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UAB set to deliver ‘revolutionary’ new cancer treatment — ‘holy grail’ of radiation therapy

The University of Alabama at Birmingham O’Neal Comprehensive Cancer Center has received what, according to the hospital, some are calling the “holy grail” of radiation therapy.

The new radiation delivering tool is a linear accelerator system called Ethos, a product by Varian, a health care company which specializes in oncology treatment. The company calls the system “a comprehensive, revolutionary new therapy that is patient-centric and personalized—from initial planning to on-couch adaptation and treatment monitoring.”

UAB says a linear accelerator is the machine that is used to deliver radiation therapy to destroy a tumor. In standard radiation therapy, medical professionals use enhanced imaging to pinpoint the location of a tumor, then craft a plan to target that tumor with radiation.

Dennis Stanley, Ph.D., an assistant professor and medical physicist in the UAB Department of Radiation Oncology, detailed the process.

“Patients typically get a CT scan so the radiation team can map out their strategy, a process that can take one to two weeks,” said Stanley. “Then, most patients get radiation for around six weeks, usually five days a week.”

The hospital says that within the timeframe of the initial CT screening to the end of treatment, things can change.

“A patient’s anatomy can change over this time period,” Stanley added. “Weight gain or loss, shifting of tissues following eating and drinking. Anatomy can change as quickly as day-to-day.”

According to UAB, adaptive therapy means the radiation plan can adapt to those changes. The Ethos system is a first-of-its-kind machine that can quickly scan a patient while they are on the treatment table prepping for their next treatment, and allow for fine-tuning of the already established treatment plan.

Samuel Marcrom, M.D., assistant professor in the Department of Radiation Oncology, said the Ethos system allows for more accuracy in the treatment process.

“We can re-image the patient while they are on the table, and compare the patient’s initial anatomy to the patient’s current anatomy,” said Marcrom. “If there have been changes, we can tweak the plan almost instantaneously. The result is a more accurate radiation treatment based on real-time information, creating an opportunity for more radiation to be delivered to the tumor with less radiation delivered to healthy tissue nearby. It is a personalized medicine approach for radiation oncology.”

According to the release, UAB Medicine and the Department of Radiation Oncology are among the first in the nation to install an Ethos system. There are only 12 currently operating in the United States. UAB used the Ethos system for the first time on Tuesday.

Stanley and Marcrom say it can be useful for many types of cancers, especially for prostate and cervical cancers due to the propensity of the internal anatomy to change over time in the pelvis. UAB will first treat pelvic tumors with Ethos, gradually moving toward lung and chest cavity cancers. Ethos is also suited for head and neck cancers.

“Ethos is another tool that helps aim radiation at the tumor target and avoid healthy tissue, much as proton therapy does,” Stanley said. “This is a valuable option for patients who are not candidates for protons, or any of our other radiation delivery systems.”

Macrom indicated that the new system provides a real-time look at the cancer, making way for better treatment.

“Ethos gives us options that we haven’t had before,” Marcrom stated. “We are able to treat a patient’s cancer based on what it looks like right now, not what it looked like days or weeks earlier. That is a significant advantage.”

Dylan Smith is a staff writer for Yellowhammer News. You can follow him on Twitter @DylanSmithAL

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