Varian Medical Systems Particle Therapy GmbH 1 | VARIAN PARTICLE THERAPY

1948 Company founded in 1948 by Russell and Sigurd Varian Varian Medical Systems A Reliable Partner in Proton 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 1948 2 | VARIAN PARTICLE THERAPY

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

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

Varian Proton Therapy Projects Project Update Varian Proton Therapy Projects Scripps PT Center Equipment order finalized/booked Q4 FY11 3 Rotational and 2 Fixed Beam Rooms KFMC-King Fahd Medical Center Equipment Order finalized/booked Q2 FY12 3 Rotational and 1 Fixed Beam & 1Eye Tx St Petersburg, Russia 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 Signed contract for Mestre, Italy 5 | VARIAN PARTICLE THERAPY

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

Why a Cyclotron? Compact & simple ProBeam™ 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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Dynamic PeakTM Scanning ProBeam™ Dynamic PeakTM Scanning 2 | VARIAN PARTICLE THERAPY

Dynamic Peak™ Scanning Specifications Range: Up to 37.6 g/cm2 Field size at isocenter: Up to 30 x 40 cm2 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

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

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 MeV ProBeam 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: Design Implementation Test V&V Concept 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 patient 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

ProBeam™ Accelerator System AC 250 Cyclotron -- Specifications Beam - Energy 250 MeV Extracted current (max) 800 nA Extraction efficiency ~80% Iron Yoke - Outer diameter 3.1 m Height 1.6 m Weight 90 t SC Magnet - Stored energy 2.5 MJ Central field 2.4 T Max. field at the coil 4 T Operating current 160 A Power of cryocoolers 40 kW RF System - Frequency 72.8 MHz Voltage 80 kV / 130 kV RF power ≤115 kW 9 | VARIAN PARTICLE THERAPY