Proton Radiotherapy Accelerators

By: Waldemar H. Schaf, Wioletta Wieszczycka

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Hardcover | 17 August 2001

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344 Pages

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Hadronic radiotherapy uses particle beams to treat tumours located near critical body structures and tumours that respond poorly to conventional photon and electron beam radiotherapy. Initial research in hadronic radiotherapy was performed using accelerators built for physics research. The good results of the proton and ion therapy programs have enhanced the tendency to use protontherapy as a routine method. There are about 20 working protontherapy facilities (first, second and third generation) and more than 30 centres are planned. This book presents the first comprehensive overview of the field with a discussion on the fundamental basis of particle physics and radiobiology, as well as review of clinical and technical specifications and designs for proton radiotherapy. In particular, the current designs of proton and heavy ion accelerators, beam delivery systems, gantries, beam monitoring and dosimetry systems, control and safety systems, patient positioning and immobilization devices, and ancillary treatment facilities are widely discussed.

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Non-Fiction Science Physics Nuclear Physics Medicine Clinical & Internal Medicine Diseases & Disorders Oncology Radiotherapy Applied Physics Medical Physics Other Branches of Medicine

Therapy & Therapeutics Medical Imaging Materials & States of Matter Booktopia Publisher Services World Scientific Publishing

Preface	p. vii
Introduction	p. 1
Cancer and Radiation Therapy	p. 1
Historical Development of Radiation Therapy	p. 3
Modern Tools for Conventional Radiotherapy	p. 9
Main Parameters of Conventional Therapy Beams	p. 9
Elements of Conventional Accelerator System	p. 11
Reasons for Development of Nonconventional Radiotherapies	p. 14
Glossary	p. 17
Beam Intensity	p. 17
Beam Range in an Absorbing Medium	p. 18
Bragg Peak Modulation	p. 19
Range Adjustment	p. 19
Radiation Field	p. 19
Field Homogeneity on a Transverse Section	p. 19
Homogeneity Region in a Plane Orthogonal to the Beam Direction	p. 20
Field Homogeneity along the Beam Axis	p. 21
Field Symmetry	p. 22
Lateral Penumbra	p. 22
Distal Dose Fall-off	p. 22
Physical and Radiobiological Properties of Hadrons	p. 24
Basic Facts in Radiotherapy	p. 24
Dose-Effects Curves	p. 24
RBE Dependence on LET and OER	p. 26
An Introduction to Hadrontherapy	p. 31
Energy Loss	p. 32
Nuclear Energy Loss	p. 33
Electronic Energy Loss	p. 34
Range and Bragg Curves	p. 35
Track Formation and Radial Dose Distribution	p. 37
Interaction of Hadrons with Biological Matter	p. 37
Cellular Organization and the Target of Radiation Action	p. 37
Hadrons' Track in Biological Matter	p. 40
RBE of Hadrons	p. 43
Fractionation and Oxygen Effect	p. 45
Status of Clinical Research in Protontherapy	p. 48
Precision in Radiotherapy and the Role of Protons in Improving Treatment Precision	p. 48
Precision in Conventional Radiotherapy	p. 48
Role of Proton Beams in Improving Treatment Precision	p. 49
Range Uncertainties of the Protons in the Patients	p. 51
Clinical Experience in Protontherapy. Patient Statistics	p. 53
Clinical Indications for Protontherapy	p. 53
Ocular Melanomas	p. 55
Skull Base and Cervical Chordomas and Chondrosarcomas	p. 57
Intracranial Tumors	p. 58
Pituitary Tumors	p. 59
Arteriovenous Malformations (AVM)	p. 60
Adenocarcinoma of the Prostate	p. 62
Hadrontherapy Diseases Categories	p. 62
Number of Hadrontherapy Patients World-Wide	p. 65
Hadrontherapy Facilities World-Wide	p. 67
Hadrons Acceleration and Beam Delivery Technologies for Radiotherapy	p. 67
Accelerator for Radiotherapy with Hadrons	p. 68
Energy Selection System	p. 70
Beam Transport	p. 70
Gantry	p. 71
Beam Delivery Systems	p. 72
Historical Development of Hadrontherapy Centers	p. 75
Hadrontherapy Centers Localized in the Research Facilities	p. 77
Second Generation of Research Hadrontherapy Facilities	p. 83
Hospital-Based Dedicated Hadrontherapy Facilities	p. 89
Planned Hadrontherapy Centers	p. 96
International Collaborations for Design an Universal Protontherapy Center	p. 107
Firm Project of Protontherapy Centers	p. 110
Requirements for Hadrontherapy Centers	p. 112
Medical and Technical Performance Specifications for the Clinical Proton Beam	p. 112
Beam Range in Absorbing Medium	p. 113
Bragg Peak Modulation	p. 114
Range Adjustment	p. 115
Field Size	p. 115
Field Homogeneity and Symmetry	p. 116
Lateral Penumbra	p. 116
Distal Dose Fall-off	p. 117
Average Dose Rate	p. 117
Dose Accuracy	p. 118
Beam Intensity Requirements	p. 118
Source to Axis Distance (SAD); Source to Surface Distance (SSD)	p. 119
Displacement of the Beam Axis from the Isocenter	p. 120
Gantry Rotation	p. 120
Time Structure of the Extracted Beam	p. 120
Beam Abort Time	p. 121
Performance Specification for the General Facility	p. 121
Treatment Rooms	p. 121
Facility Availability	p. 124
Treatment Beams	p. 125
Dosimetry Reproducibility	p. 125
Control System	p. 125
Radiation Safety of the Facility	p. 126
Operation Costs	p. 127
Protontherapy Equipment System	p. 127
Building Design	p. 127
Protontherapy Accelerators	p. 131
Performance Specifications for Accelerators Systems	p. 132
Energy	p. 132
Beam Intensity	p. 133
Quality of the Extracted Beam	p. 136
Accelerator Beam Monitoring	p. 137
Physical Characteristics of Accelerators	p. 137
Costs of the Dedicated Proton Accelerator	p. 138
Operating Principles of Proton Accelerators	p. 138
Cyclotron	p. 138
Proton Synchrotron	p. 142
Proton Linear Accelerator	p. 144
Synchrocyclotron	p. 145
Advantages and Disadvantages of Accelerators Used for Protontherapy	p. 146
Examples of Cyclotrons for Protontherapy	p. 150
A Room Temperature Design Cyclotron--Cyclone 235	p. 150
Compact Superconducting Cyclotron Design--CAL / Siemens	p. 154
Examples of Synchrotrons for Protontherapy	p. 156
Examples of Linear Accelerators for Protontherapy	p. 160
Standing Wave Design	p. 160
Booster Linear Accelerator	p. 162
Beam Transport and Delivery Systems	p. 164
Effects of Material in the Beam Path	p. 166
Multiple Scattering	p. 166
Range Straggling	p. 167
Beam Fragmentation	p. 167
Performance Specifications for Beam Transport System	p. 168
Beam Parameters	p. 168
Beam Switching and Tuning	p. 168
Beam Diagnostics, Monitoring and Safety	p. 169
Performance Specifications for Treatment Beam Line (Nozzle)	p. 171
Specifications for Nozzle Using Scattering	p. 171
Specifications for Nozzle Using Scanning	p. 174
Beam Transport Systems	p. 177
LLUMC Beam Transport System	p. 177
NPTC Beam Transport System	p. 178
Beam Preparation for Clinical Use	p. 180
Variable Range Shifters	p. 180
Range Modulation	p. 185
Transverse (Lateral) Spreading of Particle Beams	p. 187
Collimators	p. 199
Dynamic Beam Shaping	p. 202
Proton Gantries	p. 203
Specifications for the Proton Gantries	p. 204
Proton Gantries Solutions	p. 207
Corkscrew Gantry	p. 207
Large Throw Gantry	p. 208
Compact Gantry	p. 210
ITEP Proposal of Anti-Gantry (AG)	p. 214
Radiation Detectors	p. 218
Dosimetry Principles	p. 218
Beam Monitoring, Dosimetry and Microdosimetry	p. 220
Monitoring Chain	p. 220
Reference Dosimetry	p. 226
Systems for Relative Dosimetry	p. 228
Microdosimetry	p. 230
Phantoms	p. 232
Dosimetry Intercomparisons and Protocol for Protontherapy Beams	p. 233
Examples of Monitoring and Dosimetry Systems	p. 234
Cost Estimations	p. 236
Treatment Ancillary Facilities	p. 237
Performance Specifications for Treatment Ancillary Facilities	p. 237
Performance Specifications for Pre-Treatment Equipment and Diagnostic Tools	p. 237
Performance Specifications for Treatment Planning Software and Hardware	p. 238
Performance Specifications for Patient Positioning and Alignment Devices	p. 241
Treatment Planning Software and Hardware	p. 249
Algorithms	p. 250
Assessment of a Plan and Comparison of Competing Plans	p. 252
Eye Treatment Planning	p. 255
Available Systems for Treatment Planning	p. 256
Patient Positioning and Alignment Devices	p. 258
Immobilization Techniques and Devices	p. 258
Therapeutic Couch and Chair	p. 261
Verification of Patient Positioning	p. 263
Treatment Simulation	p. 265
Examples of Patient Handling Systems in the Existing Proton Facilities	p. 265
Systems for Irradiation Gated by Respiration of the Patient	p. 269
HIMAC Respirated-Gated Beam Control System	p. 269
NAC Stereophotogrammetric (SPG) System	p. 269
Control System of the Protontherapy Center	p. 272
Control System of the Protontherapy Center	p. 272
Control System Proposed for Italian Hadrontherapy Center	p. 273
Safety Systems	p. 274
Safety Requirements	p. 275
Safety System Proposed for Italian Hadrontherapy Center	p. 276
Shielding for Proton Facility	p. 279
Performance Specifications for Shielding	p. 279
Radiation Exposure	p. 280
Attenuation in Shielding	p. 280
Neutron Sources	p. 281
Attenuation in Mazes and Ducts	p. 282
Activation	p. 283
Bunker Project for Italian Hadrontherapy Center	p. 284
Beam Loss Sources	p. 284
Shielding Project	p. 285
Global Costs and Financial Analysis of the Activities of the Proton Center	p. 287
Cost Considerations of Hadrontherapy	p. 287
Comparison of Treatment Costs	p. 289
Global Costs of Existing the Proton Facilities	p. 290
Costs of the Equipment	p. 290
Operational Expenses of Existing Proton Facilities	p. 291
Staff Requirements and Costs	p. 292
Proposal of a Dedicated Protontherapy Facility	p. 293
Clinical Requirements for a Dedicated Protontherapy Center	p. 293
Equipment for Protontherapy Facility	p. 295
Building for Protontherapy Facility	p. 303
Conclusions	p. 305
References	p. 307
Index	p. 318
Table of Contents provided by Syndetics. All Rights Reserved.

Proton Radiotherapy Accelerators

At a Glance

Hardcover

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