The department has a newly installed Varian ETHOS treatment machine which went clinical in August 2020 (read about the first patient treated here).

A number of existing research projects are to be conducted to investigate the use of the system for daily online adaptive radiotherapy.

The system includes AI based auto-contouring, automated plan adaption and integrated QA solutions which allow a fully adaptive treatment to be completed within 15 minutes.

Below are a few pictures following install showing some of the team involved in the initial commissioning process.

Some of the team with the first patient treated on ETHOS
Some of the team with the first patient treated on ETHOS.
ETHOS radiotherapy machine with mural of local scenery and sky window.
ETHOS radiotherapy machine with mural of local scenery and sky window.
Some of the dosimetry team with the ETHOS machine
Some of the dosimetry team with the ETHOS machine

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Further details of the research ongoing will be updated here as it progresses.

Successful online adaptive treatments

The department has successfully rolled out online adaptive therapy using the Varian Ethos.

Patients having the bladder and prostate treated have now completed their treatment courses.

The early indications are that utilising the daily online adaptive technique may significantly reduce the doses to OARs for bladder patients in particular. Further work is ongoing to assess how best to utilise the technology to reduce margins and allow further dose sparing and improve treatments.
The next clinical site in focus is the Cervix which is currently planned using an ITV generated using a full and empty bladder CT scan. It is hoped there will be significant reduction in OAR doses and treatment volume moving away from this.

A number of abstracts have been submitted to ESTRO 2021 covering the following topics:

  • Automated plan quality for Cervix cancer
  • CBCT based Auto-segmentation for online adaptive
  • Developing an in-house training package for adaptive radiotherapy for therapeutic radiographers.

Recently work on Automated plan generation for bladder cancer using the Ethos TPS was presented at the BIR Annual Radiotherapy and oncology meeting. The slides are available.

The department have been invited to speak at the upcoming BIR Annual Congress focusing on the online adaptive workflow.