PATIENT-HOTLINE

Patients and relatives can contact short at this point of contact for questions, suggestions and criticism.

+49 (0) 800/ 660 68 00

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Contact

RINECKER PROTON THERAPY CENTER
Franz-von-Rinecker Straße (main entrance)

Schäftlarnstraße 133 (postal address)

81371 München

Do you have any questions?
+49 (0) 800/ 660 68 00

About us

The RINECKER PROTON THERAPY CENTER

The RPTC, located in Munich, is the first fully certified European proton radiation center which provides a complete hospital setting for the treatment of cancer tumors.

Our innovative therapeutic procedure involves the use of high-energy proton beams for the treatment of cancer. A key characteristic of these proton beams is that protons facilitate the three-dimensional targeting of tumours; this capability is not available with the x-rays used in conventional radiation therapy. Therefore, highly effective dosages can be delivered to the tumour while the side effects of radiation are reduced by minimizing any trauma to the surrounding healthy tissue.

Questions? +49 (0) 800/ 660 68 00

RINECKER PROTON THERAPY CENTER STATUS REPORT: TWELFTH MONTH OF CLINICAL OPERATION, MARCH ‘10
2010-03-01 08:12

RINECKER PROTON THERAPY CENTER STATUS REPORT: TWELFTH MONTH OF CLINICAL OPERATION, MARCH ‘10

ONE YEAR AGO ON 16TH MARCH 2009, THE FIRST PATIENT RECEIVED IRRADIATION THERAPY AT RPTC.   THE FOLLOWING CONTAINS OUR ANNUAL REPORT.   OUR INITIAL SET-UP PHASE IS NOW COMPLETE - HIGhLY PRECISE CANCER RADIOTHERAPY USING PROTON SCANNING IS GRADUALLY BECOMING A ROUTINE MATTER. BUT WE WILL CONTINUE TO TELL YOU ABOUT HOW WE ARE PROGRESSING - IN QUARTERLY REPORTS. PLEASE CONTINUE TO FOLLOW OUR ACTIVITIES.

RINECKER PROTON THERAPY CENTER
ONE YEAR OF SET-UP AND CLINICAL SUCCESS
PIONEERING PROTON CANCER THERAPY IN EUROPE

Cancer treatment – current status,
on-going progress in radiation therapy
CANCER: SURGERY, CHEMOTHERAPY AND IRRADIATION

Cancer treatment – current status, on-going progress in radiation therapy

 

The prolongation of the average life span in Europe is inseparably connected with the greater frequency of cancer cases (450,000 new diagnosed cases in 2010 in the FRG according to the Robert Koch Institute). To date it has not proved possible to reduce the mortality rate of cancer to much below 50%, even though early treatment is becoming ever more frequent due to improved screening examinations. Of the three pillars of cancer treatment - surgery, chemotherapy and irradiation - the former has, from a current perspective, reached its zenith. It has become less risky (anesthesia, intensive therapy), it can be applied earlier thanks to improved diagnostics (endoscopy, CT, magnetic resonance imaging) but the technical widening of surgical procedures (radical operations) has declined somewhat in recent years. Chemotherapy, along with immuno and hormone therapies, has proven very successful, but in relation to solid tumors (unlike leukemia) is faced with the problem of the development of resistance by tumor cells, which leads to the renewed spread of surviving cancer cells meaning that chemotherapy can in most cases only attain a prolongation of life but not a permanent recovery. Gene therapy is still a distant prospect; there are currently no procedures able to bring the ten- to twenty thousand gene mutations of cancer cells under control.

 

Radiotherapy, which apart from a few exceptions (isotope therapy) is currently performed using X-rays, has in recent times attained its most effective level of performance with new X-ray devices (IMRT, Cyberknife, tomotherapy, Rapid Arc). These advances have, however, not been able to eliminate the drawback of X-ray radiation: It is a "shoot-through method", whereby beams can be aimed laterally but not to a three-dimensional depth. Depending on the body and tumor geometry, three- to five-times the dosage entering the tumor is unavoidably dispersed in the healthy surrounding tissue, the resulting collateral damage and side effects restrict the applicable tumor dosage and the efficacy of the X-rays in equal measure.

 

The new particle or iontherapy, optimized in the form of proton scanning circumvents these inadequacies of the localized dosage distribution: Particle radiation can also be targeted depth-wise, i.e. in the third dimension so that it has a concentrated effect within the tumor. It preserves the healthy tissue. This has generated tremendous enthusiasm in Japan and the United States for particle or proton treatment. In Japan there are 12 large particle irradiation clinical centers currently in operation and by the end of this year it is predicted that 23 proton- and similar particle facilities will replace X-ray therapy units worldwide, with a further 15 under construction or in planning (see Appendix 1 Particle systems worldwide).

 

The first large proton therapy facility in Europe

 

Europe is lagging behind. To date there have only been small facilities that are either experimental (Paul Scherrer Institute near Zurich, Orsay, Uppsala), or only suitable for eye therapy due to a lack of penetration depth (Hahn-Meitner-Institut in Berlin, Nice, Catania, Clatterbridge), or research institutes (for heavy ions and protons, Heidelberg).

 

The first European large-scale facility for the proton therapy of cancer, the RINECKER PROTON THERAPY CENTER, began clinical operations one year ago when the first patient received treatment on 16th March 2009. Since then it has been expanded on a step-by-step basis - final set-up and clinical operations are being implemented simultaneously. The RPTC is the pioneer facility in Europe and has a head start of at least one year over all other centers licensed for healthcare. The following contains our report about our first year of set-up and clinical operations.

CLINICAL ACTIVITIES AT THE RPTC DURING THE FIRST YEAR

 

  • One year ago, the RPTC was granted official approval to treat all tumors that could previously be irradiated with X-rays. To date 77 different cancer types and localizations have been treated (see Appendix 2 tumors treated to date).
  • Patients from 20 nations have been irradiation (see Appendix 3 Origin of patients).
  • Of these 65% were patients with german medical insurance from statutory heath insurance funds which had concluded contracts with us or had approved individual cases (see Appendix 4 statutory heath insurance funds which cover costs of proton therapy). 35% to date have been privately insured or foreign patients.
  • 134 courses of treatment have been fully completed, 320 patients are currently undergoing diagnostic measures or actual radiation therapy.
  • The largest irradiated tumor was 3.8 liters in size, our youngest patient was 4 years old, the oldest was 88. One quarter of patients treated by the RPTC had already undergone an unsuccessful course of X-ray treatment.
  • Special focus is placed on children and young people with cancer whom we treat in co-operation with a large Munich-based pediatrics center. With children it is practically essential to have the benefits of proton therapy such as keeping the surrounding area free of high radiation dosage to avoid subsequent radiation-induced tumors as well as growth impairment.
  • On three of the five future irradiation units the RPTC is currently performing up to 40 radiotherapy procedures daily on a part-time operational basis, with the subsequent completion enabling the facility to undertake some 4000 treatment cases per year.

PROTON SCANNING AT THE RPTC

 

  • The RPTC deploys an advanced full-electronic proton scanning method with which tumors are scanned in individual overlapping points (up to and over 10,000 spots). Each of these spots is dose-gauged. The phenomenon of maximum tumor dosages impacting outside of the actual target area, i.e. in the healthy tissue, is completely avoided with the scanning method (see Appendix 5 Local dosage profile figure). Using this procedure ensures an absolutely consistent dosage profile that can be optimally selected by the therapists for the required local dosage within the tumor and in the tumor environs (spread).
  • All newly commissioned particle radiation facilities worldwide will, in future, also employ scanning systems.
  • Based on intensity, penetration depth and beam precision, the RPTC possesses a level of performance unparalleled anywhere else in the world (see Appendix 6 data sheet).
  • Our CT and X-ray assisted targeting system (image guided radiotherapy) already enables us to achieve an aiming precision of better than 1 mm.
  • Following on from the operational start-up of the first of four full-body therapy units (gantries) in March 2009, the second gantry began operations in November 2009 followed by the third in March 2010. Full capacity will be achieved with the fourth gantry in June 2010 to be followed by a special unit for eye treatment and the therapy of very small tumors in the head area (see Appendix 7 Expansion of capacity).
  • Our proton therapy facility was supplied by the global market leader, Varian Medical Systems of Palo Alto in the USA, but was largely assembled in Germany, while the diagnostics systems (2 magnetic resonance imagers, 2 CTs and a PET/CT) were delivered by Philips in Hamburg.

 

OUR STAFF

 

Parallel to the technical expansion of the facility, we are also continually looking for new coworkers!

 

The RPTC currently employs

 

  • 3 physicians specializing in radio-oncology
  • 1 physician specializing in radio-diagnostics
  • 1 physician specializing in anesthesia
  • 5 medical physicists
  • 3 physicists
  • 8 technical medical radiology assistants
  • 5 nursing staff and clinical auxiliaries
  • 14 technical and administrative staff
  • 15 employees in the Varian team

 

Tumor board with physicians specializing in hemato-oncology, urology, surgery and other areas as and when required.

Other radio-oncologists, medical physicists and technical medical radiology assistants are currently in the process of recruitment.

COMMUNICATION

 

  • Over half of all patients who are informed that they are suffering from a form of cancer will also look to the internet for more information.
  • Monthly internet hits for RPTC/ProHealth rising from 1,282 to 19,747. Monthly telephone inquiries received by our the call center up to 2006 (see Appendix 8 Patient inquiries chart).
  • Overview of Monthly Reports of the RPTC during the first operational year are available on the internet with detailed case descriptions and technical explanations (see Appendix 9 Monthly Reports).
  • List of german press releases (see Appendix 10 List of press releases).

 

SELECTED CASE STUDIES

 

5 case studies are enclosed with brief case history prior to therapy, with an X-ray comparative plan, with the actual proton dosage plan under which the patient was treated at the RPTC, with case history computer tomographs where relevant. (Appendix 11 Selected case studies).

 

COMPANY STRUCTURE


•   Operating company RPTC:

 

ProHealth AG, Munich

Stockholders:

 

 

AD Verwaltungs-GmbH & Co. KG (Dr. Rinecker

 

92,00 %

HypoVereinsbank Unicredit AG

 

4,00 %

WestLB AG

 

4,00 %

 

 

•   Holding company RPTC:

 

E.6 München GmbH

Stockholders:

 

 

ProHealth AG

 

30,00 %

NRW.Bank

 

17,46 %

Dr. Hans Rinecker

 

2,54 %

Imetra KG (Fondgesellschaft der Hannover Leasing)

 

50,00 %

 

 

  • Permit holders for the RPTC:
    • Clinical operating permit: ProHealth AG
    • Clinical operating concession: Chirurgische Klinik Dr. Rinecker GmbH & Co. KG
    • Inclusion of radiology in the Bavarian hospital plan: Chirurgische Klinik Dr. Rinecker GmbH & Co. KG
    • Service provider for statutory heath insurance funds (pursuant to Social Security Code V Section 116 b and Section 140 a, b): Chirurgische Klinik Dr. Rinecker GmbH & Co. KG

 

 

•   Construction phase – external financing:

original loan

commitment

disbursed

HypoVereinsbank Unicredit AG

46.00 million €

28.73 million. €

West LB AG, Düsseldorf

45.00 million €

28.10 million €

 

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