There are basically three types of particle therapy facilities currently in use. These include facilities that are: (a) associated physically with a national laboratory, (b) freestanding structures not physically connected to a hospital, and (c) hospital-based structures sharing resources with the contiguous departments.

Originally, the ability to produce therapeutic beams only existed in nuclear and high energy physics facilities owing to the size and complexity of the equipment. In these facilities, particle therapy was an afterthought, yet an important part of the research. Function was shoehorned into an existing form and although many technical concepts were initiated, the facility concept was missing. Particle therapy was carried out at laboratories such as the Lawrence Berkeley Laboratory in Los Alamos, New Mexico; the National Laboratory TRIUMF in Vancouver, Canada; Paul Scherrer Institute in Villigen, Switzerland; GSI laboratory in Darmstadt, Germany, iThemba LABS in Cape Town, South Africa; Indiana University Cyclotron Facility in Bloomington, Indiana; and others.

Stand-alone facilities were originally located in converted laboratories such as The Harvard Cyclotron Laboratory in Cambridge, MA and the Centre de Proton Thérapie d’Orsay in France. More recently, however, dedicated facilities, but distinct from the primary care hospital, are being and have been constructed for particle therapy such as those at The University of Texas M.D. Anderson Cancer Center in Houston, TX; University of Florida Proton Therapy Institute in Jacksonville, FL; the National Institute for Radiological Sciences in Chiba, Japan; and others. The concept behind these facilities is not much different than that of a hospital-based facility, although resource sharing in the latter case is more important. In these facilities form must follow function for optimal performance. Examples of hospital-based facilities include Massachusetts General Hospital’s (MGH) Francis H. Burr Proton Therapy Center in Boston, MA; Loma Linda University Medical Center’s Proton Treatment Center in Loma Linda, CA; and National Cancer Center Hospital East in Kashiwa, Japan.

As facilities are built and operated, issues of patient and staff flow are better understood, and the issues associated with ion therapy, in particular, have been developed. All facilities, nationally and internationally, seek to create a unique patient experience while maintaining an ideally functional and efficient operation.

The numbers of patients treated in the types of facilities are summarized in Figure 3.1. As the number of new facilities grows, the percentage of patients treated in stand-alone and hospital-based facilities will continue to increase and dominate the major market share.

The layout of a particle therapy facility depends on whether such a facility is freestanding or integrated into a larger medical facility. If we assume the facility is freestanding and not part of an ambulatory care or comprehensive radiation oncology facility, the breakdown of spaces could be as listed in Table 3.1.

The total area for a particle therapy facility depends on the number of treatment rooms and the associated support space. The University of Texas M.D. Anderson Cancer Center Proton Therapy Center in Houston, TX has three gantries and one fixed beam room for a total area of approximately 98,000 sq ft. The University of Florida Proton Therapy Institute in Jacksonville, FL, also with three gantries and one fixed beam room, has a total area of 86,000 sq ft (including conventional radiation rooms). The facility at MGH’s Francis H. Burr Proton Therapy Facility has two gantries and a fixed beam room for a total area of 44,900 sq ft.