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Proton therapy has been around for more than half a century, but Chinese patients don't know much about it. It has been 14 years since the first proton therapy equipment was introduced to China in 2004, and we don't know how many Chinese cancer patients have benefited from this technology. But this technology is the top of the line radiotherapy technology, for patients who need radiotherapy is the best choice, in addition to the price is expensive, other aspects of the complete victory over ordinary radiotherapy.
Proton therapy equipment manufacturer IBA dominates the global proton therapy market. However, other companies like Varian, Mitsubishi, Mevion, Hitachi, etc. are also beginning to gain a foothold in the proton therapy market, and there are nearly a dozen proton therapy equipment vendors worldwide***.
Proton therapy equipment
The proton therapy system of IBA Belgium can provide 70-230MeV proton beams, which can be used to treat tumors in any part of the body, and the following is a brief introduction to the proton therapy system of IBA. The complete proton therapy equipment consists of proton gas pedal, energy selection system, beam transport system, beam delivery system, dose monitoring system, patient positioning system and control system. At the same time, treatment planning system, tissue compensation system and collimator processing equipment and other auxiliary equipment are needed.
Proton gas pedal: an isochronous cyclotron, 4.2 meters in diameter and weighing 220 tonnes, which produces a fixed energy proton beam of 230 MeV.
Energy Selection System: Because tumors vary in depth, they require proton beams of different energies for treatment. The energy selection system can reduce the fixed energy 230MeV proton beam induced by the gas pedal to the appropriate energy according to the clinical needs.
Beam delivery system: The proton beam passing through the energy selection system is delivered to the inlet of the treatment head.
Beam Delivery System: The proton beam that reaches the entrance of the treatment head is only a few millimeters in diameter. The beam delivery system adjusts the beam in a three-dimensional direction through the scatterer, Bragg peak broadener, and avoids the normal tissues when treating tumors.
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Principle of proton therapy
Proton therapy is to take the nucleus of a hydrogen atom, which has lost electrons, and accelerate it up to about 70% of the speed of light by using a cyclotron or synchrotron, and penetrate inside the human body at this extremely fast speed to reach the specific part where the cancer cells are located, and then the speed suddenly decreases and stops, forming a sharp A dose peak, called the Bragg peak ("Bragg peak"), is formed at the end of the shot, releasing maximum energy and killing the cancer cells.
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The difference between proton therapy and ordinary radiotherapy is obvious
Radiotherapy-Scattered Bird mode: radiotherapy kills cancer cells with stronger radioactive isotope rays such as X, Y rays, the rays start from entering the surface of the human body to the continuous release of energy after they pass through the tumor tissues, for the cells in the irradiated area, radiotherapy does not have precise Selectivity, while destroying tumor cells, it also has an inhibitory and damaging effect on the surrounding normal cells.
Proton - three-dimensional fixed-point blast: Proton therapy relies on positively charged nuclear particles rather than traditional photon beams, and the proton energy can be precisely positioned to provide highly concentrated proton beam irradiation to the tumor, which does not cause damage to the surrounding normal tissue structure and minimizes side effects.
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Proton Therapy Advantages
Because of the superior physical properties of protons, proton therapy can deliver a tumor dose while reducing the dose to normal tissue. Compared to X-ray and electron beam irradiation techniques, proton therapy will definitely benefit the patient to a greater or lesser extent. Therefore, proton therapy is an option for any patient who needs to use radiation therapy. However, considering the question of the efficacy-price ratio of proton radiation therapy, we believe that there are certain advantages in certain anatomical sites of tumors (see table).
For early-stage tumors deep in the body, especially when surgery can cause high complications, mortality and cost, proton therapy may replace surgery with no less efficacy, without the need for surgery, hospitalization and the pain of disembowelment.
In addition, proton therapy may have some advantages for the elderly and frail patients, combined with the use of chemotherapy or surgery. Pediatric oncology patients with secondary radiation therapy may be a patient group that benefits more from proton therapy.
Price of proton therapy
At present, the proton and heavy ion technology is more developed internationally mainly in Germany, Japan and the United States, and most of the patients in China choose to have their treatment in these three countries.
For the charges, each country is different. In the U.S. charge per session, the general treatment completion needs 12-15 million U.S. dollars, equivalent to about 900,000 yuan, the lowest is Japan under 3 million yen, equivalent to about 180,000 yuan, Germany needs 50-60,000 euros, about 400,000 yuan. Overall, Japan is the lowest, Germany is moderately priced, and the United States is about 2-3 times as expensive as Germany.
Currently, the domestic proton therapy technology is gradually maturing, the specific price of 200,000-300,000 yuan, you need to pay out of pocket, not be able to enter the medical insurance. Proton and heavy ion therapy, because of its high price, is not covered by health insurance in most countries and regions.