Author: Kristina Young, M.D., Ph.D., medical director, radiation oncology, Providence Cancer Institute of Oregon
In 2020, Providence Cancer Institute of Oregon expanded its radiation oncology capabilities by introducing the ViewRay MRIdian Linac machine. Using MRI-guided radiation, Providence radiation oncologists can precisely target tumors for destruction while minimizing damage to surrounding normal tissue. Providence was the first facility in the Pacific Northwest and the first community hospital in the United States to offer the technology – the biggest advancement in radiation oncology in over two decades.
Higher dose, fewer days of treatment
Less than 20 years ago, standard radiation therapy required small daily doses over a period of up to nine weeks. In the past decade, enhanced technologies have made it possible to increase dosage over fewer days. Now, precision radiation delivery takes radiotherapy a step further by allowing us to treat some cancers with higher doses in only five days of radiation.
This is a game changer in radiotherapy, especially in how we treat abdominal and thoracic tumors. We’re able to target tumors we couldn’t in the past, while also improving accuracy and avoiding surrounding radiation-sensitive organs. Protecting normal organs and tissue helps reduce the risk of detrimental complications and side effects.
For example, when treating patients with borderline resectable pancreatic cancer, the MRIdian machine allows us to visualize surrounding structures, such as the small intestine, stomach, large bowel or spinal cord on a day-to-day basis. Being able to observe the slightest shift of a mass in proximity to surrounding organs, we can safely deliver a 50% higher dose of radiation compared to a standard linear accelerator.
Transforming radiotherapy through research
Between May 2020 and May 2022, 46% of the 155 patients treated with MRI-guided radiotherapy at Providence were treated for prostate cancer, and 20% were treated for pancreatic cancer. However, since acquiring the technology, Providence continues to expand treatment beyond abdomen and pelvic cancers (pancreatic, kidney, liver and prostrate) to include breast, spine and lung cancers.
Clinical trials and quality-of-life studies that evaluate MRI-guided radiation in combination with other therapies are essential to learning more about how to improve treatments on different tumor types. Current trials underway at Earle A. Chiles Research Institute, a division of Providence Cancer Institute, will evaluate the safety and efficacy of high doses of MRIdian-delivered radiation to tumors with narrow margins.
- A new study will evaluate the safety of neoadjuvant aromatase inhibitor with DPX-Survivac, DPX-Survivac plus MRI-guided radiation therapy, or DPX-Survivac with cyclophosphamide in stage I to III HR+HER2- breast cancer. This is the first attempt to use the MRIdian to deliver radiation to release the antigen and increase the efficacy of immunotherapy. While it expands on the existing body of work that combines radiation and immunotherapy, this study will deliver a more targeted, higher dose of radiation.
- A quality-of-life study will evaluate surveys from patients with prostate and breast cancers over the course of their treatment. One arm of the study will deliver radiotherapy via the MRIdian machine, the second arm will deliver radiation via a standard linear accelerator. Patients will complete the survey before, throughout and following treatment to score their quality of life with different radiation modalities.
As we continue to expand our understanding of how MRI-guided radiotherapy works to improve treatments for a wider range of tumor types, more clinical trials will be made available for patients.
Resources for patients outside metro area
Fewer days of radiation treatment not only help reduce side effects and other complications, but also mean fewer trips to treatment sessions and less disruption to patients’ daily lives. This is particularly beneficial for patients from outside the Portland metropolitan area who must travel long distances for treatment.
We can help make cancer treatment more manageable for patients who must travel by providing transportation resources as well as housing at the Providence Guest House, a 30-unit guest housing facility just one block from Providence Cancer Institute. In addition to a place to stay for the duration of treatment, patients and their families have access to their oncology team and supportive care services, including integrative medicine, oncology nutrition, social workers and nurse navigators.
New technology and treatments, as well as guest housing, are made possible by generous donors who support Providence Cancer Institute and Providence Foundations of Oregon.
To learn more or to refer a patient
- Visit The Elsie Franz Finley Radiation Oncology Center at Providence Cancer Institute or call 503-215-6029.
To refer a patient to a clinical trial
- Call 503-215-2614.
- Submit a referral form.
- Send an email.
To learn more about MRI-guided radiation therapy at Providence
- Watch a presentation by Dr. Young about MRI-guided radiation for breast cancer.
- Watch this AM Northwest interview with Dr. Young.
Kristina Young, M.D., Ph.D., is medical director, radiation oncology, Providence Cancer Institute of Oregon; radiation oncologist, The Oregon Clinic; and associate member, Tumor Microenvironment Laboratory, Earle A. Chiles Research Institute, a division of Providence Cancer Institute.
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