by
Gus Iversen, Editor in Chief | March 30, 2015
From the March 2015 issue of HealthCare Business News magazine
Varian has also entered the compact market with a single-room version of their ProBeam system; a business move that Karmalawy says was made carefully. “One critical decision we made was not to compromise clinical efficacy of the patient treatment or therapist usability of the system,” he says.
“If you have the patient volume to utilize the cyclotron and support more than one room, then multi-room is the way to go,” says Karmalawy. “However,” he adds, “in most cases, if you look worldwide, the patient volume is smaller than most people expect.”
Access to proton therapy for ideal candidates is far from satisfactory, but a regional patient population may not necessitate a traditional multi-room center. Where traditional systems are massive construction jobs that may cost hundreds of millions of dollars, compact systems bring smaller-footprint benefits to facilities with fewer treatment demands.
Compact proton therapy centers have been a part of the IBA install-base since their ProteusONE was installed at the Willis- Knighton Cancer Center in Shreveport, Louisiana, in 2013. Currently, they have sold seven of those systems. They have also sold 25 of the multi-room counterpart, the ProteusPLUS, which Olivier Legrain, CEO of IBA, says makes them the industry leader in terms of sheer sales volume.
The multi-room industry is growing, but Legrain says that growth is modest in comparison to what they’re seeing with the single room systems. “From a tech standpoint, the beauty of the compact system is that you provide the same quality of treatment for smaller volume of patients; it’s just for serving a clinical workflow instead of academic,” says Legrain.
The smaller size also means faster construction. Which, coupled with a high degree of up-time for the system, can yield significant — although less visible — cost benefits.
Pencil beam
Having a cell phone implies certain uniquely modern capabilities; you can text-message on them, you can access email; but from a technical capability standpoint, there is a big difference between a budget cell phone and a premium smart phone. Similarly, according to Karmalawy, “Not all proton systems are created equally,” and he points to the breakthroughs in pencil-beam technology as evidence of this.
“We have had pencil-beam scanning, which is now the industry standard, since 2007,” he says. “Everybody else used scattering technology and many are now retrofitting their systems with pencil beam.”
Pencil-beam therapy, a way of delivering intensity modulated proton therapy (IMPT), has emerged as a faster alternative to scattering, but the benefits extend well beyond throughput. “If you think about beam-on time as 20 or 40 seconds with our system and compare it to several minutes per field with another, the patient would move and things would change even within a minute,” says Karmalawy. That movement can compromise the treatment’s dosimetry.
