By the end of 2024, healthcare providers will detect over 2 million new cancer cases1 across the United States. More than half of patients diagnosed will require weeks of radiation therapy2 as part of their cancer care plan. Now, with the Ethos therapy system, there’s a new approach to standard radiation therapy that can shorten treatment duration, increase precision, and boost efficacy.
Ethos is an adaptive radiation therapy system that includes a linear accelerator (LINAC), says David Berlach, MD, Chair of Radiation Oncology at Maimonides. Providers can use it to adjust a patient’s cancer treatment plan as often as needed. By incorporating Ethos into its existing LINAC program in 2025, Maimonides Cancer Center is poised to become Brooklyn’s leader in delivering this advanced form of radiation therapy.
“The Ethos system represents a brand-new paradigm shift in delivering radiation oncology. This approach marks a key advancement in improving the efficacy and future of radiation therapy in cancer care,” he says. “With an adaptive radiation therapy system, we are set to streamline and simplify cancer treatments, benefiting hundreds of patients each year.”
Adapting to Tumor Changes
For traditional LINAC therapy, providers rely on CT scans done before treatment that capture the size, shape, and location of a patient’s tumor. Based on these parameters, the care team builds a treatment plan to deliver targeted radiation. However, this plan often spans several weeks, during which time a tumor’s position or volume can change, affecting treatment accuracy. As a result, traditional LINAC may lose accuracy, Dr. Berlach says.
Ethos, which resembles an open-bore CT scanner, offers a responsive solution to this challenge. Ethos enables clinicians to perform frequent imaging, sometimes daily, to detect changes in the tumor’s structure.
“Tumors can change over the treatment period needed for radiation therapy,” Dr. Berlach says. “With Ethos, we can scan patients more often — adjusting their care plan in real time. This adaptability allows us to deliver precisely targeted radiation based on the tumor’s current state, rather than relying on a static image from weeks prior.”
Creating a Better Patient Treatment Experience
The Ethos system pairs high-quality, rapid CT imaging with artificial intelligence (AI). This combination makes it easier for care teams, which comprise up to eight providers, to create the most up-to-date, tailored treatment plans before each radiation therapy session, Dr. Berlach says.
“With this system, treatment planning is done in a matter of minutes,” he says. “The plans are checked by a radiation technologist and a physician. From start to finish — capturing the scan, creating the plan, and delivering treatment — the entire process can be completed in a 30-minute session.”
The treatment process is simple and straightforward. After capturing a new CT scan, providers run the image through AI algorithms to analyze the imaging data and differentiate between healthy and cancerous tissue. The software, with the guidance of the clinician, suggests the radiation dose to be delivered and accurately pinpoint the most effective target areas. As a result, the team of doctors, nurses, physicists, and radiation therapists, develops a personalized approach with higher, more precise doses of radiation, which can potentially necessitate fewer required treatment sessions.
In addition to online adaptive radiotherapy that Ethos is specialized with, Ethos can also support a variety of procedures, including stereotactic radiosurgery and image-guided radiation therapy. Dr. Berlach says. Ethos is versatile, and providers can use the system to treat almost any type of cancer. At Maimonides, the initial focus is treating gynecologic, head and neck, and prostate cancers.
Advancing Cancer Care at Maimonides
Maimonides has used LINAC-based radiation therapy for years. Adding the Ethos therapy system strengthens the program in two impactful ways, Dr. Berlach says. First, it positions Maimonides at the forefront of radiation therapy.
“The entire field is moving toward delivering fewer treatments with higher doses of radiation,” he says. “This capability enables us to deliver these powerful doses while maintaining safety and efficacy.”
In addition, the Ethos system strengthens Maimonides’ ability to care for patients with the most complicated cancers.
“Our patient population includes many individuals with late-stage cancers, and some face social and financial challenges that complicate treatment adherence,” he says. “Having the ability to adjust the radiation dose and target it as a patient goes through therapy enables us to tailor the treatment and prevent greater toxicity going forward.”
Providing the same level of care in a shorter timeframe is also more convenient and cost effective. Patients will spend less time and money traveling to Maimonides for radiation therapy.
With the Ethos therapy system, Dr. Berlach says, Maimonides becomes an even stronger destination for cancer care, and this investment in cutting-edge technology reinforces its commitment to offering the highest standard of care in Brooklyn.
“We believe that our patients in Brooklyn and the surrounding communities deserve the same high-quality healthcare that’s available elsewhere across the country,” he says. “Being able to limit the number of treatments and help patients return to their families and their jobs sooner will make a huge impact on their quality of life.”
Learn more about radiation therapy at Maimonides Cancer Center at https://maimo.org/treatments-care/cancer-center/radiation-therapy/ or call (718) 765-2500 to make a referral.
1: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2024/2024-cancer-facts-and-figures-acs.pdf
2: https://www.who.int/news/item/05-03-2021-new-who-iaea-publication-provides-guidance-on-radiotherapy-equipment-to-fight-cancer
