More patients with cancer eligible for MRI-guided radiation therapy

Author: Kristina Young, M.D., Ph.D., and Steven Seung, M.D., Ph.D., FACR

The ViewRay MRIdian Linac (MR Linac) uses MRI-guided radiation for precise targeting to maximize tumor destruction and to minimize damage to normal tissue. The Robert W. Franz Cancer Center, a part of Providence Cancer Institute on the campus of Providence Portland Medical Center, was the first facility in the Pacific Northwest, and the first community hospital in the U.S., to offer this technology starting in the spring of 2020.

Since then, our radiation oncologists have treated more than 130 cancer patients using the MR Linac.

We continue to expand tumor types treated with the MR Linac. We now treat primarily cancers of the abdomen (liver cancer, pancreatic cancer, metastases to liver, adrenal and other areas) and pelvis (prostate cancer, metastases to pelvis), spine and breast. We are planning to expand to cancers of the chest. Providence Cancer Institute will continue to add tumor types that are eligible to receive MRI-guided radiation therapy.

The MR Linac represents the biggest advancement in radiation oncology in 20 years. It means radiation oncologists can provide stronger, shorter, more effective treatments with potentially fewer complications.

There are many important benefits of MRI-guided radiation therapy. Radiation oncologists can visualize the internal organs in real time without additional radiation exposure and can make adjustments to the radiation plan as needed – called adaptive therapy – to protect the normal organs near the tumor. With real-time visualization, we can track the tumor’s motion, turn on the beam only when the tumor falls within the target zone, and then turn off the beam if the tumor moves out of the target zone.

The MR Linac is different than other radiation therapy options because of its accuracy and short treatment time. A typical radiation treatment plan for a patient with prostate cancer, for example, usually spans seven or eight weeks. But with the MR Linac’s precision, the treatment can be as short as one week. Tumors of the abdomen pose a challenge to traditional radiation therapy since so many organs in the abdomen are radiation sensitive; any severe injury to those organs can cause detrimental complications. MR Linac is the safest modality available to treat tumors of the abdomen.

Appropriate candidates for MR Linac treatment are patients who do not have contraindications for MRI, are in relatively good shape and can tolerate lying down for 30-60 minutes, and whose cancer is limited in size and number (to be determined by the treating radiation oncologist). 

Providence Cancer Institute also conducts investigator-initiated clinical trials related to the MR Linac. We have studies for breast cancer and pancreatic cancer, and plan to expand our MR Linac studies in the future.

The MR Linac was made possible through a generous donation by the late Elsie Franz Finley. The Portland businesswoman and philanthropist gave more than $60 million to Providence Foundations over her lifetime, with much of it benefitting cancer research, technology and nursing education. In recognition of her decades of support, the Elsie Franz Finley Radiation Oncology Center at Providence Portland was named in her honor in 2019.

Kristina Young, M.D., Ph.D., is medical director of Providence Radiation Oncology; assistant member, Tumor Microenvironment Laboratory, Earle A. Chiles Research Institute, Providence Cancer Institute; and a radiation oncologist, The Oregon Clinic.

Steven Seung, M.D., Ph.D., FACR, is medical director of Providence Gamma Knife Center of Oregon; and a radiation oncologist, The Oregon Clinic.

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