Still River Systems in MIT Tech Review 9-5-2006

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Tuesday, September 05, 2006

A Cheaper Way to Zap TumorsA 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 yetto 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 togive 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' protontherapy, he adds.

Copyright Technology Review 2006.

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Still River Systems in MIT Tech Review 9-5-2006