Technology Review: A Cheaper Way to Zap Tumors Page 1 of 3

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 fewer
side effects to healthy tissue and may prove more effective.

Although these benefits of proton therapy have been known since the 1960s, it has yet
to come into wide use. A key drawback: cost. Only a handful of hospitals can afford
the equipment required to create high-energy proton beams.

Now a startup based in Littleton, MA, Still River Systems, is working with MIT
physicists to develop a smaller, less expensive proton accelerator in the hopes of
making the therapy more widely available. It expects the machine, which relies on
advances in magnet technology to energize protons enough so they are therapeutic, to
be 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 more
precisely shape the [proton] dose to the shape and thickness of the tumor," says
Timothy 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 is
damaged during proton therapy.

But giving protons high enough energy to penetrate through the body to a tumor
usually requires a large, expensive accelerator that must be housed in a different room
than the patient. In order to penetrate 20 centimeters of water (the gold standard for
these treatments), accelerators must rev up protons to 250 million electron volts. The
equipment needed to generate such high-energy proton beams costs $100-200 million.
Furthermore, in staffing, Antaya says, "For protons you need something like a small
nuclear physics laboratory."

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Antaya says the machine from Still River Systems will be small enough to fit into the
same room as the patient. "We're taking advantage of advanced magnet technology,"
he says. The company is using an accelerator known as a synchrocyclotron. Antaya
says 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 to
give 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, in
Massachusetts, Indiana, California, and Texas (ones in Florida and Pennsylvania
are under development). "If protons become more available, a lot of patients could
benefit," says Jay Loeffler, chief of radiation oncology at Massachusetts General
Hospital in Boston, which has operated a proton beam since 2001. The hospital
currently gives proton therapy to 60 patients a day.

Because proton beam therapy has not been in wide use, it is not clear which patients it
could benefit the most. Clinicians know that the biggest benefits come in patients
whose cancer has not yet spread beyond its initial site, and that children almost always
benefit, says Loeffler. Protons generally work as well as, or better than, X rays, and
with fewer side effects, he explains. Ongoing clinical trials will help clarify which
patients benefit the most from the therapy. Loeffler says patients whose cancer has
been discovered in its early stages are currently chosen for proton treatment.

Loeffler cautions that because Still River Systems has been secretive about its
technology, its new approach hasn't been evaluated by outside experts. Having a
proton facility the same size as an X-ray facility is attractive, he says; but for the
proton 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 that
the design includes "sophisticated shielding and control of the surrounding
environment." Many hospitals have expressed interest in Still River Systems' proton
therapy, he adds.

Copyright Technology Review 2006.

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