1	New Opportunities in Cancer Therapy
2	Why Does Siemens Invest in Particle Therapy? Cancer will become the leading cause of disease induced death Results of more than 43,000 patients treated with protons and 3,000 patients treated with carbon ions show significant advantages for specific tumors
3	Advantages of Particle Therapy Compared to Conventional Radiation Therapy Bragg Peak
4	Advantages of Particle Therapy Compared to Conventional Radiation Therapy
5	PT-System Architecture
6	PT-System Architecture
7	Double Strand Breaks Carbon ions produce non-reparable DNA damage due to double strand breaks (DSB) and clustered damages Protons produce mainly single strand breaks
8	Basic Data for the Combined System Synchrotron 85 - 430 MeV/u for carbon ions 50 - 250 MeV for protons RF knock-out extraction Intensity controlled raster scanning Field size up to 20cm x 20cm Penetration depth up to 30cm (water equivalent) Workflow- Optimization Position verification with x-ray (2D/3D) Robotic table Oncology Information System (OIS) Archiving (PACS) Treatment Planning
9	Technical Advantages of the Siemens System
10	Clinical Applications (1) Protons In principle all tumors that are located next to organs at risk. The inverse dose profile (Bragg Peak) reduces integral dose to non-tumor tissue Examples of typical indications: Pediatric tumors Non malignant brain tumors AVM (arterial vein malformation) Head and neck tumors Prostate
11	Clinical Applications (2) Carbon ions: In principle all tumors that are located next to organs at risk and where the high LET (linear energy transfer) effect results in an increased tumor control rate. These are in general: macroscopic, slowly growing, radioresistant, hypoxic, and deep seated tumors.
12	Potential Indications for Ion Therapy in Austria (Source: MedAustron T. Auberger, U. Mock, R. Mayer)
13	Clinical Advantage of Particles Improved Dose Distribution
14	Clinical Advantage of Particles Carbon treatment of para-aortal Lymphenode (Morbus Hodgkin phase IIB)0
15	Clinical Applications Potential for Reduction of Number of Fractions Tumor response after treatment with 79.2 GyE in 18 fractions (one field per fraction)
16	Particle Therapy with the Siemens Open System Advantages of a “combined” system: Protons are clinically proven (approx. 43,000 patients) Carbon ions are currently used in Chiba, Hyogo, and Darmstadt for selected clinical applications (approx. 3,000 patients) Additional studies underway will increase approved applications
17	Example of Particel Therapy Centers University of Heidelberg 1 x Heavy Ion Gantry 2 x Fixed Beam 1 x Research Beam
18	Heidelberg Project (HIT) Nov. 2004, Heidelberg has ordered all components related to patient environment from Siemens: Scanning & nozzle Robotic patient positioner kV imaging (2D and 3D) Therapy control system (TCS)
19	Heidelberg Project (HIT)
20	Rhön Klinikum AG- University of Marburg /Giessen
21	Siemens Workflow Optimized Particle Center
22	Particle Therapy syngo® Suite for Radiation Oncology Same look and feel between different modalities, systems and tasks Seamless workflow between imaging, planning and other IT systems Intuitive and effective handling of tasks – easy to use Continuous development, DICOM, industry Standards
23	syngo® Suite for Radiation Oncology * syngo® Planning for Particle Therapy * syngo® planning for Particle Therapy is a works-in-progress, requires FDA premarket clearance, and is not presently available for commercial distribution in the U.S.
24	syngo® Suite for Radiation Oncology * syngo® Planning for Particle Therapy * syngo® planning for Particle Therapy is a works-in-progress, requires FDA premarket clearance, and is not presently available for commercial distribution in the U.S.
25	syngo® Suite for Radiation Oncology * syngo® Planning for Particle Therapy * syngo® planning for Particle Therapy is a works-in-progress, requires FDA premarket clearance, and is not presently available for commercial distribution in the U.S.
26	Our Cooperation Partners GSI – Gesellschaft für Schwerionenforschung Society for heavy ion research (Darmstadt, Germany) synchrotron and raster scanning technology treatment optimization (biological effects of ions) treatment planning software knowledge-transfer licenses
27	Siemens and Danfysik Cooperation Siemens and Danfysik Cooperation Joint development Standardized solution for Proton and Carbon therapy in one system Danfysik is the exclusive supplier of accelerator systems for Siemens’ Particle Therapy solutions Danfysik’s accelerator systems include proton and carbon sources, synchrotron accelerators, and beam delivery systems from the synchrotron to the medical treatment rooms
28	The Siemens Open Particle Therapy Solution ...a flexible solution based on standardized modules — from one vendor Accelerator with beam line Scanning and monitoring system Treatment rooms (gantry, robotic table) Patient transport system Imaging (diagnostic and position verification) Treatment planning IT (oncology information system, administration, archiving, …) Project management Maintenance solutions Technical operating
29	Siemens Particle Therapy The Siemens Advantage Total integrated solution with optimized workflow for highest patient throughput Comprehensive service offerings in a long term partnership Combined system with Protons and Carbons to make Particle Therapy future proof Technical leadership through top innovations secures your longterm investments
30	. Siemens Particle Therapy Getting to the Point