Scanned carbon-ion beam therapy throughput over the first 7 years at National Institute of Radiological Sciences.

INTRODUCTION: In the 7 years since our facility opened, we have treated >2000 patients with pencil-beam scanned carbon-ion beam therapy.

METHODS: To summarize treatment workflow, we evaluated the following five metrics: i) total number of treated patients; ii) treatment planning time, not including contouring procedure; iii) quality assurance (QA) time (daily and patient-specific); iv) treatment room occupancy time, including patient setup, preparation time, and beam irradiation time; and v) daily treatment hours. These were derived from the oncology information system and patient handling system log files.

RESULTS: The annual number of treated patients reached 594, 7 years from the facility startup, using two treatment rooms. Mean treatment planning time was 6.0 h (minimum: 3.4 h for prostate, maximum: 9.3 h for esophagus). Mean time devoted to daily QA and patient-specific QA were 22 min and 13.5 min per port, respectively, for the irradiation beam system. Room occupancy time was 14.5 min without gating for the first year, improving to 9.2 min (8.2 min without gating and 12.8 min with gating) in the second. At full capacity, the system ran for 7.5 h per day.

CONCLUSIONS: We are now capable of treating approximately 600 patients per year in two treatment rooms. Accounting for the staff working time, this performance appears reasonable compared to the other facilities.