Cancer Treatment by Charged Particles - Carbon Ion Radiotherapy -
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1 Cancer Treatment by Charged Particles - Carbon Ion Radiotherapy - Takeshi Murakami Research Center of Charged Particle Therapy National Institute of Radiological Sciences
2 1. Introduction to 2. Carbon Ion Radiotherapy 1. Why carbon beams? 2. Results of clinical trials 3. Outline of 1. History of 2. Outline of the facility 3. Facilities in the world 4. New Facility 1. Why new system? 2. Next generation system Contents
3 Site of Tokyo Narita airport National Institute of Radiological Sciences Chiba Prefecture
4 1. Introduction to 2. Carbon Ion radiotherapy 1. Why carbon beams? 2. Results of clinical trials 3. Outline of 1. History of 2. Outline of the facility 3. Facilities in the world 4. New Facility 1. Why new system? 2. Next generation system Contents
5 Feature of the Charged Particle Therapy Physics Dose distribution Heavy ions, Protons Surface = small LET End point = large LET Dose concentrates at the end point (Bragg peak) Relative dose (%) Gamma-ray, Neutrons from Surface to End point = constant LET (LET:Lenear Energy Transfer) Depth in water (cm) C ion n gamma-ray proton
6 Dose distribution of x-rays and C beams Bolus tumor tumor X-ray Carbon beams 9 directions 3 directions
7 X (nm) X-rays Ionization density and damage of DNA DNA RBE 1.0 X (nm) Protons nm Z (nm) Z (nm) 2.5 Carbons X (nm) 0.0 2~ Z (nm) Truck structure Lethal damage
8 Result of clinical trials Head & Neck cancer (before / treatment planning / after) before 36 month after
9 Hypo-fractionation 1 day!
10 Highlight of Carbon Ion Radiotherapy
11 Number of patients, yearly base
12 Number of patients enrolled for carbon ion radiotherapy from June 1994 to February 2012 neck
13 Details of foreign patients Australia, 2 Singapore, 1 USA, 2 Poland, 1 Indonesia, 1 France, 4 Britain, 1 Germany, 1 Austria, 2 Sweden, 3 Bangladesh, 1 Russia, 4 India, 2 Korea, Italy, 23 PRC, 20 Taiwan, 13
14 1. Introduction to 2. Carbon Ion radiotherapy 1. Why carbon beams? 2. Results of clinical trials 3. Outline of 1. History of 2. Outline of the facility 3. Facilities in the world 4. New Facility 1. Why new system? 2. Next generation system Contents
15 History of constructing Heavy Ion Medical Accelerator in Chiba () 1984: 10 years strategy for confronting the cancer 1986: International Workshop on Heavy Ion Treatment Facility 1989: Start of the construction 1993: Commissioning ended, beams were successfully accelerated. 1994: Clinical Trials began. 2003: Advanced Medicine (Advanced Medical Therapy). - June. 2012: 6,512 patients were treated. (AM 3,488)
16 Devices of (Heavy Ion Medical Accelerator in Chiba) 130m
17 Devices of (Heavy Ion Medical Accelerator in Chiba) 130m
18 Devices of (Heavy Ion Medical Accelerator in Chiba) 130m
19 Making of Spread Out Bragg Peak Scattering material Beam Delivery System Dose monitor Wobbling Magnet Ridge Filter Controller Multi Leaf Collimator Range Shifter Cancer Tumor Irradiation area Bolus Collimator
20 Irradiation system of coincident with a patient s respiratory motion Accelerator Interlock system Gated beam extraction system (RF knockout method) Ion beam Treatment control Watch & record system Gate signal generator Beam monitor Irradiation room PSD Respiration waveform X-ray TV Reference Image Compare Positioning Image Positioning system using x-ray TV images Planning simulation Positioning area
21 Respiration gating for irradiation No gating Gating End-expiratory irradiation Reduction of volume Minohara et al. IJROBP 47: , 2000
22 Heavy ion radiotherapy worldwide Darmstadt Heidelberg Wiener NeustadtLanzhou Busan Lyon Pavia Penang Gunma Chiba Hyogo Tosu Kanagawa Rochester Shanghai Heavy ion Heavy ion (under construction) Heavy ion (planning) Proton Proton (under construction) Taipei
23 1. Introduction to 2. Carbon Ion radiotherapy 1. Why carbon beams? 2. Results of clinical trials 3. Outline of 1. History of 2. Outline of the facility 3. Facilities in the world 4. New Facility 1. Why new system? 2. Next generation system Contents
24 Motivation of New Treatment Facility 1 day! Prepare 1 day treatment the treatment is possible planning, and bolus, collimator -> 4-5 days Adaptive are necessary Cancer Treatment for machining, transport, inspection diagnosis and treatment in a short period
25 Irradiation Methods Broad beam Wobbling magnets Scanning scatterer Ridge filter Bolus Patient collimator Scanning magnets range shifter
26 Comparison of scanning and broad beam method Scanning Broad beam Dose distribution excellent good Moving target No Yes Irradiation time long short Dose control Elaborate Easy Bolus, collimator No Yes Beam position < 0.2mm ~ 2 mm Beam size Control No control Intensity Low High scanning Long treatment time Sensitive to the device error Not for moving target Broad beam: matured technology! New scanning system must be developed.
27 Simulation of moving tumor irradiation Non-gating Example: Φ40mm spherical target Motion:7mm in gate ( πt / 3, φ ) s( t) = cos 2s 4-40 Gating Irradiation on Moving Tumors Gating with rescanning (8 times) In order to avoid hot/cold spot due to target motion, we decided to employ gating method with rescanning
28 R&D of Fast Scanning System Scanning R&D port SB course 1. Fast scanning system 2. Respiratory motion New control system
29 Scanning with extended Flat-Top SMx Fluorescent screen SMy Beam Syn. BM plan 1. Treatment planning for fast scanning 5 2. Modification of acc. operation 2 3. Fast scanning magnet 10 We can save the dead time of synchrotron operation.
30 New Particle Therapy Research Facilities 3D Scanning with Gating (H&V): 2 rooms Rotating Gantry : 1 room Research Building for Charged Particle Therapy building Hospital New treatment facility Wall RGF QM PRN1 SMx SMy PRN2 RSF 3D Scanning 9.0 m Monitors 0 1 2m Iso-center
31 New Particle Therapy Research Facilities
32 New Particle Therapy Research Facilities 1F
33 New Particle Therapy Research Facilities 1F
34 New Particle Therapy Research Facilities 1F
35 New Particle Therapy Research Facilities B2
36 New Treatment Couch, Robotic Arm
37 END END
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