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March 2011CERN, Geneva
European Training Network for Particle Therapy
Founded by the European Commission
PARTNER
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March 20112
Some facts about cancer and hadron therapy
Treatment with hadrons is a promising treatment strategy with large future potential. Treatment with hadrons is a promising treatment strategy with large future potential.
Cancer is the second most frequent cause of death in Western societies.
About 50% of patients with cancer undergo radiotherapy in the course of their treatment.
Not all cancers can be treated with a satisfying outcome.
Hadron therapy uses particle beams (i.e. mostly proton and carbon ions) to treat tumours located near critical organs and tumours that respond poorly to conventional radiation therapy.
Hadrons have advantageous dose distributions and increased biological effectiveness.
Source: GSI
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March 20113
... to a clinical standard
from pilot projects …
Hadron therapy centers in Europe
Source: EBG MedAustron
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March 20114
... training 24 young researchers For this we still need photos of the missing researchers!
PARTNER is …
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March 20115
... a European Commission FP7 Initial Training Network (2008 – 2012)
… working on a wide range of disciplines related to hadron therapy
... a pan-European network
... focussing on intensive and multi-disciplinary training
... under the umbrella of
together with other EC projectsrelated to HT
EnterVision
PARTNER is …
Topic Location
Detectors and Accelerators applied in Medicine IFIC, Valencia
Leadership Course UNIS, Guildford
Radiobiological Hands-on-training GSI, Darmstadt
Hadrontherapy Today and Tomorrow and GRID technologies CERN, Geneva
Radiobiology KI, Stockholm
Treatment Planning MedAustron, Wiener Neustadt and Vienna
Clinical Trials CNAO, Pavia
Mathematical Modelling UNIS, Guildford
… …
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March 2011
PARTNER is …
... a collaboration
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March 2011
Clinical Studies and EpidemiologyInvestigating the clinical outcome of hadrontherapy for a wide range of cancer types
• tumour control• overall survival • quality of life
Clinical Studies and EpidemiologyInvestigating the clinical outcome of hadrontherapy for a wide range of cancer types
• tumour control• overall survival • quality of life
Simulations, Dosimetry and Treatment PlanningImproving treatment planning
• Measurements of physical quantities• Development and tuning of physics
simulation codes
Simulations, Dosimetry and Treatment PlanningImproving treatment planning
• Measurements of physical quantities• Development and tuning of physics
simulation codes
Image Guided Hadrontherapy and PET PrototypeHigh-tech systems for
• optimizing patient treatment • increasing the accuracy in localization of the tumour
Image Guided Hadrontherapy and PET PrototypeHigh-tech systems for
• optimizing patient treatment • increasing the accuracy in localization of the tumour
Information and Communications Technologies and NetworkingCommon tools for promoting collaboration in research and treatment strategies in European hadrontherapy centres
• towards the creation of a prototype GRID test-bed for hadrontherapy
Information and Communications Technologies and NetworkingCommon tools for promoting collaboration in research and treatment strategies in European hadrontherapy centres
• towards the creation of a prototype GRID test-bed for hadrontherapy
Novel Accelerator and Gantry StudiesDesign and development of new technologies for clinical requirements
• affordable cost• reduced dimensions • optimal performance
Novel Accelerator and Gantry StudiesDesign and development of new technologies for clinical requirements
• affordable cost• reduced dimensions • optimal performance
RadiobiologyExperiments elucidating the underlying biological mechanisms of hadrontherapy
• to increase the treatment effectiveness while protecting healthy tissue
RadiobiologyExperiments elucidating the underlying biological mechanisms of hadrontherapy
• to increase the treatment effectiveness while protecting healthy tissue
Research in the frame of PARTNER…
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March 20118
Software platform for evaluating combined modality treatment plansThe featurelet approach Deformable Registration algorithm The image deformation field
Image-Guided Hadron Therapy – Siemens
Workflow of ‘treatment plan of the day’ adaptive strategy
Online adaptive strategy to mitigate the effect of inter-fractional motion
The deformation field applied to the delivered dose
Valentina Zambrano
Wenjing Chen
Retrospective treatment planning study on prostate cancer cases
rectum
bladder
prostate
Region of interest (grey part)for similarity comparison
Image Guided Hadrontherapy and PET Prototype
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March 2011
Application of PET imaging in light ion therapy
PET prototype for in-situ monitoring
Brahme 2009
Development of innovative detector modules based on Multi-gap Resistive Plate Chambers (MRPC), using improved technologies over designs for High Energy Physics.
Production of therapeutically useful positron emitter beams during carbon ion deceleration
Selection of the optimal target material for 11C beam production
Marta Lazzeroni
David Watts
Brahme 2009
Image Guided Hadrontherapy and PET Prototype
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March 201110
•An interdisciplinary field that studies the biological effects of ionizing radiation, like:
1. Biophysical properties: LET and RBE
• We are assessing the relative biological effectiveness (RBE) for different ions for a range of LET values in different cell lines
2. Hypoxia and oxygen enhancement ratio (OER)
• Hypoxia causes resistance to low-LET radiation• We are reproducing different hypoxic status by using specially designed chambers, and estimating the relative OER
3. Particle beams and cell cycle response
• We are trying to understand the molecular pathways leading to cell cycle alterations and identify the intracellular targets responsible for variation in radiosensitivity
Radiobiology
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March 201111
4. DNA damage and mechanisms of cell death
• We are investigating the different types of cell death (e.g. apoptosis, necrosis, mitotic catastrophe, autophagy and senescence), and chromosome aberrations
5. Combination with chemotherapy
• We are assessing the suitability of particle beam irradiation for combination with other therapeutic modalities such as chemotherapy (e.g. temozolomide)
Binucleated with micronuclei
Mono-nucleated with micronuclei
Apoptotic, mitotic cells and cells with micronuclei
Chitralekha Mohanty
Katarzyna Zielinska-Chomej
Thanks to...
Walter Tinganelli Ming Chew
Lara Barazzuol
…Radiobiology
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March 2011
Objective::
Participate in the conceptual design for the development of novel carbon ion gantry machine.
MotivationsMotivations The challengeThe challenge
WhyWhy is this an important subject?
The magnets are the main elements The magnets are the main elements which guide the ion beam into the which guide the ion beam into the gantry structuregantry structure.
Novel Accelerator and Gantry Studies
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March 2011
Objective
Development of a linear accelerator (linac) for a carbon ion cyclinac (CABOTO).
Motivation…Motivation…
The challenge!The challenge!
Work description:
- Performance optimization of CABOTO.
- Tests of single-cell accelerating cavites to determine the highest reliable operational gradient for CABOTO.
- Comparison between RF linacs and FFAGs for hadrontherapy
To deliver a compact, dedicated accelerator, providing the best possible treatment modalities for hadrontherapy at the lowest cost.
Machine dimensions could be reduced if high gradients could be achieved in the linac without compromising machine reliability.
Cyclotron (injector)
Linac (booster, beam energy modulation)
Cyclinac
Novel Concept Accelerators for Hadrontherapy and Gantry Studies
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March 2011
… measurements for hadron therapy
o Dosimetrico Microdosimetrico Nuclear fragmentation
Objective: Improve treatment by …
Simulation, Dosimetry and Treatment planning
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March 2011
… treatment planning (TP) system support and benchmarking
o Integration of measured data into TP systems
o Development of Monte Carlo-based tools for TP
o Validation and improvement of MC physics models
… Adaptive Radiotherapy (ART)
o Use of repeated cone beam CT for adaption of TP
Objective: Improve treatment by …
Bladder and rectum variation on different treatment days
Simulation, Dosimetry and Treatment planning
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March 2011
• Subject: Development of clinical studies in diseases potentially treatable by hadrotherapy
• Role: Evaluate efficacy of hadrontherapy on patients with different tumor types treated in the European hadrontherapy facilities.
Jeffrey Tuan, Anurita Srivastava
Clincial Studies and Epidemiology
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March 2011
No computing infrastructure connecting the emerging EU hadron therapy centres for:
SituationSituation
Grid computing links distributed resources used in a multi-disciplinary virtual organisation.
ETOILE(Lyon)
HIT(Heidelberg)
CNAO(Pavia)
MedAustron(Wiener Neustadt)
PrototypePrototype
• Cross-border patient referral• Cancer Research
IT for Hadrontherapy
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March 201118
Coming soon ...
Should we mention PARTNER2?
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March 2011CERN, Geneva 19
PARticle Training Network for European Radiotherapyhttp://cern.ch/partner
This research project has been supported by a Marie Curie Early Initial Training Network Fellowship of the European Community's Seventh Framework Programme
under contract number (PITN-GA-2008-215840-PARTNER).
Coordination: CERN [email protected]
Thank you for your attention