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Title: Present and Future of Hadrontherapy

Abstract

In the developed countries every 10 million inhabitants about 20'000 oncological patients are irradiated every year with high-energy photons (called X-rays by radiotherapists) produced by electron linacs. This is the so called 'conventional' radiotherapy. Hadrontherapy is a novel technique of radiotherapy which instead of X-rays employs beams of charged hadrons, protons and carbon ions in particular. Due to their physical and radiobiological properties, they allow to obtain a more conformal treatment than X-rays, sparing better the surrounding healthy tissues with a subsequent larger control rate. By now about 40,000 patients have been treated worldwide with protons and 15 hospital based centres are either running or under construction. Carbon ion beams deliver the dose as precisely as protons and are characterized by a larger biological effectiveness than X-rays and protons. They are therefore particularly suited to treat radio resistant tumours, as proven by the clinical studies performed on about 2300 patients in HIMAC (Chiba, Japan) and on about 250 patients at GSI (Darmstadt, Germany). A second Japanese hospital based centre is now running in Hyogo and two are under construction in Europe, in Heidelberg (Germany) and Pave (Italy). A large diffusion of hadrontherapy is foreseen in the near future but amore » much larger diffusion, possibly comparable with the one of electron linacs in conventional radiotherapy, will be achieved only if much compact and cheap accelerators and dose delivery systems will be conceived and constructed. In this framework, the acceleration of protons based on laser plasma techniques represents a very interesting and challenging possibility.« less

Authors:
 [1];  [2];  [1]
  1. TERA Foundation, Via Puccini 11, 28100 Novara (Italy)
  2. (Italy)
Publication Date:
OSTI Identifier:
20798468
Resource Type:
Journal Article
Resource Relation:
Journal Name: AIP Conference Proceedings; Journal Volume: 827; Journal Issue: 1; Conference: 3. international conference on superstrong fields in plasmas, Varenna (Italy), 19-24 Sep 2005; Other Information: DOI: 10.1063/1.2195216; (c) 2006 American Institute of Physics; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
70 PLASMA PHYSICS AND FUSION TECHNOLOGY; 43 PARTICLE ACCELERATORS; 60 APPLIED LIFE SCIENCES; CARBON IONS; DOSES; ELECTRONS; HOSPITALS; ION BEAMS; IRRADIATION; LASER-PRODUCED PLASMA; LINEAR ACCELERATORS; NEOPLASMS; PATIENTS; PHOTONS; PROTON BEAMS; PROTONS; RADIOTHERAPY; X RADIATION

Citation Formats

Amaldi, Ugo, Department of Physics, University of Milano-Bicocca, Milan, and Braccini, Saverio. Present and Future of Hadrontherapy. United States: N. p., 2006. Web. doi:10.1063/1.2195216.
Amaldi, Ugo, Department of Physics, University of Milano-Bicocca, Milan, & Braccini, Saverio. Present and Future of Hadrontherapy. United States. doi:10.1063/1.2195216.
Amaldi, Ugo, Department of Physics, University of Milano-Bicocca, Milan, and Braccini, Saverio. Fri . "Present and Future of Hadrontherapy". United States. doi:10.1063/1.2195216.
@article{osti_20798468,
title = {Present and Future of Hadrontherapy},
author = {Amaldi, Ugo and Department of Physics, University of Milano-Bicocca, Milan and Braccini, Saverio},
abstractNote = {In the developed countries every 10 million inhabitants about 20'000 oncological patients are irradiated every year with high-energy photons (called X-rays by radiotherapists) produced by electron linacs. This is the so called 'conventional' radiotherapy. Hadrontherapy is a novel technique of radiotherapy which instead of X-rays employs beams of charged hadrons, protons and carbon ions in particular. Due to their physical and radiobiological properties, they allow to obtain a more conformal treatment than X-rays, sparing better the surrounding healthy tissues with a subsequent larger control rate. By now about 40,000 patients have been treated worldwide with protons and 15 hospital based centres are either running or under construction. Carbon ion beams deliver the dose as precisely as protons and are characterized by a larger biological effectiveness than X-rays and protons. They are therefore particularly suited to treat radio resistant tumours, as proven by the clinical studies performed on about 2300 patients in HIMAC (Chiba, Japan) and on about 250 patients at GSI (Darmstadt, Germany). A second Japanese hospital based centre is now running in Hyogo and two are under construction in Europe, in Heidelberg (Germany) and Pave (Italy). A large diffusion of hadrontherapy is foreseen in the near future but a much larger diffusion, possibly comparable with the one of electron linacs in conventional radiotherapy, will be achieved only if much compact and cheap accelerators and dose delivery systems will be conceived and constructed. In this framework, the acceleration of protons based on laser plasma techniques represents a very interesting and challenging possibility.},
doi = {10.1063/1.2195216},
journal = {AIP Conference Proceedings},
number = 1,
volume = 827,
place = {United States},
year = {Fri Apr 07 00:00:00 EDT 2006},
month = {Fri Apr 07 00:00:00 EDT 2006}
}
  • Tumor treatment with protons and Carbon ions can allow for a better optimization of Tumor Control Probability and Normal Tissue Complication Probability, especially for radio-resistant tumors. Exposure to protons and heavier ions is also of concern for manned space missions such as future travels to the Moon and Mars. Nuclear reactions with the human body constituents, the beam line components (for hadrontherapy), and the spacecraft walls and shielding (for space radiation protection) can significantly modify the characteristics of the primary radiation field and thus the dose distributions in the various target tissues. In this context the FLUKA Monte Carlo transportmore » code, integrated with radiobiological data and coupled with anthropomorphic phantoms, was applied to the characterization of therapeutic proton beams and the calculation of space radiation organ doses, with focus on the role of nuclear interactions. Besides absorbed and equivalent doses, distributions of 'biological' dose (modeled as the average number of DNA clustered lesions per cell induced in a given organ or tissue) were calculated as well. Concerning space radiation protection, exposure to Galactic Cosmic Rays (GCR) and Solar Particle Events (SPE) under different shielding conditions was simulated. Both for hadrontherapy and for space radiation exposure, nuclear reaction products were found to play a more important role for the equivalent and 'biological' dose than for the absorbed dose. Furthermore, while for SPEs the doses (both absorbed and equivalent/'biological') decreased dramatically by increasing the shield thickness, the GCR doses showed a slight shielding dependence. Overall, these examples of application of FLUKA to radiotherapy and radiation protection problems emphasized the need of further models and data, typically double-differential cross sections for nucleus-nucleus interactions at energies below a few hundred MeV/n.« less
  • A comprehensive and reliable description of nucleus-nucleus interactions represents a crucial need in different interdisciplinary fields. In particular, hadrontherapy monitoring by means of in-beam positron emission tomography (PET) requires, in addition to measuring, the capability of calculating the activity of {beta}{sup +}-decaying nuclei produced in the irradiated tissue. For this purpose, in view of treatment monitoring at the Heidelberg Ion Therapy (HIT) facility, the transport and interaction Monte Carlo code FLUKA is a promising candidate. It is provided with the description of heavy ion reactions at intermediate and low energies by two specific event generators. In-beam PET experiments performed atmore » GSI for a few beam-target combinations have been simulated and first comparisons between the measured and calculated {beta}{sup +}-activity are available.« less
  • In order to implement a hadrontherapy project a well defined partnership is needed. This would support both investment and research. The choice of treatment concept, site, number of gantries and financial issues should be the task to be addressed by a study group. A nodal network of medical centers should be recommended in order to assure the critical number of referrals and implement high quality clinical research trials.
  • Nuclear fragmentation measurements are necessary in hadrontherapy and space radiation protection, to predict the effects of the ion nuclear interactions within the human body. Nowadays, a very limited set of carbon fragmentation cross sections has been measured and in particular, to our knowledge, no double differential fragmentation cross sections at intermediate energies are available in literature. We have measured the double differential cross sections and the angular distributions of the secondary fragments produced in the {sup 12}C fragmentation at 62 AMeV on a thin carbon target. The experimental data have been also used to benchmark the prediction capability of themore » Geant4 Monte Carlo code at intermediate energies, where it was never tested before.« less