Our advanced radiotherapy technology
The state-of-the-art Brunel linear accelerator
radiotherapy treatments delivered annually
The Royal Marsden’s Radiotherapy department is one of the largest in the UK – treating up to 5,000 patients and delivering more than 75,000 treatments each year. As part of the Trust’s commitment to providing the latest radiotherapy techniques, a new linear accelerator was installed in 2015 at The Royal Marsden in Chelsea. The £2.3 million Varian TrueBeam machine known as the Brunel treats up to 40 patients a day for a variety of tumour types, including breast, lung, head and neck, prostate, gastrointestinal and gynaecological cancers.
The Brunel delivers all forms of advanced external-beam radiotherapy: image-guided radiotherapy (IGRT); intensity-modulated radiotherapy (IMRT); stereotactic body radiotherapy (SBRT); and volumetric modulated arc therapy (VMAT). It also has the advanced flattening filter free (FFF) delivery system, which means the treatment dose can be delivered faster.
“Developments in radiotherapy imaging allow us to target tumours with sub-millimetre precision,” says Sarah Helyer, Radiotherapy Services Manager. “Greater accuracy means that fewer healthy cells are damaged, which, in turn, means higher doses can be given. This makes treatment more effective and reduces side effects.”
In total, the Trust operates 11 linear accelerators across the department. Additionally, the CyberKnife machine in Chelsea is used specifically for stereotactic treatments. The Sutton department has a Gulmay superficial radiotherapy machine for the treatment of skin cancers. The Trust also installed the new Elekta Versa HD linear accelerator at its Sutton site. This is known as the Hawthorn Unit and can deliver the full range of advanced techniques, including the FFF delivery system.
Research into radiotherapy techniques has resulted in major advances in the way we treat patients. Dr Imogen Locke, Lead for Clinical Oncology, says: “The PACE trial, for example, is exploring the benefit of reducing radiotherapy sessions from 39 standard treatments to five delivered with stereotactic radiotherapy. This would be less time-consuming for the patient and means less radiation to healthy tissue over the course of the treatment.”
Sharing pioneering techniques
The Royal Marsden’s new radiotherapy techniques are often rolled out across the country, thanks to its commitment to training and education. New treatment methods have been shared with more than half of the UK’s radiotherapy departments.
“At The Royal Marsden, we thrive on change and embrace it,” says Dr Helen McNair, Lead Research Radiographer. “We like to try new ways of doing things for the benefit of our patients. Radiotherapy studies at The Royal Marsden have changed the way cancer patients are treated, not only here but across the country.”
students supported on courses
Training future generations
The Royal Marsden’s Radiotherapy Department prides itself on offering the best training for the next generation of radiographers. We support about 70 students over their three- and four-year courses, as well as radiographers who are undertaking a Masters.
“Although we support students on the conventional full-time three-year BSc course, we also train staff who are recruited to work in admin and clerical in radiotherapy while undertaking a part-time degree programme,” says Sarah Armstrong, Professional Development Lead. “The in-service programme allows people who would like to train to be a radiographer to work full-time and receive a salary while they undertake the part-time four-year BSc.”
Our range of radiotherapy techniques
Image-guided radiotherapy (IGRT)
A variety of imaging techniques, such as X-rays or CT scans, are used to confirm the position of the tumour and target treatment more precisely.
Intensity-modulated radiotherapy (IMRT)
Multiple beams of varying intensity are used to shape the radiotherapy more precisely.
Volumetric-modulated arc therapy (VMAT)
An advanced radiotherapy method first performed in the UK at The Royal Marsden. During VMAT, the linear accelerator delivers radiotherapy in one or more continuous arcs to conform the treatment to the exact size and shape of the tumour.
The use of multiple small beams to deliver a high dose in just a few treatments. Delivered using an IGRT technique on a linear accelerator or CyberKnife.
Delivers stereotactic radiotherapy, using a moving couch and a small linear accelerator on a robotic arm to deliver multiple beams of radiation from different angles.
Radioactive sources are placed inside the patient’s body.
These treatments are chosen on the day. The patient is imaged and the treatment plan designed to ‘fit’ the volume to be treated. For example, in bladder cancer, we will select the plan that fits the size of the bladder that day.