Introduction The magnetic resonance linear accelerator (MRL) offers improved soft tissue visualization to guide daily adaptive radiotherapy treatment. This manuscript aims to report initial experience using a 1.5 T MRL in the first 6 months of operation, including training, workflows, timings and dosimetric accuracy. Methods All staff received training in MRI safety and MRL workflows. Initial sites chosen for treatment were stereotactic and hypofractionated prostate, thoraco‐abdomino‐pelvic metastasis, prostate bed and bladder. The Adapt To Shape (ATS) workflow was chosen to be the focus of treatment as it is the most robust solution for daily adaptive radiotherapy. A workflow was created addressing patient suitability, simulation, planning, treatment and peer review. Treatment times were recorded breaking down into the various stages of treatment. Results A total of 37 patients were treated and 317 fractions delivered (of which 313 were delivered using an ATS workflow) in our initial 6 months. Average treatment times over the entire period were 50 and 38 min for stereotactic and non‐stereotactic treatments respectively. Average treatment times reduced each month. The average difference between reference planned and ionization chamber measured dose was 0.0 ± 1.4%. Conclusion The MRL was successfully established in an Australian setting. A focus on training and creating a detailed workflow from patient selection, review and treatment are paramount to establishing new treatment programmes.

The introduction of magnetic resonance (MR) linear accelerators (MR‐Linacs) into radiotherapy departments has increased in recent years owing to its unique advantages including the ability to deliver online adaptive radiotherapy. However, most radiation oncology professionals are not accustomed to working with MR technology. The integration of an MR‐Linac into routine practice requires many considerations including MR safety, MR image acquisition and optimisation, image interpretation and adaptive radiotherapy strategies. This article provides an overview of training and credentialing requirements for radiation oncology professionals to develop competency and efficiency in delivering treatment safely on an MR‐Linac.

The introduction of magnetic resonance (MR) linear accelerators (MR‐Linac) marks the beginning of a new era in radiotherapy. MR‐Linac systems are currently being operated by teams of radiation therapists (RTs), radiation oncology medical physicists (ROMPs) and radiation oncologists (ROs) due to the diverse and complex tasks required to deliver treatment. This is resource‐intensive and logistically challenging. RT‐led service delivery at the treatment console is paramount to simplify the process and make the best use of this technology for suitable patients with commonly treated anatomical sites. This article will discuss the experiences of our department in developing and implementing an RT‐led workflow on the 1.5 T MR‐Linac.

Abstract:The highest prevalence of cancer is seen in the older population. With an increase in average life expectancy, the age demographics of cancer patients have also increased. Studies have shown that health professionals are often unaware of the fact that older patients present different needs as compared to younger patients. Radiotherapy departments may also lack the necessary facilities to cater for additional care and support for older patients. The aim of this study was to investigate the experience of elderly cancer patients undergoing radiotherapy. A qualitative approach was used in this experimental research. One focus group (n = 4) and two individual interviews were conducted with participants who had previously undergone radiotherapy in Ireland. The question schedule investigated key areas of care: travelling to care, emotional difficulties, information needs, financial costs and follow-up care. A thematic long table method was used to analyse the data. Department delays, radiotherapy staff, car-parking, embarrassment and lack of self-confidence, information overload, as well as poor emphasis on support groups were the impact themes identified. One of the main issues identified was in relation to the timing of information and "information overload". Further investigation is required to elucidate this area.

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