IMPT Intensity Modulated Proton Therapy
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1 IMPT Intensity Modulated Proton Therapy VARIAN PARTICLE THERAPY Jan Timmer VPT Head of Marketing
2 Protonentherapie Varian Projecten ProBeam Eclipse 2 VARIAN PARTICLE THERAPY
3 Protonentherapie Actuele Ontwikkelingen in Nederland Afgifte maximaal vier vergunningen Behandelcapaciteit maximaal 2200 patienten per jaar Eerste patienten medio 2016 Studie kosteneffectiviteit / meerwaarde protonentherapie 3 VARIAN PARTICLE THERAPY
4 Protonentherapie Actuele Ontwikkelingen in Nederland 4 VARIAN PARTICLE THERAPY
5 Protonentherapie Geschiedenis in Nederland 5 VARIAN PARTICLE THERAPY
6 Protonentherapie Geschiedenis in Nederland Radiobiologische Experimenten 100% 50% cranial 50% caudal Konings et al. IJROBP 2005;62; VARIAN PARTICLE THERAPY
7 Protonen Nieuw in de Radiotherapie? Eerste Linear Accelerator 1956 Stanford Source: news.stanford.edu/ 7 VARIAN PARTICLE THERAPY
8 Protonen Nieuw in de Radiotherapie? Eerste Proton Behandeling 1954 Berkeley 8 VARIAN PARTICLE THERAPY
9 Voordelen van Protonen Dosisverdeling 9 VARIAN PARTICLE THERAPY
10 Voordelen van Protonen Dosisverdeling Significant minder ongewenste dosis Protons Photon IMRT 10 VARIAN PARTICLE THERAPY
11 Voordelen van Protonen Dosisverdeling Significant minder ongewenste dosis Dr. Steven Frank, MD Anderson IMPT is the future of head and neck treatment Clinical feasibility has been established IMPT can reduce beam path toxicities of IMRT We must test this hypothesis in a Phase III Trial Value proposition of HN proton therapy Hospitalization, emergency center, ambulatory center, feeding tubes Dr. Thomas Merchant, St. Jude Children s Hospital Proton Beam Therapy is the future of pediatric radiotherapy Cure rates will increase when investigators are able to exploit the physical characteristics of the proton beam to increase radiation dose to critical sub-regions of the targeted volume ASTRO presentation 2013 The Cancer Journal Volume 15, Number 4, July/August VARIAN PARTICLE THERAPY
12 Ontwikkeling Fotonen en Protonen Geschatte aantallen Wereldwijd 50,000,000 Patienten behandeld met fotonen 100,000 Patienten behandeld met protonen 12 VARIAN PARTICLE THERAPY
13 Protontherapie Ontwikkeling Als protonen zo veel mogelijkheden bieden, waarom is de technologie dan niet al veel meer ingezet? 13 VARIAN PARTICLE THERAPY
14 Protonentherapie Aantal Behandelkamers Geinstalleerd CAGR = 12% 14 VARIAN PARTICLE THERAPY
15 Protonentherapie Ratio Linacs versus Behandelkamers Protonentherapie 15 VARIAN PARTICLE THERAPY
16 Protonentherapie Wereldwijde Investering in Protonentherapie % 16 VARIAN PARTICLE THERAPY
17 Protonentherapie Overzicht Hoe ziet een protonentherapie system er uit? 17 VARIAN PARTICLE THERAPY
18 18 VARIAN PARTICLE THERAPY
19 19 VARIAN PARTICLE THERAPY
20 20 VARIAN PARTICLE THERAPY
21 ProBeam TM Compact Innovate Without Limits 21 VARIAN PARTICLE THERAPY Company Confidential
22 Protonentherapie Vier Cruciale Technologische Ontwikkelingen 1. Pencil Beam Scanning 2. On-board Imaging 3. Workflow 4. Configuraties 22 VARIAN PARTICLE THERAPY
23 1. Pencil Beam Scanning Video 23 VARIAN PARTICLE THERAPY
24 1. Pencil Beam Scanning ProBeam 35,000 fracties bestraald IMPT programma vier jaar clinisch Focus op dedicated scanning nozzles Geintegreerd planning en behandelsysteem 24 VARIAN PARTICLE THERAPY
25 1. Pencil Beam Scanning Scattering versus Scanning 25 VARIAN PARTICLE THERAPY
26 1. Pencil Beam Scanning Scattering versus Scanning Collimator, compensator No patient specific devices Bronnen: VARIAN PARTICLE THERAPY
27 1. Pencil Beam Scanning Multiple Effect Delivery fields Systeem in one op fraction Capaciteit Patients per Year Number of Treatment Rooms Rekenvoorbeeld: effect van 5 minuten benodigde tijd om collimator en compensator te vervangen 27 VARIAN PARTICLE THERAPY
28 1. Pencil Beam Scanning Definitie Is Pencil Beam Scanning hetzelfde als IMPT? 28 VARIAN PARTICLE THERAPY
29 1. Pencil Beam Scanning Definitie PSI: IMPT is the simultaneous optimization of all Bragg peaks from all fields IMPT is the pencil beam scanning equivalent of IMRT Varian: IMPT = Each individual field delivers an optimized and inhomogeneous dose such that when combined produces a uniform target dose. 29 VARIAN PARTICLE THERAPY
30 1. Pencil Beam Scanning Definitie PSI: IMPT is the simultaneous optimization of all Bragg peaks from all fields IMPT is the pencil beam scanning equivalent of IMRT Varian: IMPT = Each individual field delivers an optimized and inhomogeneous dose such that when combined produces a uniform target dose. 30 VARIAN PARTICLE THERAPY
31 1. Pencil Beam Scanning Definitie PSI: IMPT is the Simultaneous optimization of all Bragg peaks from all fields IMPT is the pencil beam scanning equivalent of IMRT Varian: IMPT = Each individual field delivers an optimized and inhomogeneous dose such that when combined produces a uniform target dose. 31 VARIAN PARTICLE THERAPY
32 Wat is IMPT? Each individual field delivers an optimized and inhomogeneous dose VARIAN PARTICLE THERAPY
33 Wat is IMPT? Each individual field delivers an optimized and inhomogeneous dose VARIAN PARTICLE THERAPY
34 Wat is IMPT? Each individual field delivers an optimized and inhomogeneous dose VARIAN PARTICLE THERAPY
35 Wat is IMPT? Each individual field delivers an optimized and inhomogeneous dose VARIAN PARTICLE THERAPY
36 Wat is IMPT? when combined produces a uniform target dose 36 VARIAN PARTICLE THERAPY
37 Wat is IMPT? Comparing Photon and Proton Plans in Eclipse 37 VARIAN PARTICLE THERAPY
38 Wat is IMPT? Passive Scattering Pencil Beam Scanning SFO IMPT 1 Field 1 Field 1 Field 3 Fields 3 Fields 3 Fields 38 VARIAN PARTICLE THERAPY
39 1. Pencil Beam Scanning Voordelen Betere dosis conformiteit Snellere behandelingen Lagere kosten Simpelere bediening Adaptief plannen eenvoudiger mogelijk Minder neutronen 39 VARIAN PARTICLE THERAPY
40 Protonentherapie Vier Cruciale Technologische Ontwikkelingen 1. Pencil Beam Scanning 2. On-board Imaging 3. Workflow 4. Configuraties 40 VARIAN PARTICLE THERAPY
41 2. On-Board Imaging Wat kunnen we leren van traktorbanden? 41 VARIAN PARTICLE THERAPY
42 2. On-Board Imaging Wat kunnen we leren van traktorbanden? 42 VARIAN PARTICLE THERAPY
43 2. On-Board Imaging 2D Orthogonal and CBCT 43 VARIAN PARTICLE THERAPY
44 ProBeam Image Guided Proton Therapy 44 VARIAN PARTICLE THERAPY
45 Protonentherapie Vier Cruciale Technologische Ontwikkelingen 1. Pencil Beam Scanning 2. On-board Imaging 3. Workflow 4. Configuraties 45 VARIAN PARTICLE THERAPY
46 3. Worklfow Multiple Behandeltijden fields Protonen in one and fraction Fotonen Fava et al., In gantry or remote patient positioning?, Radiotherapy and Oncology (2011), doi: /j.radonc VARIAN PARTICLE THERAPY
47 3. Workflow Integratie Treatment Decision Protons Photons Planning Eclipse OIS ARIA 1 Treatment Delivery Probeam 4DConsole TrueBeam 4DConsole D A T A B A S E 47 VARIAN PARTICLE THERAPY
48 3. Workflow User Interface User Interface Building on TrueBeam foundation Increased readability Connecting the user to the delivery 48 VARIAN PARTICLE THERAPY
49 3. Workflow Common User Interface Guided Workflow Console Pendant 49 VARIAN PARTICLE THERAPY
50 3. Workflow Hand Pendant Bediening met één hand Bereikbaarheid patient Eenvoudige stappen Pendant 50 VARIAN PARTICLE THERAPY
51 3. Workflow Huidige Standaard X Bediening met één hand X Bereikbaarheid patient X Eenvoudige stappen 51 VARIAN PARTICLE THERAPY
52 Protonentherapie Vier Cruciale Technologische Ontwikkelingen 1. Pencil Beam Scanning 2. On-board Imaging 3. Workflow 4. Configuraties 52 VARIAN PARTICLE THERAPY
53 4. Configuraties Multiple Effect Delivery fields Systeem in one op fraction Capaciteit Patients per Year Number of Treatment Rooms Rekenvoorbeeld: effect van 5 minuten benodigde tijd om collimator en compensator te vervangen 53 VARIAN PARTICLE THERAPY
54 4. Configuraties ProBeam Multi-Room Platform Superconducting Cyclotron Dynamic Peak TM Scanning Fixed Beam 2D Orthogonal & CBCT Big Bore Beam Line Eclipse & ARIA Integration 54 VARIAN PARTICLE THERAPY
55 4. Configuraties ProBeam Single Room Eclipse & ARIA Integration Superconducting Cyclotron Dynamic Peak TM Scanning Big Bore Beam Line 2D Orthogonal & CBCT 55 VARIAN PARTICLE THERAPY
56 Protonentherapie Vier Cruciale Technologische Ontwikkelingen 1. Pencil Beam Scanning 2. On-board Imaging 3. Workflow 4. Configuraties 56 VARIAN PARTICLE THERAPY
57 Protonentherapie Outlook Planning IMPT robustness optimization Adaptive planning Knowledge based planning & decision support Delivery Protocol specific workflow optimization Introduction advanced motion management techniques Proton radiosurgery Image Guidance 4D, gated, dual energy CBCT Proton radiography and/or proton CT In-vivo dosimetry Platform New accelerator technology (?) Cost effectiveness 57 VARIAN PARTICLE THERAPY
58 DANK VOOR UW AANDACHT VARIAN PARTICLE THERAPY Jan Timmer VPT Head of Marketing
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