Accelerators for Heavy-charged-particle Radiation Therapy

Department of Radiation Medicine, Loma Linda University Medical Center, 11234 Anderson Street, Loma Linda, CA 92354, USA.
Technology in cancer research & treatment (Impact Factor: 1.73). 09/2007; 6(4 Suppl):49-54. DOI: 10.1177/15330346070060S408
Source: PubMed


This paper focuses on current and future designs of medical hadron accelerators for treating cancers and other diseases. Presently, five vendors and several national laboratories have produced heavy-particle medical accelerators for accelerating nuclei from hydrogen (protons) up through carbon and oxygen. Particle energies are varied to control the beam penetration depth in the patient. As of the end of 2006, four hospitals and one clinic in the United States offer proton treatments; there are five more such facilities in Japan. In most cases, these facilities use accelerators designed explicitly for cancer treatments. The accelerator types are a combination of synchrotrons, cyclotrons, and linear accelerators; some carry advanced features such as respiration gating, intensity modulation, and rapid energy changes, which contribute to better dose conformity on the tumor when using heavy charged particles. Recent interest in carbon nuclei for cancer treatment has led some vendors to offer carbon-ion and proton capability in their accelerator systems, so that either ion can be used. These features are now being incorporated for medical accelerators in new facilities.

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    ABSTRACT: Several compact proton accelerator systems for use in proton therapy have recently been proposed. Of paramount importance to the development of such an accelerator system is the maximum kinetic energy of protons, immediately prior to entry into the patient, that must be reached by the treatment system. The commonly used value for the maximum kinetic energy required for a medical proton accelerator is 250 MeV, but it has not been demonstrated that this energy is indeed necessary to treat all or most patients eligible for proton therapy. This article quantifies the maximum kinetic energy of protons, immediately prior to entry into the patient, necessary to treat a given percentage of patients with rotational proton therapy, and examines the impact of this energy threshold on the cost and feasibility of a compact, gantry-mounted proton accelerator treatment system. One hundred randomized treatment plans from patients treated with IMRT were analyzed. The maximum radiological pathlength from the surface of the patient to the distal edge of the treatment volume was obtained for 180 degrees continuous arc proton therapy and for 180 degrees split arc proton therapy (two 90 degrees arcs) using CT# profiles from the Pinnacle (Philips Medical Systems, Madison, WI) treatment planning system. In each case, the maximum kinetic energy of protons, immediately prior to entry into the patient, that would be necessary to treat the patient was calculated using proton range tables for various media. In addition, Monte Carlo simulations were performed to quantify neutron production in a water phantom representing a patient as a function of the maximum proton kinetic energy achievable by a proton treatment system. Protons with a kinetic energy of 240 MeV, immediately prior to entry into the patient, were needed to treat 100% of patients in this study. However, it was shown that 90% of patients could be treated at 198 MeV, and 95% of patients could be treated at 207 MeV. Decreasing the proton kinetic energy from 250 to 200 MeV decreases the total neutron energy fluence produced by stopping a monoenergetic pencil beam in a water phantom by a factor of 2.3. It is possible to significantly lower the requirements on the maximum kinetic energy of a compact proton accelerator if the ability to treat a small percentage of patients with rotational therapy is sacrificed. This decrease in maximum kinetic energy, along with the corresponding decrease in neutron production, could lower the cost and ease the engineering constraints on a compact proton accelerator treatment facility.
    Full-text · Article · Mar 2009 · Medical Physics
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    ABSTRACT: The physics of proton therapy has advanced considerably since it was proposed in 1946. Today analytical equations and numerical simulation methods are available to predict and characterize many aspects of proton therapy. This article reviews the basic aspects of the physics of proton therapy, including proton interaction mechanisms, proton transport calculations, the determination of dose from therapeutic and stray radiations, and shielding design. The article discusses underlying processes as well as selected practical experimental and theoretical methods. We conclude by briefly speculating on possible future areas of research of relevance to the physics of proton therapy.
    No preview · Article · Mar 2015 · Physics in Medicine and Biology
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