From the October 2012 issue of HealthCare Business News magazine


One of the major reasons proton therapy has not entered the mainstream is due to the fact that building and equipping a proton center is expensive—the investment reaches and often exceeds $100 million.

According to the National Association for Proton Therapy, the technique comprises only 1 percent of all radiation oncology procedures, but will grow to 5 percent in five years. Currently, there are 10 operating centers around the country and another 10 or more under construction or in the pipeline.


“Frankly, it’s driven by the fact that Medicare pays for prostate cancer treatment,” says Schimpff. “So that’s where it’s being used a lot and why centers are opening up.”

But there are few clinical studies available documenting proton therapy’s effectiveness, and little evidence that protons are clinically superior to photons, according to Schimpff.

“There’s lots of interest, but what we clearly need are some evidence-based studies,” he says.

Flexibility
Littleton, Mass.-based company Mevion recently installed two of its smaller footprint proton therapy units in the U.S.—one at Barnes-Jewish Hospital in St. Louis, Mo. Last October and the other at Robert Wood Johnson University Hospital in New Brunswick, N.J. this July. The company says the unit, which can fit in one room and costs roughly $30 million to install, can give cancer centers the option of offering proton therapy alongside conventional radiation therapy and its more advanced companions.

In the future, experts in the field say that proton and photon therapy might even be combined during a treatment session.

“That’s technically possible, but whether it’s clinically desirable is up in the air,” says Huntzinger.

For now, Huntzinger says that equipment versatility is what’s key for photon (X-ray) therapy.

“I can safely say that there isn’t a therapy that hasn’t been invented yet by a clinician that can’t be done on our equipment. If someone wants to do IMRT or RapidArc or SBRT or SRS, we think we have a versatile platform for that,” he says.

New tools
A team of radiologists, medical physicists, dosimetrists and radiation therapists use treatment planning software to calculate everything from where a patient’s tumor will be, the directions and intensity of the dose received, and how many days a patient needs to come in for treatment.

During an involved process called contouring, the team works with a computer generated model of the patient which normally comes from CT images of the patient— and a computer generated model of the treatment machine to determine the amount of radiation that’s going to the tumor, and more importantly, how nearby structures will be damaged.

October 2012 Magazine

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