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Oncology · UK

Intensity-modulated radiation therapy, planned by a consultant clinical oncologist.

IMRT and VMAT are the UK RCR-IPEM standard for curative radiotherapy - a highly conformal dose that wraps around the target while sparing the organs around it.

A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private IMRT/VMAT course costs in the UK.

Indicative ranges across our partner centres.

In short

A private hypofractionated prostate IMRT course: £18,000–£28,000, delivered over four weeks.

Course / consultation Indicative range
Consultation with a clinical oncologist £300–£500
IMRT - prostate (20 fractions, hypofx) £18,000–£28,000
IMRT - head & neck (30–35 fractions) £28,000–£45,000
IMRT - breast (15 fractions, hypofx) £10,000–£18,000
SBRT - prostate (5 fractions) £15,000–£25,000
SBRT - lung / oligomets (3–8 fractions) £12,000–£22,000
MR-linac adaptive (per course) £25,000–£45,000
Proton beam therapy (per course) £30,000–£90,000

Prices vary by centre (Cromwell, HCA, GenesisCare, Rutherford), by the technique (IMRT vs SBRT vs MR-linac vs proton), by fractionation, and by any concurrent systemic therapy. Most NHS patients are treated in a local unit and do not pay - specialist SBRT and proton referrals go via NHS-commissioned centres.

The problem

The right technique, the right centre, the right fractionation.

Modern radiotherapy has three quiet decisions inside it - technique, centre, and fractionation. All three shape the toxicity you live with for years. We work them through with you before consent.

  • IMRT, SBRT, MR-linac or proton?

    Each has a place. We say honestly which one your diagnosis and anatomy point to - and where a proton referral is genuinely worth pursuing.

  • Standard, hypofractionated or SBRT?

    Fewer, higher-dose fractions are as good or better in many indications. Not all - the oncologist walks you through the evidence.

  • Which UK centre?

    A named consultant clinical oncologist at a centre with modern linacs, daily IGRT, and access to onward SBRT, MR-linac and proton pathways.

When it helps

The cancers we treat with IMRT and VMAT.

The UK NHS-standard indications, plus the one red flag that means an emergency rather than an appointment.

  • Prostate cancer

    Curative IMRT/VMAT at 60–78 Gy, 62 Gy in 20 fractions (CHHiP/PROFIT), or SBRT at 36.25 Gy in 5 fractions.

  • Head and neck cancer

    Parotid-sparing IMRT is standard - the technique that meaningfully reduces long-term xerostomia.

  • Breast cancer

    Whole-breast, partial-breast, chest-wall and nodal irradiation - 15 fractions or 5-fraction FAST-Forward.

  • Lung cancer (NSCLC, SBRT)

    SBRT/SABR for peripheral T1 stage tumours where surgery is not chosen or not possible.

  • Brain - glioma, meningioma, mets

    Fractionated IMRT for gliomas and meningiomas; SRS for oligometastatic disease.

  • Gynaecological - cervix, endometrium

    Pelvic (plus para-aortic when indicated) IMRT with a brachytherapy boost for cervical cancer.

  • Anal, pancreatic and sarcoma

    Chemoradiation for anal cancer; adjuvant, neoadjuvant or SBRT for pancreatic disease; IMRT for soft-tissue sarcoma.

  • Red flag: cord compression, SVCO

    New leg weakness, saddle numbness, or facial/arm swelling with breathlessness is an emergency - A&E, not a clinic booking.

Technique options

IMRT is a family - not a single technique.

What each delivery option actually involves - and which fits which indication.

  • Static-gantry IMRT

    Classic inverse-planned IMRT - 5 to 9 fixed beam angles, MLC modulating fluence. Robust, well-validated, still the workhorse.

  • VMAT (RapidArc, Elekta VMAT)

    Continuous rotating gantry - usually two arcs - delivering the whole treatment in 60–120 seconds. More efficient, better conformity for most sites.

  • SBRT / SABR

    Stereotactic ablative body radiotherapy - 3 to 8 fractions at high dose per fraction, sub-mm accuracy. Prostate, lung, oligomets, pancreas.

  • IGRT (image-guided)

    Daily cone-beam CT verification - the standard adjunct to IMRT that lets the margin around the target shrink safely.

  • MR-linac (Elekta Unity, MRIdian)

    Real-time MR-guided adaptive radiotherapy - the plan is recalculated on the machine each day against the anatomy on that day.

  • Proton beam therapy

    NHS-commissioned at Christie Manchester and UCLH - children, chordoma, base-of-skull, re-irradiation and select adults where sparing OARs matters most.

  • Adaptive IMRT (Ethos)

    Plan-of-the-day adaptive replanning - used where anatomy shifts meaningfully between fractions (bladder, cervix, some head and neck).

  • Conventional fractionation

    25 to 40 daily fractions at 1.8–2.0 Gy each - still the right choice in some head and neck, brain and gynaecological indications.

Safety and recovery

What to expect - honestly, acute and late.

IMRT reduces toxicity meaningfully versus older 3D-CRT - but it does not eliminate it. Acute effects show during and just after treatment; late effects unfold over months and years. Both matter, and both are discussed before you consent.

  • Fatigue is universal

    A cumulative tiredness that peaks in the last week of treatment and settles over four to six weeks. Not a sign anything is going wrong.

  • Skin reactions are expected

    Erythema, dry or moist desquamation in the treated field. Managed with the department’s skin protocol - usually simple emollients and, when needed, hydrocortisone.

  • Site-specific mucositis

    Head and neck: mouth ulceration, dysphagia, altered taste. Chest: oesophagitis. Pelvis: proctitis, cystitis, diarrhoea - all managed proactively.

  • Xerostomia is reduced but not eliminated

    Parotid-sparing IMRT meaningfully lowers long-term dry mouth versus older 3D-CRT - but some reduction in saliva is common.

  • Late effects unfold over months to years

    Fibrosis, lymphoedema, cardiac effect (breast - reduced by DIBH), pulmonary fibrosis (chest) and chronic bone-marrow effect (pelvic). Discussed and consented up front.

  • Prostate - urinary and bowel

    Long-term urinary and bowel toxicity is the main trade-off. A hydrogel perirectal spacer can reduce the rectal dose in the right patient.

  • Radiation-induced second malignancy

    Rare, decades later, and one of the reasons proton therapy is preferred in children and some young adults where an equivalent plan is possible.

  • Fertility and gonadal shielding

    Discussed before treatment. Sperm banking, ovarian shielding or transposition, and fertility preservation routes are arranged where relevant.

  • Red flags during treatment

    New severe pain, uncontrolled bleeding, breathlessness, spreading redness, fever or new neurological signs - call the on-treatment team the same day.

Reading your radiotherapy plan

Your treatment plan in four parts. Read the last one first.

Whichever technique was used, the summary the oncologist sends you keeps to the same shape.

A UK consultant clinical oncologist reviewing an IMRT treatment plan

A quiet reminder

Dose-volume language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the plan before you sign consent, just ask.

  1. 01 Header

    Diagnosis, stage and intent

    Tumour site, histology, TNM stage, and whether treatment is curative, adjuvant, neoadjuvant or palliative.

  2. 02 Technique

    Technique, dose and fractionation

    IMRT or VMAT, total dose in Gray, number of fractions, energy, and any concurrent systemic therapy.

  3. 03 Findings

    Target volumes and organs at risk

    GTV, CTV and PTV volumes contoured, plus the dose-volume constraints met for each organ at risk (parotids, cord, rectum, bladder, heart, lungs).

  4. 04 Impression

    Acute toxicity, follow-up, response scan

    Read this first: acute toxicity to expect, when it settles, and when the response scan is scheduled.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for IMRT/VMAT and SBRT is standard on most UK health insurance policies when the treatment is medically indicated. Proton beam therapy is NHS-commissioned; specialist private cover varies.

Frequently asked

Everything we get asked about IMRT and VMAT.

Quick answers on technique, fractionation, proton referral routes, and the side-effects that matter most.

  • What is IMRT and how is it different from older radiotherapy?

    Intensity-modulated radiation therapy uses a linear accelerator with a multi-leaf collimator (60–160 leaves) to modulate the intensity of the beam across multiple angles. An inverse-planned treatment planning system - Eclipse, Monaco or RayStation - calculates a highly conformal dose that wraps around the target while sparing organs at risk. It is a meaningful step up from older 3D-CRT for most curative solid-tumour indications.

  • What is VMAT, and is it better than IMRT?

    VMAT - Volumetric Modulated Arc Therapy (RapidArc on Varian, VMAT on Elekta) - is IMRT delivered on a continuously rotating gantry, usually as two arcs. Each treatment takes 60 to 120 seconds instead of several minutes. For most sites it gives equivalent or better conformity in less time. It is the default modern IMRT delivery.

  • Which cancers is IMRT used for on the NHS?

    IMRT/VMAT is the UK NHS standard of care for most curative solid-tumour radiotherapy - head and neck, prostate, breast, lung (including SBRT), brain, cervical and endometrial, anal (chemoradiation), pancreatic, and sarcoma. Paediatric cases are often referred for proton beam therapy where available.

  • How many sessions of IMRT will I need?

    It depends on the site and intent. Conventional courses are 25 to 40 daily fractions. Moderately hypofractionated courses (prostate CHHiP/PROFIT at 62 Gy in 20 fractions, breast at 15 fractions) are shorter. SBRT is 3 to 8 high-dose fractions. Ultra-hypofractionated courses (FAST-Forward breast, 5-fraction prostate SBRT) can complete in a week.

  • What is SBRT and is it the same as IMRT?

    SBRT/SABR is stereotactic ablative body radiotherapy - a specific IMRT technique that delivers very high doses per fraction in 3 to 8 sessions with sub-mm accuracy. It is used for peripheral early-stage lung cancer, prostate cancer, oligometastatic disease, and emerging pancreatic indications.

  • Is proton beam therapy better than IMRT?

    Not universally. Protons deposit dose at a defined depth (the Bragg peak) with almost no exit dose - useful where sparing a specific organ matters most: children, chordoma, base-of-skull tumours, re-irradiation and selected adult cases. For most adult solid tumours, IMRT/VMAT with daily IGRT gives equivalent tumour control. NHS-commissioned proton therapy is delivered at The Christie (Manchester) and UCLH.

  • What is an MR-linac and when is it used?

    An MR-linac (Elekta Unity, ViewRay MRIdian) combines an MRI scanner with a linear accelerator, allowing the plan to be adapted on the day against the anatomy actually visible on that day’s MRI. It is used where the target moves or the surrounding anatomy shifts meaningfully - pancreas, some prostate, liver, some gynaecological cases.

  • What side-effects should I expect from IMRT?

    Acute effects (during treatment and the fortnight after) include fatigue, skin erythema, and site-specific mucositis - mouth ulcers in head and neck, oesophagitis in chest, proctitis or cystitis in pelvic treatment. Late effects (months to years) can include fibrosis, xerostomia, lymphoedema, cardiac effect (breast - reduced by DIBH), pulmonary fibrosis (chest) and chronic marrow effect (pelvic). The oncologist walks you through the site-specific profile before you consent.

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