gms | German Medical Science

The first fractionated treatment at the Northeast Proton Therapy Center (NPTC) was delivered in November 2001. The radiosurgery program followed six months later in April 2002. Within another six month period, expansion beyond the existing clinical facility which included two gantries and 1 horizontal ocular beamline was deemed necessary to accommodate the proton radiosurgery caseload. With limited resources the in-house planning, budgeting, design, fabrication, acceptance testing and commissioning processes took nearly four years. In August 2006 the dedicated intra-cranial stereotactic beamline was used to treat its first patient. Three years later over 350 proton SRS cases and 110 SRT treatment courses (2700 fractionated treatments) have been successfully completed using this beamline.

The beamline specifications were created for stereotactic radiosurgery and were based on past experiences at the Harvard Cyclotron Laboratory (HCL) between 1991 and 2001. The underlying priority for this dedicated facility was to design a simple yet robust system which incorporated a fixed horizontal beamline and the STAR (Stereotactic Alignment Radiosurgery) patient positionner. The beamline configuration provides some unique constraints to achieve desired treatment goals. As a result 75% of radiosurgery cases are able to be treated with the dedicated stereotactic beamline while 10% are treated on the gantries and 15% are treated on a Linac.

Each of the stereotactic treatment delivery systems presents some logistical and technical limitations. We compare the proton delivery systems in terms of stereotactic options and describe the patient triage and treatment processes as they relate to the resources available at our facility. Patient demographics and example cases are presented.