Innovative prostate cancer treatment

North-Ryde resident and retired principal, Rod Brooks, has become the first person in NSW to receive highly targeted cancer therapy using an MR Linac.

 

The MR Linac equipment has been installed at the the GenesisCare oncology centre within St Vincent’s Hospital in Darlinghurst.

 

This is the first centre in NSW and the second in Australia to offer treatment using the Elekta Unity MR-Linac. It combines a state-of-the-art MRI imaging scanner and a linear accelerator so treatment specialists can see tumours and adapt treatment in real time.

 

The MR Linac is available to treat patients with prostate1-3 or oligometastatic cancer,4 with new capabilities to treat additional tumour types to be introduced in the future.

 

Former teacher and high school principal, Rod Brooks, 68yo, was diagnosed with prostate cancer in May 2020 after a blood test returned elevated prostate specific antigen (PSA) levels. This is the second time Rod was told he had cancer, having been diagnosed and treated for bowel cancer in 2007.

 

The MR-Linac system is the latest advancement in stereotactic body radiation therapy (SBRT), a non-invasive type of radiation therapy which involves delivering radiation from a source outside the body.5,6 While it is generally administered daily for several weeks (between 20-40 sessions in total), SRBT allows clinicians to deliver a higher dose of radiation across five or less daily sessions.6-8

 

GenesisCare MR-Linac Lead Radiation Oncologist, Dr Jeremy de Leon, said: “Many tumours are located in organs that move during or between radiation treatment sessions. Tumours can also be located near sensitive organs or tissues, such as the bladder or bowel,2,9,10 so we need to be able to precisely deliver radiation within millimetres, so we target the tumour and not other organs.

 

“The MR-Linac enables clinicians to visualise the tumour during treatment and adapt to changes in tumour size and location. This allows us to target cancer more precisely and deliver highly personalised therapy each time a patient is treated,”10-12 said Dr de Leon.

 

“This adaptive patient care in radiation therapy helps to minimise exposure to surrounding healthy tissue and may result in reduced treatment-related side effects, less treatment sessions and fewer visits to the hospital, thereby reducing the overall burden on patients.”10,11

 

Cancer is a major cause of illness in Australia, and prostate cancer is the nation's most commonly diagnosed cancer in men,13 with almost 20,000 men diagnosed with the disease last year alone. 13 It is also Australia’s third most common cause of cancer death (after lung and colorectal cancer),14 claiming the lives of more than 3,300 Australian men each year.13

 

GenesisCare Chief Executive Officer, Dan Collins, said: “More than ever in these challenging times, we want to ensure that cancer patients across New South Wales and right around the world receive the right care when it’s needed. This is why we are continuing our investment in the latest technology through our partnership with Elekta.

 

23 July 2020.

 

References

1. Prior, P., et al., MRI-based IMRT planning for MR-linac: comparison between CT- and MRI-based plans for pancreatic and prostate cancers. Phys Med Biol, 2016. 61(10): p. 3819-42.

2. Corradini, S., et al., MR-guidance in clinical reality: current treatment challenges and future perspectives. Radiation oncology (London, England), 2019. 14(1): p. 92-92.

3. Pollard, J.M., et al., The future of image-guided radiotherapy will be MR guided. The British journal of radiology, 2017. 90(1073): p. 20160667-20160667.

4. Tseng, C.L., et al., Dosimetric Feasibility of the Hybrid Magnetic Resonance Imaging (MRI)-Linear Accelerator System for Brain Metastases: The Impact of the Magnetic Field. International Journal of Radiation Oncology, Biology, Physics, 2016. 96(2): p. E628.

5. Ma, L., et al., Emerging technologies in stereotactic body radiotherapy. Chin Clin Oncol, 2017. 6(Suppl 2): p. S12.

6. American Cancer Society. Radiation Therapy for Prostate Cancer. 2019 June 2020]; Available from: https://www.cancer.org/cancer/prostate-cancer/treating/radiation-therapy.html.

7. Menten, M.J., A. Wetscherek, and M.F. Fast, MRI-guided lung SBRT: Present and future developments. Phys Med, 2017. 44: p. 139-149.

8. Prostate Cancer Foundation. Radiation for Prostate Cancer. July 2020]; Available from: https://www.pcf.org/about-prostate-cancer/prostate-cancer-treatment/radiation-prostate-cancer/.

9. Lim-Reinders, S., et al., Online Adaptive Radiation Therapy. Int J Radiat Oncol Biol Phys, 2017. 99(4): p. 994-1003.

10. Bertelsen, A.S., et al., First clinical experiences with a high field 1.5 T MR linac. Acta Oncol, 2019. 58(10): p. 1352-1357.

11. Kerkmeijer, L.G., et al., The MRI-Linear Accelerator Consortium: Evidence-Based Clinical Introduction of an Innovation in Radiation Oncology Connecting Researchers, Methodology, Data Collection, Quality Assurance, and Technical Development. Front Oncol, 2016. 6: p. 215.

12. Hall, W.A., et al., The transformation of radiation oncology using real-time magnetic resonance guidance: A review. Eur J Cancer, 2019. 122: p. 42-52.