Varian Medical Systems Particle Therapy Gmb H 1

Varian Medical Systems Particle Therapy Gmb. H 1 | VARIAN PARTICLE THERAPY

Varian Medical Systems A Reliable Partner in Proton Therapy 1948 2 | VARIAN PARTICLE THERAPY • Company founded in 1948 by Russell and Sigurd Varian • Over 2 billion USD in yearly revenues • Over 6 billion USD market capitalization • 5, 700 employees world-wide • 55% market share in global radiation oncology market

Varian Medical Systems Product Portfolio – Integrated System Solutions 3 | VARIAN PARTICLE THERAPY

Commitment History of Proton Program 1992 1997 2007 2009 2011 Varian Develops Proton Treatment Planning Varian Provides Information Systems for Proton Centers Varian Purchases ACCEL Instruments Isochronous Superconducting Cyclotron becomes clinical at PSI Complete Treatment System Delivered to Rinecker Proton Center Munich, Germany (>1200 patients) First US Pro. Beam System Delivered to Scripps Health in San Diego 4 | VARIAN PARTICLE THERAPY

Project Update Varian Proton Therapy Projects • Scripps PT Center – Equipment order finalized/booked Q 4 FY 11 – 3 Rotational and 2 Fixed Beam Rooms • KFMC-King Fahd Medical Center – Equipment Order finalized/booked Q 2 FY 12 – 3 Rotational and 1 Fixed Beam & 1 Eye Tx • St Petersburg, Russia – Equipment Order finalized/booked Q 2 FY 12 – 2 Rotational Gantries • Univ. of Maryland – 4 Rotational and 1 Fixed Beam Rooms – Ground breaking occurred April 2012 • Georgia Proton Treatment Center (Emory) – Purchase Agreement under negotiation – 4 Rotational and 1 Fixed Beam Room • 5 | VARIAN PARTICLE THERAPY Signed contract for Mestre, Italy

Pro. Beam™ Proton Platform—Overview Dynamic Peak. TM Scanning Superconducting Cyclotron Big Bore Beam Line 2 D Orthogonal & CBCT Eclipse & ARIA Integration 7 | VARIAN PARTICLE THERAPY

Pro. Beam™ Accelerator System AC 250 Cyclotron Why a Cyclotron? • Compact & simple • Continuous, high intensity beam (IMPT) • Low activation (Service) • Reproducible behavior (Operations) 8 | VARIAN PARTICLE THERAPY

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Pro. Beam™ Dynamic Peak. TM Scanning 2 | VARIAN PARTICLE THERAPY

Dynamic Peak™ Scanning Specifications: • Range: Up to 37. 6 g/cm 2 • Field size at isocenter: Up to 30 x 40 cm 2 • Dose compliance: Better than ± 2. 5% • Dose rate: Variable with a maximum of 2 Gy/min in 1 liter volume • Layer repainting 5 | VARIAN PARTICLE THERAPY

Dynamic Peak™ Scanning Intensity Modulated Proton Therapy Quality of Care IMPT Summary 8 | VARIAN PARTICLE THERAPY • Optimum dose conformity • Allows adaptive treatments and integrated boosts Workflow • Increased efficiency • Shorter and more stable treatment times

Advanced Development Role and Responsibilities: • • • Developments with high research content Contacts and collaborations with institutes Upcoming new concepts new technologies Patents Technology input to strategic planning 17 | VARIAN ONCOLOGY SYSTEMS

Development Example Development of the 250 Me. V Pro. Beam cyclotron Teams: • National Superconducting Cyclotron Lab, Michigan University, US - Baseline design and sc cyclotron design expertise • Paul Scherrer Institute, Villigen, CH - First customer, cyclotron operation expertise • Kernfysisch Versnelleren Instituut, Groningen, NL, Operation of sc cyclotrons • Varian/Accel team, Project management, Regulatory compliance, detailed engineering design teams 17 | VARIAN ONCOLOGY SYSTEMS

Development example Development Process: Concept Design Implementation Test V&V Joined design team at NSCL Commissioning and testat PSI Detailed design at Varian Fabrication 17 | VARIAN ONCOLOGY SYSTEMS

Regulatory Compliance For CE marking Establish certified Quality Management System according to ISO 13485 • Engage Notified Body for the assessment of conformity with the requirements of the European Medical Device Directive 93/42/EWG • Prepare Documentation of Design and Manufacturing Process. • Continuous review of product documentation with the Notified Body • • • Final audit of product and documentation Receive approval from Notified Body to declare CE conformity 17 | VARIAN ONCOLOGY SYSTEMS

Marketing challenges Financing Cost of equippment Cost of building Time to first patients per day Operating cost "Integrate into normal Radiation Therapy" 24 | VARIAN ONCOLOGY SYSTEMS

Call for Ideas & Research Accelerator - Cost, Size, Weight, Beam duty factor Gantry - Cost, Size, Weight Beamline - Cost, Size, Weight Scanning - Speed Commissioning - Automation 24 | VARIAN ONCOLOGY SYSTEMS

Thank you! 15 | VARIAN ONCOLOGY SYSTEMS

Pro. Beam™ Accelerator System AC 250 Cyclotron -- Specifications Beam - Energy 250 Me. V - Extracted current (max) - Extraction efficiency ~80% Iron Yoke - Outer diameter 3. 1 m - Height 1. 6 m - Weight 90 t SC Magnet - Stored energy - Central field - Max. field at the coil - Operating current - Power of cryocoolers 2. 5 MJ 2. 4 T 4 T 160 A 40 k. W RF System - Frequency - Voltage - RF power 72. 8 MHz 80 k. V / 130 k. V ≤ 115 k. W 9 | VARIAN PARTICLE THERAPY 800 n. A