatic cancer. Cancer Med. 8, 2123–2132 (2019).
  3. Siva S, Ellis RJ, Ponsky L, Teh BS, Mahadevan A, Muacevic A, Staehler M, Onishi  HWersall P, Nomiya T, Lo SS. Consensus statement from the International Radiosurgery Oncology Consortium for Kidney for primary renal cell carcinoma. Future Oncol. 2016 Mar;12(5):637-45 
  4. Siva S, Correa R, Warner A, Staehler M, Ellis R, Ponsky L et al. Stereotactic Ablative Radiotherapy for ≥T1b Primary Renal Cell Carcinoma: A Report From the International Radiosurgery Oncology Consortium for Kidney (IROCK). Int. J. Radiat. Oncol. Biol. Phys. 2020;108(4):941-949.