Icon Group operates 30 cancer centers in Australia, one in New Zealand, six in Singapore, four in Mainland China, and two in Hong Kong, with several in development across their international network. Icon was among the first sites in the southern hemisphere to deliver adaptive treatment using the Ethos™ therapy system at its cancer care facility in Wahroonga, New South Wales. The Icon Cancer Centre at Wahroonga has been effectively using Ethos for over a year and the group has recently installed another Ethos system at its Icon Cancer Centre facility in Greenslopes, Brisbane, Australia.
While initial uptake was slowed due to COVID-related issues, the Wahroonga clinic has been treating prostate cancer patients using Ethos adaptive therapy, and staff are already considering other anatomical sites that will benefit from this technology.
“Being able to adapt treatments based on what we see every day is already showing huge benefits,” said Trent Aland, Australian Director of Medical Physics at Icon Group. “Since our clinical teams have a mix of skills, including treating prostate, head and neck, and thorax, we see an opportunity to develop and offer adaptive workflows for a large range of patients. We’re also rethinking whether we need to impose burdensome preparations on our patients, like a full bladder and an empty bowel.”
Icon has been comparing both scheduled and adapted Ethos treatment plans for all adaptive treatments, and clinicians choose either the scheduled fraction or the adapted fraction on the day of treatment based on the quality of the dose volume histogram along with other key goals. The clinicians are choosing the adaptive fractions about 95 percent of the time, according to Aland.
“We have a number of important goals we consider for each target volume and organ at risk and if we see that the adaptive treatment performs better in terms of protecting healthy tissue and maximizing target dose, we choose the adaptive plan,” Aland explained. “From a data metrics perspective, we see that we are often able to deliver less dose to organs at risk and higher doses to the targets with adaptive treatments.”
Performing adaptive treatments using Ethos is also helping Icon utilize this technology efficiently and safely since Ethos incorporates features that support the radiation therapy staff’s decision-making process—especially the artificial intelligence-driven contouring.
“We’re developing two workflows, one for radiation oncologists that want or need to be at the treatments every single day, and another where the radiation oncologist is at treatment for the first few days only but available within the department if needed,” Aland said. “We’ve created a process for our radiation therapists and members of the medical physics team, who administer the remaining fractions. They’re still under the guidance of the radiation oncologist, who reviews each treatment, but doesn’t need to be there each time.”
With the second machine just installed in Queensland, Icon Group is keen to expand use of the adaptive process, especially for stereotactic body radiotherapy (SBRT).
“Our clinicians are very engaged and excited about Ethos and where that technology is going to take us in the future,” Aland said. “Radiation therapy basically changed overnight with the release of Ethos and it’s exciting to think where it’s going to take our whole industry and improve patient outcomes.”
Use the links below to access each profile/interview:
- The Treatment Adapts so the Patient Doesn’t Have To: Ethos at Queens Hospital, Romford, UK
- Royal North Shore Hospital, Sydney, Australia: Adapting to Changes in the Target
- Henry Ford Health System, Detroit, Michigan: Looking Towards Adaptation During Five-Fraction SBRT
- Royal Surrey NHS Foundation Trust, Guildford, UK: Focusing on Patients Who Will Benefit Most
- Adaptive Radiotherapy Post-COVID: An Interview with Professor Patricia Price
- Back to Table of Contents
The information captured herein represents the genuine experience of the attributed individuals and may not necessarily represent the views of Varian or the above-referenced institution. Individuals were not compensated for their participation. Radiation treatment may not be appropriate for all cancers. Individual results may vary. For more information, please visit www.varian.com/safety.