Henry Ford Cancer Institute (HFCI), Michigan: Looking Towards Adaptation During Five-Fraction SBRT | Varian

Henry Ford Cancer Institute (HFCI), Michigan: Looking Towards Adaptation During Five-Fraction SBRT

Henry Ford Cancer Institute (HFCI), Michigan: Looking Towards Adaptation During Five-Fraction SBRT

Henry Ford Allegiance (HFA) is a community-based hospital about 60 miles west of the main Henry Ford Health System campus. Its radiation oncology clinic treats approximately 450 patients a year, with more than 9,000 external beam treatments delivered. The clinic has two linear accelerators, one of which is an Ethos™ therapy system. 

“For some time, we’d been looking at expanding the treatment technology we offer and recognized that Ethos would provide us with the CT-based adaptive abilities we sought,” explained Karen Yacobucci, administrative director, HFCI System Strategic and Financial Planning.  

“We treated our first patient in November 2020, and since then have treated scores of patients using adaptive radiotherapy, which accounts for about 1,000 treatment sessions,” notes Deborah Dusseau, manager of operations.

Currently, the clinic is primarily using Ethos for adaptive treatment of prostate and bladder cancer. However, it’s considering moving this adaptive approach toward SBRT hypofractionation for prostate, as well as lung and gynecological cancers.

“Adaptive therapy has been very beneficial for both prostate and bladder cancers as we can see bladder fill and bowel changes on a daily basis and adapt the plan to spare more healthy tissue,” said Dr. Annette Kretzler, director of radiation oncology at HFA. “Although adaptive takes somewhat longer to set up than IGRT, we’ve already reduced the time slot down to about 20 minutes.  If we can draw from the precision advantages of adaptation to spare healthy tissue while using SBRT with five fractions for prostate, we’ll really be getting ahead of the curve.”

For Dr. Indrin Chetty, director of the Radiation Physics Division at the HFCI, Ethos adaptive therapy for prostate cancer is shedding light on the conservative nature of existing bowel constraints and how hypofractionated SBRT could be performed to deliver maximum dose to the gross disease while prioritizing the safety of nearby tissue.

“Using Ethos adaptively allows us to comfortably get as much dose as we can on a daily basis to the prostate and sometimes even multiple gross lymph nodes relatively high up in the pelvis that traditional planning doesn’t allow,” Dr. Chetty explained. “Previously, we were limited but recent adaptive plans show advantages over traditional treatment approaches. I’m optimistic that in the not-too distant future, adaptive radiotherapy treatment using artificial intelligence and other innovative technologies will be commonplace, sparing patient organs and reducing treatment times.”

Like the team at Queens Hospital in Romford, UK, Dr. Kretzler and her colleagues, Dr. Sean Vance and Ian Gallagher, head of physics at HFA, note that Ethos therapy brings all disciplines together, improving collaboration and communication.

“We’re all on the unit at the same time and everybody is actively involved,” Dr. Kretzler said. “It’s a transformational change, everything is different, but close teamwork, together with Varian guidance, has helped us through the process. We’ve already made a large impact and are proud to show others how to implement this novel technology in a community setting.”

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