In 1946 Harvard physicist Robert Wilson (1914-2000) suggested: Protons can be used clinically Accelerators are available Maximum radiation dose can be placed into the tumor Proton therapy provides sparing of normal tissues Modulator wheels can spread narrow Bragg peak Robert Wilson Wilson, R.R. (1946), Radiological use of fast protons, Radiology 47, 487.
1946 1954 1967 1974 Robert Wilson suggests use of protons First treatment of tumors (brain) First large-field proton treatments in Sweden Large-field fractionated proton treatments program begins at HCL, Cambridge, MA 1990 First hospital-based proton treatment center opens at Loma Linda Univ. Med. Ctr. 2001 2nd proton center opens at Mass General 2004-06 3 more centers open in TX, FL, and IN 2009-10 2 additional centers open in OK, PA
Protons are particles with a positive charge found in the nucleus of an atom In Proton Therapy protons are produced by a machine called a cyclotron. Proton Therapy Cyclotron
Protons exit from the cyclotron and are directed by magnetic fields to the patient
Protons deposit their maximum energy in the tumor and then stop
Traditi onal 6x 1980 Traditi onal 15X 1985 3 Field Vertex 1990 3D Conform al 1995 IMR T 2000 Prot on 2009
Protons deposit their maximum energy in the tumor and then stop
Pediatric Cancer Brain Cancer Lung Cancer Prostate Cancer Colorectal Cancer Spinal Cord Cancers Eye Cancers Base of Skull Sarcomas Breast Cancer Head & Neck Cancer Esophageal Cancer Gantry treatment room
Significant decrease in side effects Significant cost savings by decreasing short & long term complications in pediatric cancer patients Decrease in secondary cancers later in life from unnecessary radiation exposure. Decreased travel for East Tennessee patients and families
2 Example: Improvements in Pediatric Cancer* Side Effects Protons Photons Restrictive Lung Disease 0% 60% Reduced Exercise Capacity 0% 75% Abnormal EKGs 0% 31% Growth Abnormality 20% 100% IQ Drop 10 Point by 6 Yr Old 1.6% 28.5% Risk of IQ score <90 15% 25% *Head, Neck, & Chest Treatment Areas J. Metz M.D. Reduced Normal Tissue Toxicity with Proton Therapy Comparative effects for lung cancer treatment. Oncolink 4.29.02
2 Example: Improvements in Lung Cancer Acute Side Effects Protons Conventional Radiotherapy (Photons) Nausea/Vomiting 0% 30% Shortness of Breath 0% 16% Esophagitis <5% 31% Fatigue <5% 23% > 5 lb Weight Loss 0% 34% J. Metz M.D. Reduced Normal Tissue Toxicity with Proton Therapy Comparative effects for lung cancer treatment. Oncolink 4.29.02
Example: Improvements in Prostate Cancer Modality Dose Recurrence Complications Conventional Radiation <60GY 38% 22% Conventional Radiation 60-65GY 36% 35% Conventional Radiation 70GY 28% 45% Conventional Radiation >75GY 20% 60% PROTONS 75GY 5% 12% N. Mendenhall M.D., Presentation, University of Florida,
Currently Only 7 Centers Operational in US TPT
Operating Under Development
Portions of 5 States: Tennessee Kentucky North Carolina Virginia Georgia 2014 Population: 4,021,777 2014 Cancer Incidence: 22,727
Additional 4 States: Alabama Ohio South Carolina West Virginia 2014 Population: 22,725,011 2014 Cancer Incidence: 123,409
Improve the Health of Tennesseans Now Tennessee Ranks 29th in Cancer Incidence but 46th in cancer deaths according to the latest NCI data Improve Cancer Patient Benefits Now Market Interest is Growing Beyond Research Cancer Patients of Knox County & East Tennessee are Traveling Outside State for Service Need for More Centers to Perform Research If Not Now, When? If Not Us, Who?
Building 43,000 Sq. Ft. 4 Vaults Cyclotron Vault 3 Treatment Vaults Building Costs $23 Million Equipment Costs $45 $50 Million Completion Time 18-24 Months
East Tennessee Healthcare Center Dowell Springs Medical / Business Park Population Center of Knox County
Economic Impact Study by Dr. Murray / UT 45-50% of Patients Travel from Outside of State Patients Will Spend 6-8 Weeks in Area Will Employ ~40 Medical Professionals $30 Million Annual Impact on Community Create over 500 jobs in the state
For further information contact: Scott Warwick ProVision Healthcare 865.384.7636 swarwick@pvhealthcare.com