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Instead of lying on a couch under a rotating machine, the patient sits or perches on a chair that turns in front of a fixed beam. Because the heavy beam line no longer has to rotate, a proton machine can fit in an ordinary radiotherapy room.
A rotating gantry is the largest and most expensive part of a proton centre. Upright systems remove it: the beam stays horizontal and a robotic chair rotates and tilts the patient in front of it, with an upright CT scanner for imaging in the treatment position. P-Cure's proton system was cleared by the FDA on 20 March 2023 (K221996) as a synchrotron with a single fixed beam and a seated patient, for the head, neck and thorax; its 2025 clearance (K242418) allows seated or supine treatment. Leo Cancer Care's Marie positioning and imaging system was cleared on 25 July 2025 (K250970) for treatment in the "upright position rather than conventional supine treatments", with its Eve patient positioner cleared in 2024 (K231612), and was CE-marked in May 2026. Mevion combined Marie with its compact cyclotron in the S250-FIT, cleared on 12 September 2025 (K250986); the 510(k) summary limits fully seated treatment to "sites above the mid-chest or carina". Mevion states that the system fits "a standard 110 m² (1,200 sq ft) LINAC vault", and the first patient was treated at Stanford in June 2026.
Upright treatment is old in fixed-beam particle rooms and in some photon work, but it needs imaging in the upright position because organs sit differently when a person sits. The open questions are which sites it suits beyond the head, neck and upper chest, how reproducible daily set-up is, and whether patients who struggle to lie flat (with breathing difficulty, pain or swallowing problems) find it easier; no randomised comparison with supine treatment was found.
A fixed horizontal beam treats a patient who is rotated and tilted by a robotic chair; an upright CT or radiographic imager images the patient in the treatment position so the plan matches the seated anatomy.
Query for this technology: (TITLE:"Upright radiotherapy positioning" OR ABSTRACT:"Upright radiotherapy positioning" OR TITLE:"Leo Cancer Care Marie, P-Cure, Mevion S250-FIT" OR ABSTRACT:"Leo Cancer Care Marie, P-Cure, Mevion S250-FIT" OR TITLE:"Upright radiotherapy" OR ABSTRACT:"Upright radiotherapy" OR TITLE:"Seated proton therapy" OR ABSTRACT:"Seated proton therapy") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Upright radiotherapy positioning (Leo Cancer Care Marie, P-Cure, Mevion S250-FIT), not a curated reading list.
Shares Particle therapy machines: from Loma Linda to proton rooms in a linac vault, carbon gantries and FLASH, Proton therapy machines: cyclotrons, synchrotrons and single-room systems and the tag machines-wave3.
Shares Particle therapy machines: from Loma Linda to proton rooms in a linac vault, carbon gantries and FLASH, Proton therapy machines: cyclotrons, synchrotrons and single-room systems and the tag machines-wave3.
Shares Brain metastases (secondary brain tumours), Non-small-cell lung cancer and the tag machines-wave3.
Shares Non-small-cell lung cancer and the tag machines-wave3.
Shares Mevion Medical Systems, Particle therapy machines: from Loma Linda to proton rooms in a linac vault, carbon gantries and FLASH, Proton therapy machines: cyclotrons, synchrotrons and single-room systems, Proton therapy.
Shares Particle therapy machines: from Loma Linda to proton rooms in a linac vault, carbon gantries and FLASH, Proton therapy machines: cyclotrons, synchrotrons and single-room systems, Proton therapy.
Shares Leo Cancer Care, P-Cure, Mevion Medical Systems, Proton therapy.
Shares Carbon-ion synchrotrons and facilities, Particle therapy machines: from Loma Linda to proton rooms in a linac vault, carbon gantries and FLASH, Proton therapy machines: cyclotrons, synchrotrons and single-room systems, Proton therapy.
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