Royal Marsden is first to use RaySearch oART planning for targeted treatments

The Royal Marsden NHS Foundation Trust has become the first hospital in the world to treat a patient using an advanced radiotherapy planning system from RaySearch Laboratories. The technology introduces online adaptive radiotherapy (oART), which enables clinicians to make same-day adjustments to a treatment plan, while the patient is on the treatment bed.

Treatment is delivered using the Accuray Radixact linac, the latest version of the RayStation treatment planning system and The Royal Marsden’s existing oncology information system. With oART, clinicians can generate a new, personalised treatment plan every day.

The adaptation takes place during the treatment session, accounting for subtle changes such as weight fluctuations and bladder filling, and allows highly precise, targeted treatment that minimises damage to healthy tissue and reduces side effects.

The Radixact linac enhances image-guided radiotherapy, which uses imaging to ensure precise tumour targeting. The machine features an integrated CT scanner that captures high quality images over the whole treatment area, allowing radiographers to accurately assess the patient’s internal anatomy and direct radiotherapy more precisely. While NHS hospitals use the Radixact linac, The Royal Marsden is the first to integrate it with oART technology.

This milestone was made possible by The Royal Marsden Cancer Charity, which funded the specialist computing system, an AI-enhanced automated adaptive replanning feature that supports the oART technology, as well as the hospital’s Radixact linear accelerator. A donation by the Lady Garden Foundation has enabled research to improve treatment delivery and ensure oART meets the specific needs of gynaecological cancer patients, helping pave the way for national training and wider adoption across UK centres.

Consultant clinical oncologist Dr Susan Lalondrelle said: “Being able to tailor each treatment session to the patient’s daily anatomy is a major step forward in delivering more personalised cancer care. The Royal Marsden, RaySearch and Accuray are continuing to work together on future developments, thanks to a generous donation from the Lady Garden Foundation, which will further enhance cancer care.”

RaySearch founder and CEO Johan Löf commented: “Online adaptive radiotherapy has been a key focus for RaySearch for many years and I am happy that The Royal Marsden has treated its first patient using this groundbreaking RayStation technology. RayStation has very advanced tools available for taking online adaptive into clinical practice, and we look forward to collaborating with the team at The Royal Marsden to further improve efficiency in this field, and thereby advance cancer treatment.”

Picture: tailoring each treatment session to the patient’s anatomy is a major step forward in delivering more personalised cancer care at The Royal Marsden.

Read this report on page 3 of the July 2025 issue of RAD Magazine.