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The Final Frontier of Radiation Therapy

David Pahor

With advances in radiation therapy, cancer treatment has come a long way in the last twenty years. Therapy with high-energy photons from medical linacs has become the mainstay of oncology and saves millions of lives each year. At the same time, a multitude of advanced radiation therapy modalities has reached maturity, such as particle, boron neutron capture and heavy-ion therapy. The clinical and manufacturer communities are now concentrating on optimising, leveraging and consolidating the performance and capabilities of specific subsystems and elements of radiation therapy devices and facilities worldwide.

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The Room of Irradiation

One such element is the treatment room – the special bunker in a therapy facility where patients receive radiation to their cancerous tissues. This bunker is only a small part of the entire space taken by the radiation therapy device and its supporting systems – but it is usually the only part that the patient sees.

The treatment room is much more than a carefully designed space with thick shielded doors and concrete walls; it is the totality of positioning, imaging, measurement, and treatment equipment inside the room that enables the patient’s carefully planned and controlled irradiation.

MedAustron Treatment Room

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The Beam and the Patient

In particle therapy (PT) centres – except in heavy-ion facilities – the clinical team usually maneuvers the radiation beam around the patient lying on the treatment table in order to facilitate irradiation from multiple angles. In boron neutron capture therapy (BNCT) clinics, on the other hand, the beam is fixed, and all the positioning is achieved by moving and angling the patient in front of the fixed collimator of the BNCT beam shaping assembly.

Whatever the modality of radiation therapy, the treatment room is both the place where the patient has to feel as relaxed as possible throughout the treatment and where the oncology staff carries out all the patient preparation procedures. These are, for example, patient setup, positioning, verification and, possibly, pre-treatment and guidance imaging.

To assure that the beam will reach the exact cancerous parts of tissue, clinicians sometimes need up to twenty minutes to adjust the patient’s position before treatment correctly. This way, the patient can spend half an hour, or more being irradiated in the treatment room.  

Patient Treatment

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Challenges and Improvements

From the viewpoint of technology, and even more so, of standardisation, manufacturers can bring about a range of improvements to make radiation therapy even better. This holds especially for its most promising domains, particle therapy, including proton and heavy-ion therapy, and boron neutron capture therapy.

With all the advances in modern radiation therapy and the rising number of young innovative manufacturers, the potential for the particle and BNCT treatment domains is significant. But before radiation therapy can fulfil its full clinical and technological promise, it has to improve upon several conditions, among which are: 

  • costly and complex development and maintenance of radiation therapy devices;
  • many radiation therapy systems have an older architecture and provide no upgrade support to meet future needs and technology innovations;
  • “walled gardens” of technology with custom interfaces and protocols that lack standardisation and –
    • do not facilitate operability between systems of various manufacturers;
    • are of lower overall quality;
    • are of higher long-term cost;
    • inhibit technological advancements and the implementation of innovations;

Specifications of a Future-proof Treatment Room

Tomorrow’s treatment room must assure several high-level benefits – and fit in most of the existing hospital‘s bunkers. Obviously, patient throughput should be increased, and clinical operations made easier. The hospitals’ total cost of ownership of radiation therapy devices should decrease, and the benefits for medical insurers and society should be maximised.

The treatment room should also be designed as part of an optimised radiation-therapy device architecture, tightly integrated with the beam source.

And, of course, patients should be made to feel even more at ease and enjoy a better experience.

Conclusion

The effectiveness of particle therapy and BNCT can be increased significantly, much more than that of conventional radiation therapy. Namely, PT and BNCT are currently far less standardised than their high-energy photon counterpart and have a more significant potential to be optimised. 

The potential gains for clinics, health insurers, patients and disruptive medical device companies can be significant, lowering the total cost of ownership and possibly transforming PT and BNCT into the most economically viable radiation therapy modalities.

Innovative radiation therapy treatment rooms are the junction where all of the patient-facing technological advancements of PR and BNCT can meet – and create a future-proof software and systems solution for clinical efficacy and treatment affordability. These will, in turn, allow patients to enjoy improved treatment and better outcomes! 

Are you interested in learning about the core approaches, technologies, implementations, and optimisations that form Cosylab’s comprehensive solution for the Treatment Room of the Future?

Please read our next blog, where we shall reveal in detail why the treatment room is the final frontier of radiation therapy, where Cosylab’s experience and innovation push the envelope!

The particle therapy industry in China has entered a stage of rapid development, actively supported by the Chinese government, hospitals, scientific research institutions and private capital.

That is why the world premiere of the Cosylab Treatment Room of the Future will be at the online conference Innovation Forum of Key Technologies and Components of Particle Therapy in China on the 21st of May, 2022, hosted by the Department of Engineering Physics and the Research Center for Technological Innovation at the Tsinghua University. 

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