Features and Specifications

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Kevin Stevenson
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1 A NEW WAY TO DO WHAT YOU DO BEST FIGHT CANCER Features and Specifications ProBeam Proton Therapy System

2 PROBEAM PROTON THERAPY SYSTEM FEATURES AND SPECIFICATIONS The ProBeam proton therapy system from offers the latest techniques in intensity-modulated proton therapy (IMPT). This fully integrated system brings together advanced capabilities in treatment planning, oncology information, imaging, and patient positioning with the latest in scanning technology. This document presents an overview of the major ProBeam system features and the individual ProBeam subsystems. The specifications included are intended as a potential approach to configuring the ProBeam system.

3 OVERVIEW OF SYSTEM CONFIGURATION Proton therapy system layout Gantry and robotic treatment table Proton therapy system layout The proton therapy hardware consists of a cyclotron, an energy selection system, and multiple treatment rooms in the form of either rotating gantry or fixed beam rooms. The beam is transported from the accelerator and the energy selection system to the treatment rooms via the beam transport system. Dynamic Peak integrated scanning technology for IMPT treatments Proton accelerator: 250 MeV isochronous superconducting cyclotron Energy selection system Beam transport system

4 EXAMPLE CONFIGURATION The overall footprint of the facility below is approximately 1,900 m² (20,400 sq ft). Total height is approximately 12 meters (39 feet). Gantry and robotic treatment table The gantry beam line provides symmetrical beam spot sizes at the isocenter. The beam can be adjusted for a variety of radiation applications. At the treatment position, the minimum beam radius is 3 mm (1 sigma). The beam line is optimized to reduce the dependence of the beam direction on energy shifts. The distance between the exit of the final bending magnet and the isocenter gives ample space for the x-y scanning system. For verification of patient positioning, the gantry utilizes two X-ray amorphous silicon detectors for double-axis verification. The gantry and treatment table ensure precise positioning of the beam relative to the tumor volume. The gantry is supported by large roller bearings and is balanced with counterweights. This unique structure design provides excellent stability. All treatment tables are computer controlled with six degrees of freedom. They are designed for a load of 250 kg (550 lbs) and are equipped with load cells to permit patient weight variation compensation. This dynamic compensation permits the treatment table to be positioned within a radius of 0.5 mm, thus making the use of a third X-ray axis obsolete. Time spent in patient positioning is reduced. In an emergency, the system allows the table to be manually moved into a safe position without electrical power. Safety/collision detection In order to avoid collisions between nozzle and patient or treatment table, the nozzle is equipped with laser sensors that will slow down gantry and treatment table motion when approaching a collision situation. Contact sensors will then engage emergency brakes.

5 Table Top Roll Pitch Robotic Arm PARAMETERS OF THE GANTRY PARAMETERS OF THE TREATMENT TABLE Maximum outer dimension 10.0 m (~ 32.5 ) Maximum length 10.2 m (~ 33.2 ) Maximum Load X-axis movement range Vertical range 250 kg (550 lbs) 240 cm 60 cm Inner diameter 4.9 m (~ 16 ) Inner length 3.5 m (~ 11.6 ) Maximum gantry rotation angle 380 Maximum rotational speed 6 /s (1 rpm) Table top rotation around vertical axis Couch orientation ± 95 Pitch ± 3 Roll ± 3 Head forward or feet forward Maximum deviation of the gantry rotation angle Maximum deflection of the optical axis* ± 0.1 ± 0.5 mm Absolute positioning precision, radius sphere (135kg) load Relative positioning precision for small displacements, radius sphere (135kg) 0.5 mm < 0.2 mm * The optical axis is defined by the position of the gantry magnets, which are properly aligned during installation. Varying operating conditions will lead to small deviations of the actual optical axis from the ideal position.

6 DYNAMIC PEAK INTEGRATED SCANNING TECHNOLOGY Dynamic Peak integrated scanning technology provides a beam with round cross-sections at the isocenter. This scanning nozzle can deliver intensity-modulated proton therapy (IMPT) treatment. The x-y deflection system consists of two orthogonal scanner magnets. SCANNING SYSTEM PARAMETERS Proton energy Field area MeV (usable energy range) 30 cm x 40 cm Minimum beam radius 3 mm (1 ) Dose delivery 2 Gy/l/min

7 Proton accelerator The Varian 250 MeV superconducting isochronous cyclotron is based on a well established clinical design. Key features of the cyclotron Continuous operation of superconducting coil eliminates magnet warm-up phase for improved operational efficiency Stand-alone cryogenic system with automatic helium re-liquefaction High extraction efficiency Compact internal ion source for reduced size and cost Compact footprint for reduced structural cost and improved serviceability Pillbox design allows easy access by an automatic lifting system of the upper iron yoke Automatic control system operation Energy selection system The variable slit energy selection system allows the energy to be adjusted from 240 MeV to 70 MeV, and permits selection of an appropriate energy spread. Three high-density graphite wedges are positioned via a linear movement into the beam path to allow precise and fast variation of beam energy. The energy can be selected within the specified energy range in steps of 0.1 g/cm² for ranges higher than 5 g/cm² and 0.05 g/cm² for ranges below 5 g/cm². Energy reproducibility at isocenter is at least 0.05 g/cm² for all energies. Beam transport system The beam transport system delivers the proton beam to a selected treatment room. It permits the beam spot at the patient to remain independent from any gantry angle. It is designed for flexibility in the number of treatment rooms and enables future expansion. The switching time between rooms is 30 seconds.

8 PROBEAM Proton Therapy System Particle Therapy 3100 Hansen Way Palo Alto, CA Tel: Varian Particle Therapy GmbH Mottmannstr Troisdorf Germany Tel: varian.com/probeam USA Regional Offices California Corona, CA Tel: Georgia Marietta, GA Tel: EMEA, CIS and India Headquarters Switzerland International AG Cham, Switzerland Tel: EMEA, CIS and India Regional Offices Austria Gesellschaft m.b.h. Brunn am Gebirge, Austria Tel: Belgium Belgium N.V./S.A. Diegem, Belgium Tel: Finland Finland Oy Helsinki, Finland Tel: France France Buc, France Tel: Germany Deutschland GmbH Darmstadt, Germany Tel: Hungary Hungary Kft. Budapest, Hungary Tel: India India Pvt Ltd. Mumbai, India Tel: India Pvt Ltd. Chennai Branch, India Tel: India Pvt Ltd. Delhi Branch, India Tel: Italy Italia, S.p.A. Milano, Italy Tel: The Netherlands Nederland B.V. Houten, The Netherlands Tel: Russia (RUS) LLC Moscow, Russia Tel: /24 Scandinavia Scandinavia A/S Herlev, Denmark Tel: Spain/Portugal Ibérica, S.L. Madrid, Spain Tel: United Kingdom /Ireland Authorized Representative in the EU UK Ltd. Crawley, UK Tel: Asian Pacific Headquarters China China Ltd. Beijing, China Tel: Asian Pacific Regional Offices Hong Kong Pacific, Inc. Kowloon, Hong Kong Tel: Japan K.K. Chuo-ku, Tokyo, Japan Tel: Australia Australasia Pty Ltd. Sydney, Australia Tel: Latin American Headquarters Brazil Brasil Ltda. São Paulo, Brasil Tel: Specifications subject to change without notice. Not all features or products are available in all markets. Intended Use Summary The Varian ProBeam Proton Therapy System provides protons for precision radiotherapy of lesions, tumors, and conditions anywhere in the body where radiation treatment is indicated. Safety Radiation treatments may cause side effects that can vary depending on the part of the body being treated. The most frequent ones are typically temporary and may include, but are not limited to, irritation to the respiratory, digestive, urinary or reproductive systems, fatigue, nausea, skin irritation, and hair loss. In some patients, they can be severe. Treatment sessions may vary in complexity and time. Radiation treatment is not appropriate for all cancers Inc. All rights reserved. Varian, and ProBeam are registered trademarks and Dynamic Peak is a trademark of, Inc. RAD 10177B 09/2014

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