To date, the UFPTI has delivered more than 21,000 proton therapy treatments, to patients with head-and-neck, skull-base, sarcoma, prostate, pancreas and pituitary cancers. Gary Barlow, the centre's administrative technical director, told medicalphysicsweb that 107 proton treatments had been performed on the day that we visited.
Barlow - who manages the radiation therapy staff, and oversees the patient treatment scheduling, daily treatments and simulation operations - explained that 70% of patients travel to the UFPTI from out-of-town. They'll live in Jacksonville for the eight weeks it typically takes to complete a treatment course (which generally comprises 38 to 41 fractions). He also emphasized the benefits offered by the facility being able to perform conventional radiotherapy alongside proton treatments.
First port-of-call on our tour: the imaging systems. Pre-therapy scanning is performed using an open MRI scanner and a large-bore 16-slice CT with 4D capability, both from Philips. There's also a PET/CT scanner, employed for post-treatment range verification.
The 98,000 sq. ft site contains three proton treatment rooms, each equipped with a gantry that rotates 360° around the patient couch, enabling the proton beam to be delivered from any angle. Each of the three gantries has a different aperture and is used for specific types of treatment. There's also a fourth room nearing completion, which will house a fixed beam for treating eye cancers and other ocular diseases.
The gantries are equipped with IBA Universal Nozzles, which are used clinically in single- and double-scattering modes. A uniform scanning mode is currently under commissioning, and the UFPTI is working with IBA to develop pencil-beam scanning in the nozzle, which would enable the delivery of intensity-modulated proton therapy.
The next stop was the cyclotron itself: an IBA Proteus 235. The cyclotron provides a continuous 230 MeV proton beam, which can be varied between 70 and 230 MeV (with a resolution of 0.1 MeV) by the energy selection system. The beam transport system can switch the beam from one room to another in less than a minute.
"This is a really exciting facility to work in, it's a privilege to be associated with this state-of-the-art site," said Barlow.