Therapeutic radiographers now deliver MR-linac treatments without clinical oncologist present

Therapeutic radiographers in The Royal Marsden NHS Foundation Trust’s MR-linac unit have started treating patients for the first time without a clinical oncologist present, following a training and supervision programme.

The Royal Marsden, London, has been at the forefront of MR-linac treatments since the first UK patient was treated more than three years ago.

The MR-linac workflow enables treatment to be adapted to the daily position and shape of the tumours and organs at risk. Previously this has required a clinical oncologist to be present to contour the target area and approve the plan in the control area for each treatment. Therapeutic radiographers were responsible for patient set-up, image acquisition and registration, and treatment delivery alongside physicists for treatment planning and checking, and have now taken on the additional role of contouring.

Lead research radiographer Dr Helen McNair, reader in translational therapeutic radiography at the Institute of Cancer Research, said: “It is very exciting for us to have progressed to this stage as it has been something we have been working towards under a NIHR/HEE senior clinical award grant. The training has been thorough and we have been well supported by our clinical oncology and physics colleagues.

“We are currently evaluating the treatments for prostate and oligometastases before moving onto other tumour sites. This will be hugely beneficial for patients and the service, as we will be able to offer more flexibility for appointments and it brings us in line with standard radiotherapy treatments.”

Therapeutic radiographer Gillian Smith commented: “The training has been thorough with extensive support from our clinical oncologist colleagues. Therapeutic radiographers are used to interpreting CBCT and CT images so it has been interesting to learn about differences in anatomy on MRI, which is pertinent to target and organ at risk delineation.

“This development and up-skilling continues to evolve the role of the therapeutic radiographer in leading more complex treatment delivery, and paves the way for additional career progression for future radiographers.”

Picture: Lead research radiographer Dr Helen McNair.

Published on the front page of the June 2021 issue of RAD Magazine.

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