title: The world's first single-room proton therapy facility: Two-year experience.
abstract: OBJECTIVE
  This is a review of our 2-year experience with the first single-gantry proton therapy (PT) system.
  
  
  METHODS
  All patients were consented to participate on an institutional review board-approved prospective patient registry between December 2013 and December 2015. PT was delivered in a single-room facility using a synchrocyclotron with proton beam energy of 250 MeV. The dataset was interrogated for demographics, diagnosis, treatment modality, and clinical trial involvement. Cases were classified as simple or complex based on fields used and immobilization. The volume of photon patients treated in our department was collected between January 2011 and December 2015 to evaluate the impact of PT on our photon patient volume.
  
  
  RESULTS
  A total of 278 patients were treated with PT, including 228 (82%) adults and 50 (18%) pediatric cases. PT patients traveled a mean distance of 83.3 miles compared with 47.4 miles for photon patients queried in 2015. Rationale for treatment included reirradiation (20%), involvement in prospective clinical trial (14%), and proximity to critical structures to maximally spare organs at risk (66%). Forty patients were enrolled on 5 adult and 3 pediatric prospective clinical trials. The most common histologies treated were glioma (27%) and non-small cell lung cancer (18%) in adults, and medulloblastoma (22%) and low-grade glioma (24%) in pediatric patients. Prostate cancer composed 6% of PT. Complex cases composed 45% of our volume. Our photon patient volume increased yearly between 2011 and 2015, with 2780 patients completing photon treatment in 2011 and 3385 patients in 2015. PT composed 4% of overall patients treated with external beam radiation.
  
  
  CONCLUSIONS
  The installation of our single-gantry proton facility has expanded the treatment options within our cancer center, helping to increase the number of patients we see. Patients travel from twice as far away to receive this treatment, many for typical PT indications such as pediatrics or to participate in prospective clinical trials.
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, The Alvin J. Siteman Comprehensive Cancer Center and Barnes-Jewish Hospital, St. Louis, Missouri.
authors.forename: Jessika
authors.initials: J
authors.lastname: Contreras
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, The Alvin J. Siteman Comprehensive Cancer Center and Barnes-Jewish Hospital, St. Louis, Missouri.
authors.forename: Tianyu
authors.initials: T
authors.lastname: Zhao
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, The Alvin J. Siteman Comprehensive Cancer Center and Barnes-Jewish Hospital, St. Louis, Missouri.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Perkins
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, The Alvin J. Siteman Comprehensive Cancer Center and Barnes-Jewish Hospital, St. Louis, Missouri.
authors.forename: Baozhou
authors.initials: B
authors.lastname: Sun
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, The Alvin J. Siteman Comprehensive Cancer Center and Barnes-Jewish Hospital, St. Louis, Missouri.
authors.forename: Sreekrishna
authors.initials: S
authors.lastname: Goddu
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, The Alvin J. Siteman Comprehensive Cancer Center and Barnes-Jewish Hospital, St. Louis, Missouri.
authors.forename: Sasa
authors.initials: S
authors.lastname: Mutic
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, The Alvin J. Siteman Comprehensive Cancer Center and Barnes-Jewish Hospital, St. Louis, Missouri.
authors.forename: Beth
authors.initials: B
authors.lastname: Bottani
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, The Alvin J. Siteman Comprehensive Cancer Center and Barnes-Jewish Hospital, St. Louis, Missouri.
authors.forename: Sharon
authors.initials: S
authors.lastname: Endicott
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, The Alvin J. Siteman Comprehensive Cancer Center and Barnes-Jewish Hospital, St. Louis, Missouri.
authors.forename: Jeff
authors.initials: J
authors.lastname: Michalski
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, The Alvin J. Siteman Comprehensive Cancer Center and Barnes-Jewish Hospital, St. Louis, Missouri.
authors.forename: Clifford
authors.initials: C
authors.lastname: Robinson
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, The Alvin J. Siteman Comprehensive Cancer Center and Barnes-Jewish Hospital, St. Louis, Missouri.
authors.forename: Christina
authors.initials: C
authors.lastname: Tsien
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, The Alvin J. Siteman Comprehensive Cancer Center and Barnes-Jewish Hospital, St. Louis, Missouri.
authors.forename: Jiayi
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, The Alvin J. Siteman Comprehensive Cancer Center and Barnes-Jewish Hospital, St. Louis, Missouri.
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Fischer-Valuck
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, The Alvin J. Siteman Comprehensive Cancer Center and Barnes-Jewish Hospital, St. Louis, Missouri.
authors.forename: Dennis
authors.initials: D
authors.lastname: Hallahan
authors.affiliation: Department of Radiation Medicine, Long Island Jewish Medical Center, New Hyde Park, New York.
authors.forename: Eric
authors.initials: E
authors.lastname: Klein
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, The Alvin J. Siteman Comprehensive Cancer Center and Barnes-Jewish Hospital, St. Louis, Missouri. Electronic address: jbradley@radonc.wustl.edu.
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mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000532:radiotherapy*; D058958:Organs at Risk; D061766:Proton Therapy / Q000009:adverse effects