Healthcare Design - November 2015 - 62

THE NEXT WAVE

Breakthroughs in radiation therapy-specifically, the use
of heavy particles, such as protons and carbon-ions-are
creating promising new possibilities for treating cancer.
First came proton therapy, which uses proton beams
to target tumors with greater accuracy than X-rays or
gamma rays. Carbon-ion therapy, a newer approach,
enables treatment of deeper and more sensitively located
cancer cells with even higher precision. Long adopted in
Europe and Asia, the treatment is now tiptoeing its way
into North America.
And the design for this complex treatment method is
equally challenging, starting with size alone. Carbonions, being larger than protons, require a higher acceleration to achieve the required energy for treatment,
resulting in a larger equipment size.
The planning of treatment rooms, specifically, is based
on the type of radiation beam used. For example, the typical room size for fixed-beam angles-usually 30, 45, or
90 degrees-is around 600 square feet. Unlike horizontal
beams, vertical or oblique beams come from above and
require ceiling heights of almost 60 feet to accommodate
the necessary magnets.
A gantry can rotate 360 degrees to generate radiation
beams at any desired angle, increasing the possibility of
treating hard-to-reach tumors. These are approximately
40 feet in diameter and 60 feet in length, weigh about
600 tons, and require a space that's more than 60 feet
high for rotations. The ceiling design of a gantry room
usually includes a hatch for maintenance and replacement of machine parts, too.
These patient spaces are supported by the equipment
room, which is where all the action takes place. The ion
source, linear accelerator, synchrotron, and beam lines
emerge from here. Even though the length of the linear
accelerator varies between 16 to 33 feet, it must be supported by a synchrotron. A synchrotron is about 70 to 100
feet in diameter and 200 feet in circumference-huge
enough to create planning constraints.
To address structural loading concerns, treatment
and equipment rooms should be located on lower floors,
either on-grade or in the basement.

HCDmagazine.com 11.15

The heavy carbon-ions also require greater shielding
as compared to other forms of radiation. The entry to
treatment rooms is usually designed as a maze to avoid
leakage of radiation. The number of turns in the maze
depends on the amount of shielding required, making
it either a single- or double-maze entry-both equally
common in existing facilities. Utilizing the earth as a
natural radiation shield in the basement areas can be
more economical, as well. The wall thickness for radiation
protection is based on calculations by shielding consultants and can range between 6 to 10 feet.

The design of public spaces can play a key role in
lending a human touch and balancing the institutional
character of such facilities. Sights and sounds of nature,
natural light, warm materials such as wood, family-friendly amenities, etc., can create a more therapeutic setting.
Within the treatment rooms, creating positive distractions through simulation of the sky or other pleasant imagery on the walls or ceilings can help alleviate patients'
stress during their procedures. This can be particularly
beneficial in treatment rooms fitted with a gantry because
of the intimidating equipment and the complexity of the
procedure.

The layout of a typical carbonion treatment center may look
something like this conceptual
model, including (1) public
spaces with nature views
to alleviate patient
stress, (2) a fixedbeam treatment
room with doublemaze entry, (3) a
treatment area located within
a triple-height gantry, (4) an
equipment room with the ion
source and linear accelerator
placed within the synchrotron
ring and beam lines connecting
to treatment rooms, (5) a
control area immediately
outside the treatment room,
and (6) internal corridors
punctuated to bring in natural
light.

Dyutima Jha, Assoc. AIA, EDAC, is director of research and
healthcare planner at Kahler Slater (Singapore). She can be
reached at djha@kahlerslater.com.

MORE ONLINE To read more on designing
facilities to support carbon-ion therapy, including
more details on interiors considerations and why
growth in the field is anticipated, see HCDmagazine.
com/carbon-ion-therapy.

As the latest breakthrough in delivering
radiation for cancer treatment, carbon-ion
therapy is gaining popularity worldwide
and inching toward more adoption in the
U.S., calling for designs that support the
highly complex technology By Dyutima Jha

http://www.hcdmagazine.com/carbon-ion-therapy http://www.hcdmagazine.com/carbon-ion-therapy http://www.HCDmagazine.com

Healthcare Design - November 2015

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