Munich Center First to Provide Breakthrough Intensity-Modulated Proton Therapy

A leading cancer clinic in Germany has become the first hospital in the world equipped to provide clinical treatments using intensity-modulated proton therapy (IMPT), a precise and fast way to deliver conformal proton therapy treatments.

Rinecker Proton Therapy Center (Munich; Germany) is able to provide advanced IMPT treatments due to improvements in the scanning delivery system enabled by equipment provider Varian Medical Systems, Inc. (Palo Alto, CA, USA). The hospital has also reached a milestone by bringing its fourth treatment gantry into clinical use.

"The advantage of IMPT over other forms of proton therapy is the potential for improved dose conformity and better sparing of dose to critical structures,” said Dr. Joerg Hauffe, chief executive officer of ProHealth, the center's operating company. "By including IMPT in our clinical program, we can be very flexible in planning our therapies and use the full potential of these advanced treatments for the benefit of our patients. Proton therapy is already recognized as a very effective way of targeting tumors while minimizing dose to surrounding healthy tissue and this allows even greater precision.”

Varian has been at the forefront of advances in treatment precision including intensity- modulated radiotherapy (IMRT) and image-guided radiotherapy (IGRT). "We recognized the potential of IMPT when we entered the proton therapy field,” said Moataz Karmalawy, head of Varian's particle therapy group. Scanning beam technology combines a high quality of care with the potential for higher patient throughput and improved cost efficiency, and we believe it will improve the economics and effectiveness of proton therapy.”

Unlike conventional X-ray based radiotherapy where the beam passes completely through the body, proton therapy kills tumors by delivering heavier particles that stop at specified depths within the anatomy, thereby reducing exposure to healthy tissue. Scanning beam technology enables IMPT by modulating dose levels on a spot-by-spot basis throughout the treatment area. Irradiations from multiple angles are combined in an innovative way to improve control of dose distributions. Scanning beam technology also eliminates the time-consuming need to insert manually separate shaping accessories for each beam angle in order to correlate the beam to the shape of the tumor.

"It's a real landmark that Rinecker Proton Therapy Center has become the first hospital to offer IMPT to treat patients,” added Mr. Karmalawy, pointing out that the Paul Scherer Institute PSI [Villigen PSI] in Switzerland, which uses a Varian cyclotron to generate protons, was the first to carry out IMPT treatments in a research environment.

IMPT has been made possible following technologic developments by Varian. "We have improved the beam delivery precision to less than one millimeter, enhancing the delivery of IMPT,” said John Braze, installations program manager for Varian particle therapy. "Improved precision reduces the constraints in the optimization process, allowing a quality of dose distribution that was previously not possible.”

Moreover, RPTC has been provided with a software upgrade, which enables clinicians to make use of new ‘repainting' functionality. This functionality allows clinicians to treat moving targets by splitting the dose into multiple sweeps of the scanning beam.

Related Links:
Rinecker Proton Therapy Center