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 Tuesday, September 05, 2006
A Cheaper Way to Zap Tumors
A smaller cyclotron could bring proton radiation therapy to more patients.
By Katherine Bourzac
Half of all cancer patients in the United States require radiation to combat their tumors.A form of radiation that uses protons, rather than X rays, to zap tumors causes fewerside effects to healthy tissue and may prove more effective.Although these benefits of proton therapy have been known since the 1960s, it has yetto come into wide use. A key drawback: cost. Only a handful of hospitals can affordthe equipment required to create high-energy proton beams.Now a startup based in Littleton, MA, Still River Systems, is working with MITphysicists to develop a smaller, less expensive proton accelerator in the hopes of making the therapy more widely available. It expects the machine, which relies onadvances in magnet technology to energize protons enough so they are therapeutic, tobe in hospital trials in 2008.During traditional radiation therapy, a clinician aims X-ray beams at a patient's tumor.The X rays damage DNA and other molecules in the cancer cells--and in healthy cells--in the beam's path. Proton beams can be focused far more sharply. "You can moreprecisely shape the [proton] dose to the shape and thickness of the tumor," saysTimothy Antaya, a technical supervisor at MIT's Plasma Science and Fusion Center,who is working with Still River Systems. As a result, less surrounding healthy tissue isdamaged during proton therapy.But giving protons high enough energy to penetrate through the body to a tumorusually requires a large, expensive accelerator that must be housed in a different roomthan the patient. In order to penetrate 20 centimeters of water (the gold standard forthese treatments), accelerators must rev up protons to 250 million electron volts. Theequipment needed to generate such high-energy proton beams costs $100-200 million.Furthermore, in staffing, Antaya says, "For protons you need something like a smallnuclear physics laboratory."Page 1 of 3Technology Review: A Cheaper Way to Zap Tumors4/11/2009http://www.technologyreview.com/printer_friendly_article.aspx?id=17418&channel=biom...
 
Antaya says the machine from Still River Systems will be small enough to fit into thesame room as the patient. "We're taking advantage of advanced magnet technology,"he says. The company is using an accelerator known as a synchrocyclotron. Antayasays the new machines will be an order of magnitude smaller and an order of magnitude less expensive than current ones. And he says one of the group's goals is togive the system a simple interface so that it doesn't require a large, highly-trained staff.Currently, only four hospitals in the United State have proton beam facilities, inMassachusetts, Indiana, California, and Texas (ones in Florida and Pennsylvaniaare under development). "If protons become more available, a lot of patients couldbenefit," says Jay Loeffler, chief of radiation oncology at Massachusetts GeneralHospital in Boston, which has operated a proton beam since 2001. The hospitalcurrently gives proton therapy to 60 patients a day.Because proton beam therapy has not been in wide use, it is not clear which patients itcould benefit the most. Clinicians know that the biggest benefits come in patientswhose cancer has not yet spread beyond its initial site, and that children almost alwaysbenefit, says Loeffler. Protons generally work as well as, or better than, X rays, andwith fewer side effects, he explains. Ongoing clinical trials will help clarify whichpatients benefit the most from the therapy. Loeffler says patients whose cancer hasbeen discovered in its early stages are currently chosen for proton treatment.Loeffler cautions that because Still River Systems has been secretive about itstechnology, its new approach hasn't been evaluated by outside experts. Having aproton facility the same size as an X-ray facility is attractive, he says; but for theproton accelerator to be in the same room as the patient it must be proved safe--cyclotrons can give off stray radiation, as well as using tremendous voltage and power.Antaya says that his group has taken safety into account from the beginning and thatthe design includes "sophisticated shielding and control of the surroundingenvironment." Many hospitals have expressed interest in Still River Systems' protontherapy, he adds.Copyright Technology Review 2006.
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Page 2 of 3Technology Review: A Cheaper Way to Zap Tumors4/11/2009http://www.technologyreview.com/printer_friendly_article.aspx?id=17418&channel=biom...
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reply04 / 11 / 2009
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