Proton therapy and other innovative ion-beam applications in IFJ PAN Krakow Adam Maj

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EFINION Workshop 9-11 July 2014; Vrachati, Corinth, Peloponnese Greece Proton therapy and other innovative ion-beam applications in IFJ PAN Krakow Adam Maj

Large and medium-size scientific centres in Poland WROCŁAW Wroclaw University Wroclaw University of Technology WARSZAWA Warsaw University (with Heavy Ion Lab.) Warsaw University of Technology National Centre for Nuclear Research (in Swierk) Institute of Plasma Physics and Laser Microfusion KRAKÓW Jagiellonian University University of Science and Technology Krakow University of Technology Institute of Nuclear Physics (with Cyclotron Centre Bronowice)

Scientific and technological involvement in large nuclear physics laboratories in Europe CERN: LHC: CMS,Atlas, Alice,LHCb, CERN2GS, COMPASS; ISOLDE, France: GANIL/SPIRAL2, ITER, ILL Germany: FAIR/GSI, DESY (FLASH, XFEL), W7X UK: JET Italy: LNL, LNS, LNF, GranSasso Sweden: ESS and worldwide Japan: KEK (Belle1, Belle2), T2K, RIKEN Russia: Dubna JINR USA: RHIC,MSU/FRIB, Fermilab, CEBAF, SLAC, Oak- Ridge, ANL AstroparticlePhysics: ESO, Cherenkov Telescope Array, Pierre

IFJ PAN in Kraków was established in 1955, thanks to Prof. Henryk Niewodniczański, who was the 1st director (until his death in1968). Prof. Niewodniczański was post-doc of Ernest Rutherford. Since 2003 IFJ PAN belongs to Polish Academy of Sciences (PAN)

ca. 500 personnel Prof. 50, Assoc. Prof. 40, Ph.D. 150 PhD studies ca. 90 students 6 divisions: 27 departments centres of excellence centres of advanced technology 4 accredited laboratories Equipment and Scientific Infrastructure Construction Division General information

Particle physics and astrophysics Nuclear and strong interactions physics Condensed matter physics Interdisciplinary and applied research Theoretical physics Main Research Fields

Fundamental rights of nature Elementary components of matter and their interactions The universe: the beginning, today, and the future Complex systems: from quarks and leptons to galaxy groups and financial markets Basic questions

Coordination: IFJ PAN projects on MNiSW Roadmap SPIRAL2 Polish contribution in international project on ESFRI Roadmap (physics) SUNLAB underground laboratory in Sieroszowice national research centre (physics) ESS-European Spallation Source Polish contribution in international project on ESFRI Roadmap (interdisciplinary sciences)

IFJ PAN projects on MNiSW Roadmap CTA: Observatory for TeV gamma-ray astronomy Polish contribution in international project on ESFRI Roadmap (astrophysics) FAIR: Facility for Antiproton and Ion Research Polish contribution in international project on ESFRI Roadmap (physics) European XFEL: European X-Ray Free Electron Laser Polish contribution in international project on ESFRI Roadmap (interdisciplinary sciences) NLEJ: National Laboratory for Nuclear Energy national research centre (energy science)

IFJ PAN in FP7 Projects SPIRAL2PP ENSAR TIARA Hopefully soon: ENSAR2

CCB Cyclotron Center Bronowice

Accelerators at IFJ PAN Krakow - first cyclotron developed in Poland, 48 cm (1955) -Soviet built classical U-120 (opened 22.11.1958, stopped 1994), 12 MeV deuterons -isochronic AIC-144 developed at IFJ PAN (from 1995) 60 MeV protons 2 MeV proton van de Graaff (from Strasbourg) since ca. 2000 U-120 classical cyclotron - IBA Proteus C-235 230 MeV protons (start of operation Dec 2012)

1. Eye melanoma treatment with the (old) proton AIC-144 cyclotron

Eye melanoma Eye malanoma: -malignous cancer, -growing inside the eye-ball -mainly in white population, -250 cases/year in Poland Proton radiotherapy of eye - the most successful cancer treatment survival > 90% In Europe 7 centers - Berlin, HMI, D - Catania, INFN, I - Orsay, Inst. Curie, F - Nice, F - Claterbridge, UK - PSI Villigen, CH - IFJ PAN Kraków, PL Eye melanoma cancer USG of eye cancer

The method of eye treatment T. Kajdrowicz, M. Bajer Treatment Planning System Eclipse

IFJ PAN eye treatment room at AIC-144 Therapy room developed at IFJ 2006-2009 in collaboration with Helmholtz Centre, Berlin P. Olko M. Jezabek NCRH

How to broaden of the Bragg peak? Original range: 28 mm Modulation of the range: 28 mm

Parameters of eye line beam at AIC-144 a. u. 1,1 1,0 0,9 0,8 0,7 0,6 0,5 0,4 0,3 0,2 0,1 FWHM = 2,94 mm Max/Plateau = 4,97 25,75 mm 27,8 mm 28,15 mm 28,27 mm 29,08 mm 0,0 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 range in H 2 O [mm] (90%-10%)=0,71 mm a.u. 1.1 1.0 0.9 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 25,06 mm 1,18 mm 1,19 mm 0.0-25 -20-15 -10-5 0 5 10 15 20 25 distance [mm] PT centre Range [mm] Max/plateau F.W.H.M. [mm] Distall fall-off d 90%-10% [mm] CATANA 30.60 4.68 3.29 0.81 CCO 31.0 4.85 3.65 0.80 PSI 30.0 4.47-1.10 IFJ 28.4 4.97 2.94 0.75

Regular patient treatment The first patient treated at IFJ PAN in February 2011 35 patients treated till the end of 2013 From April 2013 the eye proton therapy financed by the National Health System 50 patients are to be treated in 2014

2. National Consortium of Hadron Radiotherapy NCRH Grounded: 12.09.2006 IFJ PAN Kraków coordinator Akademia Górniczo-Hutnicza Medical University, Warszawa, Center of Oncology, Warszawa Center of Oncology, Krakow Center of Oncology, Poznań Holycross Center of Oncology, Kielce National Center of Nuclear Research, Warszawa Warsaw Polytechnic Silesia University Warsaw University Phase 1: Cyclotron Center Bronowice at IFJ PAN Krakow Phase2: Carbon Cyclotron in Warsaw 20

3.03 2011 Just before the start..

April 2011 Paweł Olko Magdalena Zydek Marek Jeżabek Adam Maj

Autumn 2011

May 2012

Installation of the Proteus C-235 cyclotron 11 May 2012

Instalation of IBA Proteus C-235 cyclotron

11 May 2012

Spring 2013

Autumn 2013

Beam delivery system at IFJ PAN Krakow

General layout NCRH Gantry 2 Gantry 1 Eye treatment Exp. area Cyclo vault Medical building Utility rooms Laboratories

Proteus C-235 cyclotron Ion Beam Applications S.A. (IBA), Louvain-la-Neuve, Belgium cyclotron: isochronic, 4-sectors, CW particles protons ion source: P.I.G with hot cathod proton energy: 230 MeV (β = 0.596, γ = 1.245), constant energy dispersion: E/E < 0.7% beam intensity: emmitance 600 na (4 x 10 12 p/s) 0.1 na (6 x 10 8 p/s) horizonthal - 11 π mm mrad, diameter height: 434 cm 210 cm 32

Proton energy selector Energy selector 70-230 MeV E/E < 0.7 % Beryllium absorber for changing the beam energy

Development of the new eye line and the Medical Device Directive 93/42/EEC CE marking is a legal requirement for medical devices intended for sale in Europe: The Medical Devices Directive (MDD) (Council Directive 93/42/EEC Revised as 2007/47/EC Compliance with the revised directive became mandatory on March 21, 2010. New eye therapy room under development by IFJ PAN will undergo CE marking

Energy selector Proton current 230 MeV minimum 500 na Transmission from 230 MeV do 70 about 0,4% (for Be) We need 70 MeV,. 2 na, distal falloff < 2 mm

Methods of beam formation Scattered beam Scanning beam

Techniki dostarczania wiązki protonowej Scanning versus scattered beam

Pencil scanning beam lower doses from scattered radiation Robert Kaderka, Ph.D Thesis, GSI, 2011 For scanning proton beam the doses for distant organs due to scattered radiation are 2-3 orders of magnitude lower than for MV X-rays

Active beam delivery pencil beam scanning

Advantages with proton radiotherapy with gantry scanning beam Cancer of rectum Wolff H.A. et al. Radiother Oncol 2012; 102: 30-37

Thermoluminescence foils (2D-TLD) - measurements of scanning beams TLD foil developed at IFJ PAN Jan Gajewski, IFJ PAN

IBA dedicated gantry at IFJ PAN BG2 BG1 Radius of the bending magnet: ρ = 1468.5 mm Range (g.cm - B1G2 B2G2 Energy (MeV) 2 ) Current (A) Field (T) Current (A) Field (T) 98.40 4.00 155.39 0.81772 165.39 0.84105 140.10 14.00 226.54 1.17675 239.75 1.20743 191.09 24.00 279.06 1.38966 292.37 1.42410 230.22 33.00 332.45 1.54071 343.86 1.57598

Orthogonal X-Rays and FP imagers Proton Scanning Nozzle Robotic PPS

IBA dedicated gantry with the scanning beam - 3 mm and 6 mm diameters available - Intensity: dose of 2 Gy delivered to volume of 10 x 10 x10 cm3 in 90 s

IFJ PAN Gantry - Spot diameter Spot diameter (1 σ) [mm] Energy [units of range in H 2 O /cm]

Planed treatment starting in October 2015 250-350 per gantry after 3-4 years of operation 100 eye melanoma patients/year full operation in 2020 about 600 800 patients/year, about 18 500 fractions/year

The main applications of the scanning gantry Cancers of: -Central Nervous System - head and neck - prostate - children

Scientific programme of CCB Radiobiology for treating cancer 1. Radiobiology 2. Nuclear physics 3.Clinical research 4. Dosimetry 1) Is the RBE for scanning beam equal to RBE for scattered beam? 2) Is for scanning beam the bystander effect observed? 3) Is the RBE higher at the end of Spread Out Bragg peak? 4) Is the clinical RBE for protons = 1.1 suitable for all type of cancers? Scanning beam? 5) Probability of secondary cancer 6) Are the new radiobiological models needed?

Scientific programme of NCRH 1. Radiobiology Calibration of cosmic ray detectors for space dosimetry 2. Nuclear physics 3.Clinical research 4. Dosimetry 99% of ions in cosmic-rays are protons Phantom with TLDs from IFJ 49

Laboratories for radiobiology - Two rooms for preparation of biological materials - Preparation of the irradiation stand

Timetable of CCB - signing the contract 08.2010 - start of the construction 03.2011 - installation of the C-235 cyclotron 05.2012 - acceptance tests 11.2012 - medical building and gantry 1 06.2014 - installation of gantry 2 06.2015 - end of the contract 09.2015 Total cost (buildings, cyclotron, eye therapy room, 2 gantries): 62 M (85%: EU, 15%: PL)

Proton radiotherapy with gantry in Europe Existing centres with gantries 1. Orsay 2. PSI Villigen 3. Heidelberg 4. Munchen 5. Prague 6. Essen In construction : 6 centers 1. Dresden 2. Krakow 3. Pavia 4. Trento 5. Uppsala 6. Wiener Neustadt Pawel Olko 9 03 2012 52

Although the primary objective of the facility is proton cancer therapy, an extensive research program at this cyclotron is planned in the field of nuclear physics, radiobiology, dosimetry and medical physics. Experimental hall

Research at CCB Krakow (Coordinator: A. Maj) Experimental Program Committee (Coordinator: M. Kmiecik) University of Milano, IPN Orsay, GANIL LNL Legnaro/Padova, KVI Groningen, Physikzentrum RWTH Aachen, ATOMKI Debrecen, RIKEN IPHC Strasbourg IEM CSIC of Madrid Univ. of Santiago di Compostela Tech. Univ. of Munich Nigde Univ., Turkey IFIN-HH Bucharest International Advisory Committee (chair: M. Harakeh) Electronics and Data Acquisition Group (Coordinator: M. Ziębliński) Institutions involved in research Infrastructure Group (Coordinator: W. Męczyński) IFJ PAN Jagiellonian University (UJ), University of Silesia (US), University of Warsaw (UW), See: http://experimentsccb.ifj.edu.pl

International Advisory Committee Faical Azaiez (IPN, Orsay, France) Angela Bracco (University of Milano and INFN, Italy) Bogdan Fornal (IFJ PAN, Kraków, Poland) - co-chair Zsolt Fulop (ATOMKI, Debrecen, Hungary) Muhsin Harakeh (KVI, Groningen, Netherlands) - chair Robert Janssens (Argonne National Laboratory, USA) Stanisław Kistryn (Jagiellonian University, Kraków, Poland) Marek Lewitowicz (GANIL, Caen, France) Adam Maj (IFJ PAN, Kraków, Poland) Krzysztof Rusek (Warsaw University, Poland) Hideyuki Sakai (RIKEN, Japan) Nicolae Victor Zamfir (IFIN-HH, Bucharest, Romania) Wiktor Zipper (University of Silesia, Katowice, Poland)

Beam at the target for the first time: February 21, 2013

First meeting of the IAB: 30.08.2013 Status of the project was reviewed, LoIs were discussed and recommendations given New call for proposalas and LoIs: http://experimentsccb.ifj.edu.pl/pdfs/call_for_proposals_ccb.pdf

Following the recommnedationf of the IAB presently 2 major detector systems are foreseen: 1. Detector BINA (moved from KVI Groningen) for light nuclei reactions studies The program to study the dynamics of few-body systems

Gamma-decay of Giant and Pygmy Resonances 1. KRATTA array (CsI telescopes) at forward direction to measure the energy of inelastically scatter protons in order to reconstruct the excitation energy (resolution ca. 1%) and select excitation energy bins 2. HECTOR array to measure high energy gamma-rays 3*. PARIS Demonstrator for PDR measurements with high-resolution, in coincidence with KRATTA 4*. Germanium array * - in dedicated campaigns

Comissioning od HECTOR array in Krakow July 2014

Test bench for detectors and electronic tests (in preparation)

Tests of various LaBr 3 detectors (CALIFA and PARIS) have been performed at CCB inn March 2013 and June 2014 (within GANAS@NUPNET project) 45 physicists from abroad participated IPN Orsay IEM CSIC of Madrid Universfity of Milano Tech. Univ. of Munich IPHC Strasbourg Univ. of Santiago di Compostela IFIN-HH Bucharest ATOMKI Debrecen, Nigde Univ., Turkey RIKEN, Japan University of Aachen Heavy Ion Laboratory, Warsaw Jagiellonian University, Krakow Silesian University, Katowice

First proton spectra from the Ti(p,p ) reaction measured at CCB with a LaBr 3 detector Spectra of protons at different beam energies measured with a 2" x 2" x 2" LaBr 3 :Ce crystal at 5 deg. relatively to the beam axis. The spectra are normalized to have the same height of a proton peak.

Pulse Shape Analysis LaBr/LaCl Phoswich (court. of O. Tengblad) LaCl LaBr E LaBr3 vs E Tot tail vs total Energy above punch through measured for the first time!!

National Laboratory of Cyclotrons Warsaw / Kraków Ongoing efforts to include NLC (CCB at IFJ PAN and HIL at Warsaw University) in the HORIZON2020 ENSAR project as Transnational Access Facility The nuclear physics research programme of NLC aims at obtaining high quality data on nuclear properties at and around the valley of stability. Therefore, it is complementary to the programmes of large-scale European RIs, which are concentrated on the physics of nuclei very far from the stability line, often at the limits of detection. The investigations carried out in Warsaw and Kraków are also in many aspects complementary - at CCB high-energy proton beam is available while at SLCJ beams of heavier nuclei from boron to argon can be accelerated.

3. Response of biological cells after single proton hit irradiation (2 MV van de Graaff)

Study of double strand DNA break after one proton hit Wojciech Polak, Ph.D. Thesis Krakow, 2006

Outreach activity at IFJ PAN Performance Physics The Largest Spectacle of the Universe - Małopolska Reasercher s Night, 2013. Ca. 1200 visitors in one day

Recent bottom-up initative in Poland - to construct the IFMIF facility in Rzeszow (called ELA-MAT)

Summary 1. Proton radiotherapy of eye melanoma started at IFJ PAN Krakow in February 2011 on AIC-144 60 MeV cyclotron 2. The 230 MeV IBA cyclotron is used for basic research and detector tests from Jan. 2013 3. Two IBA scanning proton gantries will be operational in 2014 (gantry1 ) and in 2015 (gantry2) 4. Radiobiological and other application studies are conducted with the proton 2 MV van de Graaf 5. IFMIF-ELAMAT facility in Poland? - New polish initiative with strong IFJ PAN participation

List of contributors Paweł Oko (Pawel.Olko@ifj.edu.pl) Marek Jezabek Teresa Cywicka-Jakiel Konrad Gugula Tomasz Horwacik Tomasz Kajdrowicz Barbara Michalec Jacek Sulikowski Liliana Stolarczyk Jan Swakon Janusz Lekki Mirek Zieblinski and many others 73