The Royal Marsden offers a truly comprehensive radiotherapy service.
Our team of highly skilled clinical oncologists, medical physicists and therapeutic radiographers has a long tradition of excellence and innovation.
Patients at The Royal Marsden have access to the latest radiotherapy machines and techniques, as well as clinical trials for new treatments.
The decision whether to use radiotherapy and which type of radiotherapy to use is made on a patient-by-patient basis.
Different tumour types respond to radiotherapy in different ways so all patients require an individualised treatment plan.
Where appropriate, radiotherapy at The Royal Marsden is used to treat many different forms of cancer, including skin cancer, head and neck cancer, breast cancer, cervical cancer, anal cancer and prostate cancer. Radiotherapy may be given alongside chemotherapy and/or surgery.
The Royal Marsden is also a specialist referral centre for sarcoma and paediatric radiotherapy.
Types of radiotherapy we offer
Developments in radiotherapy allow us to target tumours with more accurate doses of radiation than ever before. Greater accuracy means that fewer healthy cells are damaged, which in turn means that stronger doses can be given, making treatment more effective and, usually, shorter.
Here are some of the main types of radiotherapy we offer using the latest state-of-the-art equipment:
Image-guided radiotherapy (IGRT)
IGRT is the use of a variety of imaging techniques, such as X-rays or CT scans, alongside radiotherapy. Imaging allows us to confirm the position of the patient and the tumour and target the radiotherapy beam more precisely. The Royal Marsden was at the forefront of the move towards the greater use of IGRT, which is a routine treatment at both our hospitals.
Intensity-modulated radiotherapy (IMRT)
IMRT uses linear accelerators to deliver very precise doses of radiation which are shaped to the size of the tumour. It is a routine radiotherapy treatment at The Royal Marsden for some cancer types.
Volumetric modulated arc therapy (VMAT)
VMAT is a new radiotherapy method first performed in the UK at The Royal Marsden. This kind of radiotherapy is also called RapidArc – both names are specific to the equipment manufacturers, but are the same technique.
Using three-dimensional volume imaging, treatment can be designed and delivered to maximise the radiation dose the tumour receives and minimise exposure of the surrounding healthy tissue. The angle of the beam, the dose rate and the leaf speed are all independently controlled, making this a very accurate form of treatment. Arc therapy treatments also take much less time to deliver than other radiotherapy techniques.
Stereotactic radiotherapy (also called radiosurgery) is the use of multiple small beams to deliver radiotherapy treatment which is shaped to the size of the tumour. It is most often used on small, well-defined tumours. Stereotactic radiotherapy is usually delivered using a linear accelerator but there are also machines designed specifically for this purpose, such as CyberKnife.
CyberKnife is a new machine used to deliver the latest in stereotactic radiotherapy. It uses a moving couch and a small linear accelerator on a robotic arm to deliver multiple beams of radiation from different angles. It works best on small tumours with well-defined edges. CyberKnife is able to deliver multiple doses of highly concentrated radiation from a variety of angles. It can also adjust the delivery, for example to match the patient's breathing motion.
The Elekta Unity Magnetic Resonance Linear Accelerator (MR Linac) combines two technologies – an MRI scanner and linear accelerator – to precisely locate tumours, tailor the shape of X-ray beams in real time and accurately deliver doses of radiation to tumours that move from day to day.
The ability to target tumours with radiation beams in real time will be particularly effective for cancers that change position through bladder filling or bowel changes and should reduce the side-effects for the patient. For example tumours in the prostate, upper abdomen, bladder and bowel would be targeted in real time – allowing the radiation beams to be adjusted with enhanced precision during the course of treatment.
Brachytherapy is different to the other treatments listed above. Instead of the ionising radiation source being outside the body, patients have radioactive sources placed inside their body. This can be done in an operating theatre, at the Radiotherapy Department in Chelsea or in Nuclear Medicine by drinking a radioactive drink or by IV injection.
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