WPCNR East Ender. By John F. Bailey. September 30, 2004: WPCNR has received correspondence from Udo Klein, Managing  Director of ACCEL Instruments GmbH of  Gladbach, Germany, the creators of the new compact superconducting medical proton therapy system  for the Rinecker Proton Therapy Center in Munich, being built by Pro Health AG also of Munich, now under construction, scheduled to be commissioned in 2006.

 

Mr. Klein tells WPCNR the New York Presbyterian Hosptal proton accelerator under consideration, manufactured by Optivus systems is not easily adaptable to the cyclotron stable beam technology developed for the Paul Scherrer Institute in Switzerland, as New York Presbyterian Hospital apparently assumes from today’s statement issued by Geoff Thompson, the NYPH spokesperson.

FIRST IN A SERIES OF GERMAN CENTERS

WPCNR has also learned that the ACCEL system  “stable beam technology” is the type of proton accelerator system, a compact accelerator (cyclotron) with a direct beam capability, is expected to replace all of Germany’s 400 linear accelerators as well as the gamma knive systems, with 10 to 20 proton centers similar to  the Rinecker Proton Therapy Center, which will be operated a private commercial center.

 

There is also a new study out this year, providing more evidence that proton therapy works to stop cancer tumours cold, without side effects, making it, apparently a more valuable asset to New York Presbyterian Hospital if they select the correct technology. The University of Pennyslvania Health System in Philadelphia is, according to Mr. Klein, “are in touch with us and others.” WPCNR has placed a call to the University of Pennyslvania Health System for confirmation of the seriousness of these explorations by that 2.7 Billion Dollar institution.

 

Beam Me, Scotty.

 

New released research appearing in the International Journal of Radiation Oncology Biology Physics in 2004  report  the proton therapy as practiced at the Loma Linda University Medical Center  in California is effective in curing cancer even among patients with high P.S.A. counts, the blood count indicating presence of cancer in the body.

 

From 1992 to 1997, the Loma Linda beamed cured 90% of persons diagnosed with tumour cancers with a low P.S.I. rate of less than 4.0,  and 82% of those patients with a P.S.I. rate of 4 to 10. Patients with P.S.A.s between 10 and 20, were cured at the rate of 62%, and patients with PSA’s of more than 20, experienced a 45% cure rate. The study evaluated 1,255 patients treated at Loma Linda between October 1991 and December 1997. All were treated with protons and X-rays; none had prior surgery or hormonal therapy. Three consecutive rises of PSA were used to indicate biochemical failure.

 

  Curiously, according to statistics provided by Pro Health Ag, the owner-developers of the Rinecker Proton Therapy Center, 50% of all U.S. Cancer malignancies are surgically removed. The remaining 50% treated with radiotherapy. In Europe, 50% of cases are also treated surgically, 40% by radiotherapy (X-Rays), and 27% of those by radiotherapy alone, and 13% combined treatment.

 

The results are that only 45% of cases are cured. The radiotherapy cure rate varies form 0% to 96%.

 

Loma Linda Pioneering Device has a Second Generation Model

 

WPCNR (from first reports last week by SwissInfo note previous story), learned that the compact proton accelerator which ACCEL manufactures requires less space, less power, and delivers a more effective, accurate proton punch to cancer tumours than the Loma Linda accelerator manufactured by Optivus, previously planned by the New York Presbyterian Hospital. The new cyclotron with the fixed beam was developed by the Paul Scherrer Institute in Switzerland.

 

Mr. Klein explains the difference between the new compact accelerator and the Loma Linda pioneer device: “The Loma Linda type accelerator is a synchrotron, which has a discontinuous beam by nature and needs a higher controlling effort to get it stable. Cyloctrons (the Accel accelerator) instead deliver a continuous and stable flow of protons. Upgrading (a synchrotron) is a very costly and time consuming thing, interrupting operations.”

 

WPCNR asked if the new ACCEL device was U.S. F.D.A.-approved, and Mr. Klein advised “FDA approval for proton therapy systems is a process ALONG with engineering design and manufacturing according to our discussions with them.”

 

Less Costly?

 

WPCNR inquired about the cost of the ACCEL cyclotron being installed in Munich?  Klein explained Munich has ONE cyclotraon and FIVE treatment rooms, four with a gantry and one fixed beam room. Total project costs including the whole facility are on the order of 120 Million Euro, (or $144 Million ).

 

When the proton accelerator Optivus, Loma Linda model was originally proposed by the New York Presbyterian Hospital in 2002, it was estimated to cost $100 Million. The price tag of the actual facility now being asked to have its site plan renewed Monday at the October 4 Common Council meeting have never been accounted for by New York Presbyterian Hospital. It may cost the NYPH considerably more for that unit when they finally sign the contract, whenever that may be. Mr. Thompson did not say when the NYPH actually would start building.

 

Doctor Reaction?

 

Mr. Klein said doctors like the more versatile beam on the new ACCEL compact cyclotron: “Doctors are more interested in the treatment modalities, beam characteristics, patient environment, planning systems, integrated software, etc. They don’t care so much about the accelerator although this is the heart of the system defining beam quality, scanning speeds to a large extent.”

 

Power Use of New Accelerator Slightly More Efficent.

 

Klein said the Munich cyclotron used “several hundred kilowatts less” than the Loma Linda accelerator model. A thousand kilowatts equals one megawatt. The NYPH Environmental Impact Statement prepared in December 2001 for this project said that the peak power demand for the Center’s equipment would be approximately 9.25 Megawatts. The new Accelerator in Munich would cut that demand and cost by approximately 300 KW, (if “several” means 2 to 300 kilowatts), bringing the peak power demand slightly under 9 Megawatts, just by rough guestimate.

 

To put this into perspective, 9.25 Megawatts the peak power demand (the EIS appears not to mention the average power demand), is enough power to light 92,500 100 watt light bulbs, and to light 4 light bulbs in every one of the 25,000 households in White Plains.

 

 

The Treatment Difference.

 

WPCNR wanted a layman’s definition of the main difference between the Loma Linda accelerator and the ACCEL accelerator in Munich, Klein writes, “The basic difference is SCANNNG versus SCATTERIN. For scattering, like in Loma Linda, you need to shape and collimate the beam with heavy and patient-specific material to match the shape of the tumor. With scanning, you control the irradiated field with the software.”

 

Klein whose company which is creating the proton accelerator for the Rinecker Proton Therapy Center, said regarding the treatment: “We believe and we can demonstrate that ACCEL delivers the most compact and most innovative system worldwide. The Loma Linda system uses a synchrotron which we do not consider the appropriate choice for today’s fast scanning proton therapy. It cannot be expected that protons can be produced, accelerated and precisely guided for radiation therapy pruposes in considerably smaller systems in the future.”

 

Building Does Not Have to Be As Large.

 

WPCNR asked if the ACCEL accelerator could fit into an existing building. Klein said this was not possible but  did allow that it was “compact” as its description implies:

 

“The requirements of the footprint of a proton therapy system plus the radiation shielding necessities usually require a tailor-made building. There are only a few cases worldwide where parts of existing buildings could be used for proton therapy systems brought in. Those buildings however had been used for housing other accelerator equipment before.”

 

For extensive coverage of the Rinecker Proton Therapy Center, WPCNR suggests a trip through cyberspace to www.rptc.de, the Center’s website.