Experience with the first three lung cancer patients to receive magnetic resonance (MR)-guided radiotherapy on the Elekta Unity MR-Linac in the United Kingdom (UK)
Crockett, Cathryn Benson, Rebecca Berresford, Joe Chuter, Robert Clough, Abigael Faivre-Finn, Corinne Freear, Linnea Marchant, Thomas E Nelder, Claire L Pitt, Eleanor
Crockett, Cathryn
Benson, Rebecca
Berresford, Joe
Chuter, Robert
Clough, Abigael
Faivre-Finn, Corinne
Freear, Linnea
Marchant, Thomas E
Nelder, Claire L
Pitt, Eleanor
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Abstract
Background: The Elekta Unity MR-Linac has been in operation at
the Christie NHS Foundation Trust since May 2019. The clinical
implementation of thoracic MR-guided radiotherapy has been a key
objective ever since.
Methods: A team of clinicians, physicists, and radiographers worked
collaboratively to produce a protocol for the delivery of radical
radiotherapy to patients with stage III lung cancer (Fig. 1).
Results: The first lung cancer patient in the UK was treated in July
2021 and a further two patients have subsequently followed. Two
patients had stage III NSCLC and the other had oligometastatic
stage IV NSCLC (T4N2/3 thoracic disease and a single gluteal metastasis). The latter patient received radical radiotherapy as part of the SARON trial, including MR-guided stereotactic ablative radiotherapy
to the metastasis. All three patients had bulky primary tumours
in different locations within the lungs – anterior left upper lobe,
posterior right upper lobe invading ribs and left upper lobe invading
mediastinal pleura. The clinically available T2 3D MR sequence
appeared to provide the best image resolution for all three patients.
The first patient was treated with a clinician present for every
fraction. However, during the treatment course of patient two, a
‘clinician-light’ approach was adopted, whereby a clinician was only
contacted if dose constraints for organs at risk were found to be
above a predefined level or there was clinical concern. The average
couch time for each patient was 42, 50 and 45 minutes, respectively.
Treatments were well tolerated and to date, no unexpected toxicities
have been reported.
Conclusion: Thoracic MR-guided radiotherapy using an Adapt to
Position workflow has been successfully clinically implemented
at the Christie NHS Foundation Trust. We aim to move to an Adapt
to Shape workflow once 4D MR imaging, tracking and gating
technologies are made available on the Elekta Unity.
Description
Date
2022
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Crockett C, Benson R, Berresford J, Chuter R, Clough A, Corinne F, et al. Experience with the first three lung cancer patients to receive magnetic resonance (MR)-guided radiotherapy on the Elekta Unity MR-Linac in the United Kingdom (UK). Lung Cancer. 2022;165:S50-S1.