Status of non-european particle therapy facilities. Marco Durante
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1 Status of non-european particle therapy facilities Marco Durante
2 USA proton therapy several new centers announced/planned max number of patients still LLUMC (~15,000)
3 USA heavy ion therapy None since BEVALAC in Berkeley SPARC (San Francisco Bay Area Particle Accelerator Research Center) is a collaborative effort between Stanford/SLAC and LBNL/UCSF SPARC should be a R&D facility for clinical trials comparing heavy ions, protons, and X- rays Business plan marks a capital outlay of 200 M$ Funds should come from SLAC/UCSF/NCI/Philanthropy/Stanford/ DOE/AHRQ/Vendors/Private investors - Expected time 5 years A very ambitious plan has been proposed by the Mayo Clinic (MN): phase I 2 protontherapy centers, phase II with He and C, and phase III with several ions for research. Phase I has been approved and business plan for Phase II-III are under way The field of ion-beam therapy is blossoming in Europe and Asia, and for the U.S. to resume leadership requires a major policy change. June 2010
4 Asia Japan 2 centers (NIRS+GHMC) in operation with C-ions, 1 with H+C (Hyogo), 3 with H Planned: 2 C-ion facilities (SAGA-HIMAT and Kanagawa) and 2 protontherapy facilities China IMPCAS (C) and WPTC (H) in operation Shanghai Particle Therapy Center (H+C) under construction 2 more protontherapy centers under construction (Beijing and Taiwan) Future plans also in Korea, Malaysia, and Saudi Arabia
5 Patients treated in Asia + plans Institute Facility Country Particle Treatment rooms Patients (treated until or planned/ year) NIRS HIMAC Japan C Hyogo HIBMC Japan C H Gunma GHMC Japan C 3 90 IMP CAS HIRFL China C Fudan SPTH China C H Kyushu SAGA-HIMAT Japan C Kanagawa KCC Japan C 4 880
6 Now ~ 6,000 patients treated Spot-scanning fully operational New therapy facility building with 1V+1H+1G rooms Gantry under construction
7 Clinical experiences have demonstrated that C-ion RT is effective in such regions as the head and neck, skull base, lung, liver, prostate, bone and soft tissues, and pelvic recurrence of rectal cancer, as well as for histological types including adenocarcinoma, adenoid cystic carcinoma, malignant melanoma and various types of sarcomas, against which photon therapy are less effective. Furthermore, when compared with photon and proton RT, a significant reduction of overall treatment time and fractions has been accomplished without enhancing toxicities. The NIRS experience NIRS annual report 2010, Tsujii et al.
8 Pancreas cancer Combination of Gemcitabine and Carbon-ion therapy Courtesy of Dr. Shigeru Yamada, NIRS 1y- OS 43.2GyE+400mg/m 2 50% 43.2GyE+700mg/m 2 83% 43.2GyE+1000mg/m 2 83% 45.6GyE+1000mg/m ECOG 1) 2008 Year n Treatment 34 GEM+RT(50. 4Gy) 12m Survival 24m MST(m) 50% 12% GEM 32% 4% 9.2 NIRS 30 GEM+CIRT 74% 44% ) ASCO2008 Patric J. Loehrer Senior
9 IMP-CAS Lanzhou C-ions 195 MeV/n C-ions 235 MeV/n No SOBP modulation based on LET/RBE Physical dose uniform in the PTV
10 Patients treated at HIRFL C-ions 80 MeV/n C-ions 250 MeV/n
11 First Japanese facility by a public-private partnership
12 Korea Institute of Radiological and Medical Sciences The new hospital in Budan aims to build a "Northeast Asian Specialized Region for Cancer Treatment," offering "tourism, recuperation, and treatment" in one package, in order to attract medical tourists from Japan and other Asian countries and to establish a research cluster that connects industry, academia, and research institutes. It will (~2016) include PET-CT, Cyberknife, IMRT and a heavy ion treatment center
13 Cooperation International Open Laboratory 1. Molecular biology (J. Nickoloff, CSU, USA; P. Jeggo, Univ. Sussex, UK) 2. Particle therapy (A. Brahme, Karolinska Institute, Sweden) 3. Space radiation (T.K. Hei, Coulmbia University, USA) 4. Radiation quality (M. Durante, GSI, Germany) The IOL is a grant of ~50 M plus access to HIMAC beamtime KO meeting on at the Techniche Universität Darmstadt See:
14 Beyond America and Asia Russia ITEP, Moscow (p, C-ions planned) PNPI, St. Petersburg (p) JINR, Dubna (p) South Africa ithemba (p, especially radiosurgery for AVM)
15 M. Durante (Director) G. Kraft (Helmholtz Professor) G. Taucher-Scholz (DNA damage) B. Jakob (DNA repair) S. Ritter (Chromosome aberrations) C. Fournier (Late effects) W. Kraft-Weyrather (Clinical radiobiology) M. Scholz (Biophysical modelling) M. Krämer (Treatment planning) C. Bert (Moving targets) C. La Tessa/R. Pleskač (Dosimetry)
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