Global first at The Royal Marsden uses latest radiotherapy technology and equipment to tailor treatment plans for people with cancer
The Royal Marsden has become the first hospital in the world to use online adaptive radiotherapy (oART) technology from RaySearch Laboratories, thanks to funding from The Royal Marsden Cancer Charity.
Online adaptive radiotherapy (oART) technology allows clinicians to tailor the radiotherapy that each patient receives in real time, giving significantly more precise and targeted treatment to minimise damage to healthy tissue and reduce patient side effects.
Key points
- The Royal Marsden is the first hospital in the UK to use the The Accuray Radixact linear accelerator (Linac) with online adaptive radiotherapy (oART) software. The progress in patient treatment was made possible with funding from the Charity, thanks to a generous donation from the Lady Garden Foundation.
- This method of radiotherapy improves care for people with cancer, as treatment can be tailored more effectively by clinicians to each patient in real time, reducing side effects.
- Funding from the Charity allowed The Royal Marsden to acquire the RayStation system from RaySearch in 2024. The oART technology uses a computing system called the ARTemis platform.

What is online adaptive radiotherapy (oART)?
Normally, radiotherapy is given with a treatment plan that clinicians make for each patient based on their body scan. The treatment plan will include a margin of surrounding healthy tissue to allow for changes to the patient’s body during treatment, such as weight fluctuations or bladder filling. However, if bigger changes occur, the patient is likely to need a new treatment plan.
By using the oART system, clinicians can personalise each patient’s treatment plan by adapting radiotherapy doses in the moment, allowing for these slight changes in the body. Aligning the treatment to changes in the patient’s body that may affect where the tumour is means that oART technology can be used to improve radiotherapy for people with cancer. Targeting the tumour so precisely ensures that this innovative technology minimises damage to surrounding healthy tissue, helping to reduce patient side effects.
A major step forward
Dr Susan Lalondrelle is a Consultant Clinical Oncologist at The Royal Marsden NHS Foundation Trust.
“We are extremely proud to be the first cancer centre in the world to treat a patient using Raysearch’s advanced online adaptive radiotherapy technology on Radixact, and we are hugely grateful to The Royal Marsden Cancer Charity for funding this vital equipment.
“Being able to tailor each treatment session to the patient’s daily anatomy is a major step forward in delivering more personalised cancer care. This achievement reflects The Royal Marsden’s ongoing commitment to leading innovation in radiotherapy. 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.”

Benefits for people with cancer
Susan Gravett was the first patient to be treated with oART at The Royal Marsden. “It was exciting to have the opportunity to benefit from a new way of delivering radiotherapy treatment that will hopefully give patients in the future fewer side effects.”
Progress in targeted treatment also means patients can return to hospital less often for further scans or treatment sessions, helping to reduce the anxiety they may feel.
Upgrading the system for radiotherapy treatment at The Royal Marsden will ensure people with cancer can benefit from oART technology and any future advances that use artificial intelligence to improve patient treatment plans.
With support from the Lady Garden Foundation, research into using oART in treatment plans for people with gynaecological cancers will help to pave the way for implementing this technology more widely across the UK.
The difference you make
“We are thrilled that the Charity’s support, alongside the generous contribution from the Lady Garden Foundation, has made it possible for The Royal Marsden to become the first hospital in the world to use RaySearch Laboratories’ pioneering online adaptive radiotherapy technology. This new technology brings us closer to more personalised, precise cancer treatment and I'm proud that the Charity’s generous supporters have made it possible for The Royal Marsden to pave the way in improving cancer treatment for the benefit of patients both in the UK and around the world.” Antonia Dalmahoy, Managing Director of The Royal Marsden Cancer Charity
The Royal Marsden continues to be a place of radiotherapy innovation. With your support, we help experts at the hospital to develop future treatment that is saving the lives of people with cancer, everywhere. Find more ways to support us today.
Glossary
ARTemis: The automated software for online adaptive radiotherapy (oART) from RaySearch Laboratories which can sort high-quality images into plane during treatment, now used at The Royal Marsden on the Radixact linear accelerator (Linac) machine.
Online adaptive radiotherapy (oART): This type of radiotherapy treatment can be adjusted by clinicians in real time based on changes within the patient’s body, such as weight fluctuations or bladder filling. By adapting the treatment plan to the needs of the patient in this way, side effects can be reduced.
With your support, we help experts at the hospital to develop future treatment that is saving the lives of people with cancer, everywhere.