Proton therapy is an advanced form of radiation treatment that is able to target tumors with precision. For pediatric patients and for patients with tumors that are in close proximity to vital organs, critical structures, or significant normal tissue, proton therapy would be the treatment of choice. However, most hospitals and cancer treatment centers do not offer proton therapy. One of the primary reasons is the space needed to accommodate proton therapy technology.
Advances in proton therapy technology are shrinking the size of the accelerators, reducing the space needed, and allowing more hospitals and treatment centers to consider proton therapy treatment.
As the technology becomes smaller and more accessible, it is important to understand that the size of the technology impacts more than the space it occupies. It is also important to recognize that there is not a standard definition of small or compact, two terms commonly used by companies to describe their technology.
Why size is more than space
In addition to the physical space needed to accommodate the equipment, the size of the technology impacts the following: delivery and installation, construction, shielding, equipment, personnel, and patient treatment.
Delivery and Installation
The smaller the technology, the lower the delivery and installation costs.
The lightweight, compact, modular design of ProTom’s Radiance 330® Proton Therapy System allowed it to be transported to Massachusetts General Hospital via one 26-foot two-axle truck. Once at MGH, only standard equipment was needed for installation and no facility hatch was required. In fact, the system was transported via pallet jacks and forklifts inside corridors, freight elevators, and down an elevator shaft.
This delivery and installation stand in sharp contrast to what is necessitated for other systems.
Multiple tractor-trailer trucks, heavy equipment, and a facility hatch have been standard requirements for delivery and installation. The costs associated with each of these are substantial. Reducing these requirements not only makes delivery and installation easier, it also reduces the cost.
When the size of the technology is reduced, construction costs can be reduced.
When the footprint required is smaller, it is possible for the facility itself to be smaller. This reduces construction requirements and costs.
The ability to use lighter-weight or standard equipment for construction not only reduces the cost of equipment needed, but also allows for less underground construction reinforcement, reducing the cost of materials.
Radiance 330®’s low neutron background radiation generation rate allows for above-grade installation requiring less excavation and less concrete for radiation, further reducing construction costs.
The compact, modular design of Radiance 330® makes it possible to install the system in existing space significantly impacting costs associated with construction. At MGH, for example, Radiance 330® was installed inside two empty linac vaults within an active radiation oncology department.
Concrete is used in radiation shielding. An analysis of four proton accelerator manufacturers finds that the shielding requirements for each system have a significant impact on space needed and on cost.
The Radiance 330® for example, requires five feet of HD concrete at a cost of $710,000. At the other end of the spectrum, a system requires 8 feet of HD concrete at a cost of $1.45 million.
Duplication of facilities, ancillary equipment, and personnel
The ability to add a proton therapy system to an existing cancer center, or to install a proton therapy system within an existing hospital or cancer center, reduces or eliminates the need for the duplication of facilities, ancillary equipment, and personnel. This not only makes things simpler for patients and staff, it also reduces costs.
Radiance 330®’s compact and modular design has the smallest synchrotron footprint on the market – making the system fully adaptable and customizable. This flexible design includes interchangeable sub-systems that can be installed in purpose-built or existing facilities, and which can be expanded.
ProTom installed the Radiance 330® inside two empty linac vaults, three levels below ground, within MGH’s Department of Radiation Oncology. The installation of the proton therapy system did not impact the daily operations of a radiation oncology department.
The ability to install a proton therapy system without disrupting daily operations is significant as it allows for patients to continue necessary treatment without interruption, and it does not impact revenue generation.
Size is relative
More companies are introducing “small” and “compact” proton therapy technology. It is important to recognize that there is no definition for a small or compact system. When selecting the right proton therapy technology for your facility it is important not to take size at face value. Rather, it is important to ask for specifics about the space needed. Equally important, is the need to ask for information about the equipment needed for delivery and installation, construction costs, radiation shielding, and the impact on daily operations as each of these will have an impact on your bottom line.
Compact Proton Therapy Technology
The Radiance 330® Proton Therapy System has the smallest synchrotron footprint in the market and a modular/flexible design that includes interchangeable sub-systems. It can be installed in purpose-built or existing facilities.