Stanford Medicine unveils new facility offering proton therapy

Stanford Medicine opened a facility on Tuesday providing proton therapy to cancer patients. The treatment offers a new radiotherapy option previously unavailable in Northern California. 

Proton therapy is a noninvasive form of radiation therapy that uses positively charged particles instead of X-rays to destroy tumor cells, minimizing damage to healthy neighboring cells.

Existing Stanford Medicine facilities lacked the space to hold traditional proton therapy machines, which are typically housed in multi-story buildings. Radiation oncology professor and co-director of particle therapy at Stanford Medicine, Billy Loo, and his team had to look outside of existing options.

“Necessity was the mother of invention,” Loo wrote in an email to The Daily. Mevion Medical Systems created a more compact cyclotron, dramatically reducing the size of the machine to that of around half a basketball court. Leo Cancer Care Inc. saved space by developing a system in which patients sit upright during radiotherapy treatments. 

Combining the ideas led to the development of the new machine, the MEVION S250-FIT Proton Therapy System. It sits at just 1,200 square feet, located inside the Stanford Medicine Cancer Center. According to Loo, the new model sits at a similar size to conventional high-energy X-ray systems that are used in 99% of cancer radiotherapy, making it easier than ever to incorporate proton therapy into existing facilities. 

The advantage of proton therapy is clear to Loo. “For our patients, the key is being able to eliminate their cancer without causing unacceptable collateral damage,” he told Stanford Medicine.

“The main benefit of proton therapy is in the properties of the beam,” wrote Yuan James Rao, associate professor of radiation oncology, in an email to The Daily. Proton therapy, by stopping at a desired distance in the body, does not have an “exit dose” like other radiotherapies, reducing radiation exposure to the body. 

At the same time, the precision of proton therapy helps minimize damage to neighboring cells, which is especially important when treating tumors near key organs such as the brain or heart. This approach is also important in treating children, who are more sensitive to the effects of radiation.

“Over 80% of children with cancer are cured of their disease and have many decades of life after completion of radiation therapy, giving them a longer time to potentially develop and experience side effects of radiation therapy,” wrote Susan Hiniker, associate professor of radiation oncology and pediatric radiation oncologist, in a statement to The Daily. The potential side effects make it especially important to minimize their radiation exposure.

Although proton therapy is a significant innovation and often helpful, it’s not a universal fit for every treatment. 

“Depending on the location of the tumor and nearby organs and dose constraints, in some cases, other forms of radiation therapy may be better,” Hiniker wrote. The medical center offers a suite of treatment techniques, offering the “latest equipment and treatment techniques for a wide variety of cancers.” 

In the event that it is the best option, though, patients will no longer need to travel to receive care. 

“By having proton therapy at Stanford, we are able to create a more level playing field in access to this technology for those patients who we think are likely to benefit from it, irrespective of their ability to travel long distances to access it,” wrote Hiniker.

Radiation therapy treatments can last up to two months, and long-term stays 7-8 hours away from home pose a significant financial and emotional burden on families.

Looking forward, Stanford Medicine hopes to continue to advance the technology. One example is “arc” therapy, where the proton beam is delivered while rotating the therapy. The rotation was made possible by delivering radiation therapy sitting up, as it “becomes very easy to rotate the patient to bring beams from many different angles to focus the radiotherapy on tumors,” wrote Loo.

“This allows us to use the advantages of more beam angles to optimize where the dose is delivered,” wrote Rao. 

Another innovation that is being explored in proton therapy is FLASH, where radiotherapy is delivered in a fraction of a second instead of over several minutes. Loo, who studies the technique in his lab, wrote that studies have shown that FLASH can reduce injury to normal organs without compromising tumor killing.

“Some proton therapy systems can be used to bring FLASH clinical trials to patients in selected scenarios, and we are working to do so with our new system,” he wrote.

To Loo and his colleagues, the future seems bright. Nine other hospitals are installing the new system even before the first patient has been treated. With radiotherapy benefiting about two-thirds of patients, “anything we can do to substantially improve radiotherapy is a big gain for cancer therapy overall,” Loo told the Stanford Report.

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