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ProteusONE

™

Compact proton therapy solution

Protons are Possible

www.iba-proteusone.com

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Some features are under development and are subject to review by competent authorities (FDA, Notified bodies, et al...)

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PrOTON ThEraPY. a TrUE sUccEss iN caNcEr carE Proton therapy is used today to treat many cancers and is particularly appropriate in  situations where treatment options are limited and conventional radiotherapy presents an  unacceptable risk to the patient. These situations include eye or brain cancers, tumors close to the brain stem or spinal  cord, prostate cancers, and pediatric cancers. 

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1. cENTral NErvOUs sYsTEM Adult Low and High Grade Gliomas Pediatric Gliomas Acoustic Neuromas · Recurrent or Unresectable Meningiomas · Recurrent or Unresectable Craniopharyngiomas Chordomas and Low Grade Chondrosarcomas Arteriovenous Malformations Medulloblastomas Pituitary Adenomas Posterior Fossa Tumors 2. EYE & OrbiT Uveal Melanomas Macular Degeneration Choroidal Melanomas Retinoblastomas Choroidal Metastases Orbital Rhabdomyosarcomas Choroidal Hemangiomas Optic Gliomas 3. hEaD & NEcK Paranasal Sinus Salivary Glands Carcinomas Nasopharynx · Primary and Recurrent Esophogeal Carcinomas Recurrent Carcinomas 4. ThOrax Non Small Cell Lung Carcinomas Breast Cancer Early Stage-Medically Inoperable Paraspinal Tumors Soft Tissue Sarcomas Lymphomas

For a general overview of the clinical aspects of proton therapy, refer to the following works: - “Proton and charged particle radiotherapy” by Thomas F. Delaney, Hanne M. Kooy - “Proton Therapy”, Series: Radiation Medicine Rounds Volume 1 Issue 3 by James M. Metz and Charles R. Thomas, Jr.

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5. gasTrOiNTEsTiNal  MaligNaNciEs Oesophageal Carcinomas Reccurent Rectal Cancer Pancreatic Cancer Hepatocellular Carcinomas 6. PElvis Early Stage Prostate Carcinomas Locally Advanced Prostate Carcinomas Locally Advanced Cervix Carcinomas Pelvic Sarcomas Pediatric Malignancies Ewing’s Sarcomas Retroperitoneal Sarcomas Genicologic Carcinomas

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ProteusONE

 IBA ProteusONE ™ is a compact single-room proton therapy solution. It benefits from the latest technologies of ProteusPLUS ™ that have been developed over the years with top clinical institutions worldwide. ProteusONE ™ is designed to bridge the gap between conventional radiotherapy and proton therapy. ProteusONE ™ offers extended treatment solutions (IMPT, IGPT) enabling physicians to leverage completely on the clinical effectiveness offered by the proton beam precision. ProteusONE ™ has been inspired by everyday clinical practice. Its design enhances the patient experience by fostering a soothing environment while making the medical staff daily practice safer and easier. Finally ProteusONE ™ is the IBA response to make protons affordable. It is a proton therapy system that is smaller, more affordable, easier to install, easier to operate and ultimately easier to finance. With ProteusONE ™, protons are possible for more patients worldwide.

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Treating with

ProteusONE

IBA ProteusONE  ™ is a compact singleroom proton therapy solution. It offers EXTENDED treatment solutions. This proton therapy solution offers treatment capabilities that will allow you to fully leverage the clinical effectiveness offered by proton beam precision. On the one hand, ProteusONE  ™ proposes the Pencil Beam Scanning mode enabling the delivery of Intensity Modulated Proton Therapy (IMPT ) treatment plans.

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De li ve ri ng t he  be   am to t ad apt iv he ne E I M AG ar E G es t m UI DE il D li PR mete OT ON r TH ERA PY

On the other hand, the latest imaging techniques are incorporated in ProteusONE  ™ to enable adaptive Image Guided Proton Therapy (IGPT).

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Treating with Intensity modulated Proton Therapy ProteusONE  ™ delivers the proton beam to the tumor using the Pencil Beam Scanning (PBS) modality. Thanks to its precision and its specificities, PBS enables Intensity Modulated Proton Therapy. This provides the ability to precisely target the tumor and control the intensity and spatial distribution of the dose with sub-millimetric precision. With ProteusONE  ™ IMPT capabilities, you will have the ability to precisely sculpt the dose into the target tumor, reaching high levels of conformality and dose uniformity, even in complex-shaped tumors.

What is Pencil Beam Scanning (PBS)? PBS is a proton beam delivery mode. The proton beam is steered across the target volume, one layer at a time, pixel by pixel, to precisely match the shape of the tumor. This active scanning technique allows the physicians to modulate or change the intensity of the beam at any specific location in the target. PBS key advantages: — Thanks to its millimeter precision, PBS offers the ultimate capability of sculpting the dose with very high levels of conformality and dose uniformity, even in complex-shaped tumors. — It enables Intensity Modulated Proton Therapy (IMPT) as well as Single Field Uniform Dose (SFUD) deposition. — PBS is easy to operate and limits the use of patient specific devices. It delivers the smallest possible neutron dose to the patient as it does not use apertures or compensator devices. — Combined with the appropriate devices and treatment strategies, it is adequate to treat moving tumors.

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delivering the beam to the nearest millimeter ProteusONE ™ brings together the most  advanced techniques of Patient Positioning  for Proton theraPy treatments, therefore  enabling your treatment Procedures  to leverage Proton beam Precision.  the technology develoPed over the years  by iba and its clinical Partners has Proven  successful in delivering the Proton beam  with sub-millimetric Precision. 

220° Of TrEaTMENT frEEDOM iN  ThE MOsT cOMPacT DEsigN EvEr  DEvElOPED The IBA 220° Compact Gantry Treatment  Room* combines the following advantages:  —  Uncompromised positioning treatment  options provided by a continuouslyadjustable treatment angle combined  with 6° freedom of movement offered  by the patient positioner. All treatment  angles can be achieved.  —  The most compact gantry design* ever  developed for proton therapy, while still  enabling easy patient access and noncoplanar treatments. —  It enables advanced imaging  technologies (Cone Beam Computed  Tomography* (CBCT), Fluoroscopy,  2.5D Digital x-ray Imaging).

rObOTic PaTiENT POsiTiONiNg  sYsTEM (rPPs)  Positioning the patient with the utmost care  while ensuring the precision of this position  in the treatment environment is key to  clinical effectiveness. The robot selected by IBA for the  ProteusONE™ extends the treatment  possibilities by allowing a wider treatment  volume, 6° freedom of movement and noncoplanar treatment capabilities. ProteusONE ™ RPPS advantages include: —  positioning with 6 axis of freedom  including pitch and roll capacity;  —  capability for additional services such  as water phantom handling or quality  assurance tools coupling; —  a greater extension of the arm  in the treatment room, allowing  further applications; —  small footprint.

* CBCT and 220° Compact Gantry are ongoing developments. The marketing approval will be subject to review by competent authorities (FDA, Notified bodies,et al…)

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Towards adaptive IGPT… Proton therapy has always used imageguidance for patient positioning in order to meet the accuracy requirements set by the superior dose distribution of the Bragg peak. Thanks to ProteusONE  ™ imaging solutions, you will have the ability to image the patient in order to provide the radiation oncologist with all relevant anatomical information that could lead to real IMAGEGUIDED Proton Therapy.

2.5D orthogonal x-ray and fluoroscopy In addition to automatic registering, 2.5D imaging and “in treatment” fluoroscopy will be made possible by two digital x-ray panels. Fluoroscopy is an imaging technique that produces real time x-ray video of body structures. The system enables the medical user to observe the position of the tumor and the treatment area during the treatment. It is particularly adapted   to follow patient organs movements.

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NEw cONE bEaM cOMPUTED  TOMOgraPhY* Currently, two orthogonal x-ray projection  images are used to compare the  treatment position of the patient with the  planned position. If Computed Tomography (CT) data can  be directly acquired in the treatment  room of the proton therapy system, it is  possible to compare them with the CT  images of the radiotherapy treatment  planning system. This gives much more  accurate results than the conventional  orthogonal alignment system. Clinical  users can then apply similar positioning  and imaging protocols as those used in  their IGRT practice. 

IBA and its clinical partner are currently  fi nalizing the development of a proton  therapy system that accommodates  CBCT* technology in the 220° Compact  Gantry Treatment Room* design  confi guration.  The IBA solution brings the  advantages of: —  acquiring CBCT* image in room and  in treatment position; —  ensuring accurate patient positioning; —  enabling the detection of anatomic  modifi cations of the patient on  the radiological path.

First images of an head phantom produced using FDK reconstruction of images acquired on IBA PT Gantry CBCT test bench (or prototype).

* CBCT and 220° Compact Gantry are ongoing developments. The marketing approval will be subject to review by competent authorities (FDA, Notified bodies, et al…)

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a design

i nspired by clinical care Working with clinicians and nurses in the development of proton therapy worldwide over the last 20 years has led the IBA team to understand that successful treatment does not only depend on proton beam physics.

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ProteusONE  ™ has been designed to enhance the patient experience by fostering a soothing environment. At the same time, all care has been taken to facilitate medical staff daily practice.

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Optimized staff experience

Open treatment enclosure*

In-room imaging control

The ProteusONE™ is designed with an open treatment enclosure*. It allows the physicians and nurses to have easy access to the patient in treatment position. This facilitates patient care and improves positioning procedures while allowing noncoplanar treatments.

In addition to treatment controls from the therapy control room, all imaging can be controlled from inside the treatment room for improved patient care, greater ease of use and efficient streamlining of positioning procedures.

Gantry Rolling Floor (GRF)

* CBCT and 220° Compact Gantry are ongoing developments. The marketing approval will be subject to review by competent authorities (FDA, Notified bodies, et al…)

Thanks to the highly original design of the GRF, the patient remains very accessible to the medical staff even though the gantry rotates around the isocenter (220°). The GRF ensures staff safety during clinical operations, allowing them to focus on their core tasks and patient wellbeing.

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Soothing patient environment To design the ProteusONE ™ treatment room, IBA partnered with Philips Design’s expert team of designers who have a longstanding experience in the development of patient-friendly medical environments.  This has led to a design that soothes patients undergoing treatment procedures. Natural materials and appeasing colors have been carefully selected to create a peaceful environment. In order to help the patient feel more comfortable, the room design offers some degree of personalization (eg. a music station has been incorporated).

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Proton therapy made affordable

Through the development of proton therapy projects worldwide with many different clinical institutions, the IBA team has learned that the biggest challenge is not developing leading-edge technology, nor convincing clinicians about the effectiveness of protons in oncology, but making this technology accessible to more patients worldwide. This is the challenge that IBA has taken on. ProteusONE  ™ is our response; a proton therapy system that is smaller, more affordable, easier to install, easier to operate and ultimately easier to finance.

 W hen si ze m atte   W rs hen it come s to t    ime and money

With ProteusONE  ™, protons are possible for more patients worldwide.

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When size matters… In many areas, size matters. This is particularly true in the medical context where every square foot is invaluable. There is a common belief that proton therapy is big, if not to say huge.   It is therefore thought to be inaccessible for most institutions.

The IBA team is working relentlessly to prove this belief false. The result is the ProteusONE ™: a PT solution with a footprint the size of approximately two linac vaults.

When it comes to time and money… Bringing proton therapy to the community is a tough challenge for most oncology institutions, even though proton therapy has today gained worldwide recognition as a powerful cancer treatment modality.

medical community at a lower cost while optimizing the time to first patient.   Those two factors contribute to create a proton therapy solution that is easier to develop and finance.

The success of a proton therapy project often comes down to issues related to time and money.

In addition, IBA is currently developing a partnership with financial institutions worldwide to provide ProteusONE ™ customers with simple and accessible leasing solutions.

With ProteusONE ™, IBA has made a breakthrough in terms of PT affordability. ProteusONE ™ brings proton therapy to the

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leading institutions have already chosen iba. Join them to develoP the future of cancer care together. sTaY fOcUsED ON PaTiENT carE, wE caN  rUN ThE sYsTEM fOr YOU Our experience with more than half of the  clinical proton therapy centers worldwide  has led us to understand the worries  and clinical complexities that arise when  treating cancer. Our commitment is to  ensure your clinical success by providing  reliable tools with the highest availability  possible (over 95% uptime). This will  enable your institution to become a  reference cancer center using the latest  radiotherapy modality, proton therapy. To date, being part of the IBA proton  therapy client network and benefi ting  from our service organization experience  has helped centers around the world to  successfully deliver more than 300,000  fractions to cancer patients. Your team will be able to focus on the  clinical aspects of cancer care while  IBA’s team takes care of ensuring that  your proton therapy system runs at top  performance and meets the highest safety  and reliability standards.

OPEraTiON aND MaiNTENaNcE sErvicEs  iN a NUTshEll With more than 70 service  professionals in three continents,  you can have access to our qualifi ed  fi eld support team at any time, day  and night. In addition to personalized  support, other key services are  provided:  —  24/7 remote support service,  online or over the phone, is an  important component to keep your  equipment’s high uptime. —  A team of IBA trained specialists  will operate the system onsite  to ensure the highest level of   availability for clinical treatment. —  In case of emergency, we can  deliver spare parts the same  day via our extensive spare parts  worldwide network with hubs in  America, Asia and Europe. —  Because technology changes  quickly, IBA develops both update and upgrade packages tailored  to your center’s confi guration and  training programs to increase your  team’s effi ciency. NEw sErvicE fEaTUrEs iNclUDE: —  Remote Service Connections to  proton therapy accelerator systems; —  Worldwide Computerized  Maintenance Management Systems.

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2 InDIAnA unIversIty heAlth Proton therAPy center Bloomington, IN, USA

rOOMs

Two gantry rooms. Treating since 2004

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rOOMs

4 cDh Proton therAPy center, A Procure center Chicago, IL, USA

rOOMs

One gantry room, two inclined-beam rooms, one fixedbeam room. Treating since 2010

Procure Proton therAPy center Seattle, WA, USA

2 mAssAchusetts generAl hosPItAl Burr Proton therAPy center Boston, MA, USA

rOOMs

Cyclotron, Energy Selection System (ESS), two gantry rooms. Treating since 2001

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rOOMs

rOOMs

rOOMs

New cyclotron connected to two existing fixedbeam rooms. Extension of the existing facility by one gantry room. Treating since 2009

In development. Expect to have four treatment rooms. Opening in 2013

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centre De ProtonthÉrAPIe De I’InstItut curIe Paris (Orsay), France

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BronowIce cyclotron center Kraków, Poland

rOOMs

Cyclotron, ESS, one research room, one fixed-beam room. Opening in 2013

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rOOMs

4 feDerAl hIgh-tech meDIcAl center Dimitrovgrad, Russia, Europe

rOOMs

Cyclotron, two gantry treatment rooms, one dual beam treatment room and 1 eye treatment room. Opening in 2013

Procure Proton therAPy center In oklAhomA cIty Oklahoma City, OK, USA

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rOOMs

First USA Proton Therapy facility in a private practice setting, one gantry room, two inclined-beam rooms, one fixed-beam room. Treating since 2009

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5 hAmPton unIversIty Proton therAPy InstItute Hampton, VA, USA

rOOMs

4 unIversIty of florIDA Proton therAPy InstItute Jacksonville, FL, USA

2

rOOMs

rOOMs

wAnjIe Proton therAPy center Zibo, China Cyclotron, ESS, one gantry room, one fixed-beam room. Expandable by two additional gantry rooms. From project start to first patient treated in only three years. Treating since 2004

Cyclotron, ESS, three gantry rooms, one fixed-beam room. Treating 100 patients per day within two years of opening. Treating since 2006

In development. Expect to have four treatment rooms. Opening in 2013

nAtIonAl cAncer center Kashiwa, Japan Cyclotron, ESS, two gantry rooms. Developed in association with Sumitomo Heavy Industry, LTD. Treating since 1998

Cyclotron, ESS, four gantry rooms, one fixed-beam room. Fastest build to date for IBA and partners. Treating since 2010

4 Procure Proton therAPy center Princeton, NJ, USA

nAtIonAl cAncer center Ilsan, Korea Cyclotron, ESS, two gantry rooms, one fixed-beam room. Expandable by one gantry room. Treating since 2007

rOOMs

rOOMs

Cyclotron, ESS, three gantry rooms, one fixed-beam room. First Proton Therapy center based on a public-private partnership (PPP) model.

skAnDIonklInIken Uppsala, Sweden Cyclotron, ESS, two gantry rooms, one research room. Opening in 2013

westDeutsches ProtonentherAPIeZentrum essen (wPe) Essen, Germany

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rOOMs

unIversIty of PennsylvAnIA heAlth system roBerts Proton therAPy center Philadelphia, PA, USA Cyclotron, ESS, four gantry rooms, one fixed-beam room, one research room. The largest Proton Therapy center project to date. Treating since 2009

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rOOMs

AgenZIA ProvIncIAle Per lA ProtonterAPIA (AtreP) Trento, Italy Cyclotron, ESS, two gantry rooms and one fixed-beam room. First gantry-equipped Proton Therapy center in Italy. Opening in 2013

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rOOMs

unIversItAtklInIkum cArl gustAv cArus Dresden, Germany Cyclotron, ESS, one gantry room, one research room. Opening in 2014

4 Proton therAPy center cZech s.r.o. Prague, Czech Republic

rOOMs

Cyclotron, ESS, three gantry rooms, one fixed-beam room. The first of its kind in eastern Europe. Opening in 2012

This map has been last updated in September 2011.

IBA has designed and installed the majority of clinically operating proton therapy centers in the world.

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Contact us Americas Toll-free: 1 877 IBA 4 PBT T +1 904 224 6100 Europe, Middle East and Africa T +32 10 203 342 F +32 10 475 923 Russia & CIS T/F +7 495 648 69 00  E-mail: info@iba-russia.ru Asia Pacific T +86 10 8080 9186 E-mail: info-pt@iba-group.com Visit us online at:   www.iba-proteusone.com

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While all care has been taken to ensure that the information contained in this publication is correct,   we accept no responsibility for any inaccuracy and reserve the right to modify this information. Technical specifications are based on standard operating conditions and may be subject to variations. Pictures and illustrations are not contractual. ProteusONE ™ is the brand name of a new configuration of the Proteus 235 including some new developments subject to review by competent authorities before marketing. Empath is a registered trademark of IBA Particle Therapy. IBA, a Belgian company, is listed on the panEuropean stock exchange EURONEXT and its annual reports can be downloaded on the website: www.iba-worldwide.com. Published by IBA S.A., Chemin du Cyclotron, 3  1348 Louvain-la-Neuve, Belgium. This brochure is printed on ECF woodfree coated paper. It was produced with plants that comply with ISO 14001, the environmental management standard.

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IBA Group | 2011 | ProteusONE ™ 2011

IBA Particle Therapy With more than 25 years of experience, IBA is at the forefront of developing the technology and treatment facilities for delivering proton therapy to meet growing demands. IBA, the market leader, has designed and equipped the majority of clinically operating proton therapy centers around the world. At IBA, our expertise and knowledge cover all aspects of the process, from site selection to design, systems integration and maintenance, together with financing offerings and many other services. Our team of experts has unrivaled experience in designing, building, installing and operating proton therapy facilities. We do what it takes to help create the right proton therapy facility for you and your patients and help you stay on the leading edge of cancer treatment. Our goal is to ensure the highest equipment performance to keep you on time and on budget.

Visit us online at:

www.iba-proteusone.com

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ProteusONE  

IBA présente Proteus ONE™, un système de protonthérapie plus compact et plus rentable.

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