Technology trends of carbon-ion radiotherapy and NSIR's - Ansto

Technology Trends of Carbon-Ion Radiotherapy

andNIRS’s Role for its promotion

HIMAC

NIRS

Contents: 1. Feature of heavy ion radiotherapy2. Irradiation methods and necessary equipments3. Facilities worldwide4. Government's strategy and the role of NIRS

A. KitagawaLeader, Promotion of Carbon Therapy Team

(Senior Researcher, Dept. of Accelerator and Medical Physics)Research Center for Charged Particle Therapy

National Institute of Radiological Sciences

1. Feature of heavy ion radiotherapy

HIMAC

NIRS

Low dose distribution at high energy region

Particles’ movement in a straight line

Particles’ energy is slowly decreasing through the interaction

High dose distribution near the stopping position

Photons’ amount and energy are steadily decreasing

Charged particle

photon

Secondary electrons or radicals affect DNA in cells

High dose distribution due to amount of photons

• Physical effectiveness depends on amount of dose

• Biological effectiveness depends on micro distribution of dose

Low dose distribution, and a few photons penetrate deep

Interaction of radiations in materials


HIMAC

NIRS

Physical advantage of heavy ion


0

20

40

60

80

100

0 5 10 15

Depth in water (cm)

Rel

ative

dos

e (%

)

C ion

n

gamma-ray

proton

Lateral biological dose distribution

0

1

2

3

4

5

-8 -6 -4 -2 0 2 4 6 8

lateral position (cm)

Dos

e (G

yE)

Cproton

Good longitudinal dose localization due to the Bragg peak.

Good transverse dose localization due to the low scattering.

HIMAC

NIRS

Linear Energy Transfer (LET)Energy deposition / path length

Relative Biological EffectivenessRBE = Dose of X-ray / Equivalent dose

of the particleLET-RBE

• low LET(X, γ); RBE = 1• high LET(heavy ion); RBE > 1• too high LET; RBE < 1

low LET radiation

too high LET

high LET

1μm Ionization

L ET (k eV / µm )

lowLETtoo high

LET（ov er kill）

high LET

RBE

1

Biological effectiveness


HIMAC

NIRS

Comparison between heavy ion and other radiotherapy

Advantage of heavy ion

- Good concentrate physical dose distribution due to Bragg curve

- Lower multiple scattering in the lateral direction

- Large relative biological effectiveness (RBE) at the stopping point


Tumor

RBE are equal at any place

Tumor

X-ray

proton

RBE is higher at tumor

Tumor

RBE is low as p or X-ray

Heavy Ion

HIMAC

NIRS

Why carbon beam was chosen?

Thickness: ~ Single Bragg peak

Depth: ~ 26 cm

(A. Brahme, private communication)

~ 6 cm

~ 16 cm

Biological Depth-Dose Distribution of 6cm SOBP

0

1

2

3

4

5

0 5 10 15 20Depth in Water

Bio

logi

cal D

ose

(GyE

)

He

C

Ne

Proton

TumorNormal tissue


2. Irradiation methods and necessary equipments

HIMAC

NIRS

Spread Out of Bragg Peak (SOBP)

In order to realize the advantage of heavy ion RT, It’s important the irradiation technique to obtain a large uniform irradiation volume from the pencil shaped and mono-energetic heavy ion beam.


Calculating SOBP bio-clinical depth dose

C290MeV/u beam　SOBP 6.0 cm

Mono-energy peak(Bio-clinical)

(Relative)

Sum

Spread Out of Bragg Peak (SOBP)

HIMAC

NIRS

Categories of irradiation methods

The irradiation methods are roughly divided into two categories at present facilities.

1. Passive ‘Wobbler’ method

2. Active ‘Pencil beam scanning’ methodslike ‘spot scanning’ or ‘raster scanning’.


HIMAC

NIRS

Wabbler method for making irradiation field

Scatterer

X- and Y- scanning magnets

Scatterer

X- and Y- scanning magnets

Scatterer

− The beam profile is originally sharp.

Multi-leaf Collimator

− In order to enlarge the size of beam, a scatterer is inserted.

− A pair of orthogonal magnets is used to form a uniform dose in the lateral distribution.

− A multileaf collimator tailors the beam according to the perpendicular cross section of the tumor.


HIMAC

NIRS

Ridge filter for making SOBP

RidgeFilter

RangeShifter

BolusCollimator

− The beam energy is originally monochromatic.

− In order to expand the beam energy, a ridge filter is inserted.

− A range shifter is used for energy absorbers for the fine tuning of the range.

− In order to adjust the end-point to the curvature of tumor, a bolus collimator is set.

Tumor


HIMAC

NIRS

Scatterer

Wobbler Magnets

FieldTarget

Ridge Filter

IonizationChamber

Patient Collimator

Multi-Leaf Collimator

Range Shifter

Patient Compensator

Equipments of Wobbler method


HIMAC

NIRS

Layer-stacking wobbler methodBroad-beam scanning

Dose monitor

Wobbler Magnetsand Scatterers

Range shifter

Multi-leaf Collimator

Painting the target volume with thin SOBP layers. Each layer changes in the depth, area and shape.

Ridge Filter

Compensator

T. Kanai, et al., Med. Phys. 33, 2989 (2006).


HIMAC

NIRS

Respiratory gated irradiation

Irradiation room

Positioning area

Accelerator Treatment control

Gate signal generator

Watch & record system

Beam monitor

Planning simulation

Reference Image

Positioning systemusing x-ray TV images

Compare

X-ray TV

Positioning Image

PSD

Respirationwaveform

Gated beam extraction system(RF knockout method)

Interlock system

Ion beam

- Irradiation system of coincident with a patient‘s respiratory motion -

S. Minohara et al., Int. J. Rad. Oncol. Bio. Phys. 2000;47:1097


HIMAC

NIRS

Pencil beam scanning method

Beam scanned x- and y- direction by magnets

Beam energy changed slice by slice

Beamon/off

x (mm)

y (m

m)

0

0

50

-50

50-50


Uniform dose distribution is obtained according to accumulation of the weighted beam path / spot

HIMAC

NIRS

History of Pencil beam scanning

1979 Spot scanning system for proton RT at NIRS1980’s 1-D raster scanning for pion and proton RT at PSI1997 3-D raster scanning for heavy ion RT at GSI

Advantage: Good dose distributionDrawback:This method is extremely sensitive to organ motion during treatment.

The development on the respiratory gated scanning method is now a hot topic in this field, even for p-RT.


HIMAC

NIRS

Summary of irradiation methods

II. a) Pencil-beamScanningI. a) Wobbler

I. b) Layer-stacking wobbler II. b) Scanning without respiratory gate

Head, Prostate, Lung, Liver…

Target volume


Unexpected dose


HIMAC

NIRS

Structure of acceleratorRange: 25cm Max. beam energy

[Wobbler]400MeV/u for C

[Scanning]350MeV/u for C

Dose rate: 5GyE/min.at 15x15cm Max. beam intensity(22cm dia.)

[Wobbler]1x109pps for C

[Scanning]4x108pps for C

~ 3.3s

1 ~ 2 sSynchrotron

Linac

Ion Source


3. Facilities worldwide

HIMAC

NIRS

History of heavy ion radiotherapy

* include research room, + exclude other rooms for proton only, pps: particle per second, ppp: particle per pulse (spill)


Max.Energy

H V Other MeV/uLawrenceBerkeley

LaboratoryBevalac

Berkeley(USA)

1975 -1992

433 1 1 0 0wholebody

Scatterer /Wobbler

670for Ne

1E10 ppp(0.25Hz)

Elec.Stat.+ Alvarez

PIG 3

National Instituteof Radiological

Sciences (NIRS)HIMAC

Chiba(Japan)

1994 -6512

(Feb.'12)3 2 2 0

wholebody

Wobbler / Layerstacking / Raster

scanning400

1.8E9 pps(typ. 0.3Hz)

RFQ+ Alvarez

ECRIS,PIG

324 hours /6 days / 10

month

2times /year

Gesellschaft furSchwerionenfors

chung (GSI)

UNILAC +

SIS

Darmstadt(Germany)

1997 -2009

440 1 1 0 0head &

neckRaster

scanning430

1E6- 4E10 ppp

RFQ+ IH

+ AlvarezECRIS 1

7 days /4weeks at5 per year

5times /year

Hyogo Ion BeamMedical Center

(HIBMC)HIBMC

Hyogo(Japan)

2002 -1393

(Mar.'12)3+ 2 1

1(fix45)

wholebody

Wobbler 320 2E9 ppsRFQ

+ AlvarezECRIS 2

5days /1week

1times(4days) /1month

Institute ofModern Physics

(IMP)

HIRFL-CSR

Lanzhou(China)

2009 -shallow 103

deep 56 (Oct.'11)

1 1 0 0 sarcomaWobbler /

Layerstacking

235 5E8 ppp Cyclotron ECRIS 17days /1week

2times /year

UniversityHospital

Heidelberg

Hidelberg IonTherapyFacility(HIT)

Heidelberg(Germany)

2009 -~900

(May '12)3 2 0

1Gantor

y

wholebody

Rasterscanning

430 1E9 ppp RFQ + IH ECR 2

GunmaUniversity

Gunma-UniversityHeavy -Ion Medical

Center (GHMC)

Maebashi(Japan)

2010 -424

(Dec.'11)4* 2 3* 0

wholebody

Wobbler /Layer

stacking400 1.2E9pps

RFQ +APFIH

ECR 1

Fondazione CentroNazionale

AdroterapiaOncologica

Centro NazionaleAdroterapiaOncologica

(CNAO)

Pavia(Italy)

2012 --

(Oct.'12)3 3 1 0

wholebody

(start:hea

Rasterscanning

400 4.5E8ppp RFQ + IH ECR 2

Irradiationmethod

Targetdeseases

Name offacility

Institute /Hospital

Treat-mentrooms

Totalpatients

Startyear

Location(Country)

Irradiatin port Maintenance interval

Operationschedule

No. ofion

souce

Type ofion souce

Type ofinjector

Typical beamintensity fromaccelerator

HIMAC

NIRS

Pioneer’s work at LBL1940‘s R. Willson proposed the medical application of heavy ion.

1975 LBL start the clinical trials (mainly Ne ions).

Biological and Medical Research with Accelerated Heavy Ions at the Bevalac, LBL-11220, UC-48 (1980).E.A. Blakely et al., Adv. Radiat. Biol. 11, 295 (1984).

W.T. Chu et al., Rev. Sci. Instrum. 64, 2055 (1993).

1992 Research was aborted due to the shutdown of physics program.


HIMAC

NIRS

HIMAC project

Size: 60 x 120 mConstruction cost: 32.6GJPY

(Building 14.6GJPY)(machine 18.0GJPY)

Heavy Ion Medical Accelerator in Chiba

‘84 ‘85 ‘86 ‘87 ‘88 ‘89 ‘90 ‘91 ‘92 ‘93 ‘94Feasibility studyDesign of machine

Manufacturing & installation of machine

Design of Buildings

Installation of UtilitiesConstruction of Buildings

Research

commissioning

SurveyMachine

InjectorSynchrotron

Irradiation system,…

BuildingsBuildings

Electricity, cooling system, …

Developments of devices

Clinical trialsPhysics & Biology

‘84 ‘85 ‘86 ‘87 ‘88 ‘89 ‘90 ‘91 ‘92 ‘93 ‘94Feasibility studyDesign of machine

Manufacturing & installation of machine

Design of Buildings

Installation of UtilitiesConstruction of Buildings

Research

commissioning

SurveyMachine

InjectorSynchrotronIrradiation system,…

BuildingsBuildings

Electricity, cooling system, …

Research & developments for devices technology (incl. biology)

Clinical trials

Physics & Biology

“Summary at the 10th anniversary of the heavy ion radiotherapy”, edited by MEXT, Monbu-Kagaku Jihou No.1541, August 2004, pp. 10-49.


HIMAC

NIRS

Major features:

- intensity modulated raster-scanning beam-delivery system

- R&D for the rotating gantry system

The first 3D scanning in the world

T. Haberer, in PAC09

GSI, Darmstadt


HIMAC

NIRS

- Funded by Japanese local government

- 1st dual use facility for proton and carbon beams in the world.

- maximum beam energy of carbon is 320 MeV/n

HIBMC, Hyogo


HIMAC

NIRS

superficially-placedtumor therapy

deep-seated tumor therapy

- A new treatment room and beam delivery system for deep-seated tumors has been installed in the Cooling Storage Ring (HIRFL-CSR).

- A clinical trial for treatment of deep-seated tumors has begun in March 2009.

IMP, Lanzhou


Q. Li et al., Med. Bio. Eng. Comput. 45, 1037 (2007).

HIMAC

NIRS

T. Haberer, in PAC09

- 1st medical dedicated facility in Europe.

- proton & carbon are available

- 3D raster scanning for head & neck

- 2 treatment rooms and 1st heavy ion rotating gantry is installed

- Start Nov. 2009

Hidelberg University, Germany


HIMAC

NIRS

Gunma University, JapanTreatment room

Ion source

Synchrotron


Demonstration facility of the downsized carbon-RT facility in Japan.- Dedicated carbon only- Wobbler & layer-stacking- construction cost12 GJPY- size 60x50 m- start since Mar. 2010 S. Yamada et al., NIRS-M-218, p.170 (2009).

RFQ+APF-IH Linac

HIMAC

NIRS

Facilities under construction



Max.Energy

H V Other MeV/uKyushu InternationalHeavy-Ion TreatmentCenter

Saga Heavy IonMedical Accelerator inTosu (SAGA HIMAT)

Tosu(Japan) C 2013 2012

(plan) 3 2 1 145deg. whole body

Wobbler /Layer stacking /Raster scanning

400 1.2E9pps

Syn +RFQ +

IHECR 1

Fudan UniversityShanghai CancerHospital

Shanghai Protonand Heavy IonTherapy Hospital

Shanghai(China) C, p 2013 2012

(plan) 3 1 2 1Lung, Liver,head&neck,etc

Rasterscanning 430 3E8pps

Syn +RFQ +

IHECR 3

EBG MedAustronLtd. MedAustron

WienerNeustadt(Austria)

C, p, O 2014 2013(plan) 3* 2* 1 0

whole body(no eyetumor)

Rasterscanning 400 1E9pps

Syn +RFQ +

IH

ECR/EBIS/

Volume4

Kanagawa CancerCenter

Ion-Beam RadiationOncology Center (I-ROCK)

Yokohama(Japan) C 2014 2014

(plan) 4 4 2 0 whole bodyWobbler /Layer stacking /Raster scanning

430 1.2E9pps

Syn +RFQ +

IHECR 1

No. ofion

source

Location(Country)Name of facility

1st beamfromaccel-erator

Beamintensity

Targetdeseases

Typeof ionsouce

Institute / Hospital

Typeof

accelerator

Number ofirradiatin port Irradiation

method

Treatment

rooms

Ionspecies

Sche-duledstartyear

HIMAC

NIRS

Facilities under construction


W. Pirkl et al., IPAC11

SAGA HIMAT

Clinical trial of proton has been started.

CNAO

MedAustron

HIMAC

NIRS

Facilities under construction or planning



Max.Energy

H V Other MeV/u

ETOILE foundation ETOILE Lyon(France) C, p 2011

Gansu Tumor HospitalHeavy Ion TherapyFacility inLanzhou (HITFiL)

Lanzhou(China) C 2014 2013

(paln) 4 2 2 145deg. whole body

passive /spotscanning

400 4E8pps Syn +Cyc ECR 1

Wuwei Tumor HospitalHeavy Ion TherapyFacility in Wuwei(HITFiW)

Wuwei(China) C 2014 2013

(plan) 4 2 2 145deg. whole body

passive /spotscanning

400 4E8pps Syn +Cyc ECR 1

Korean Institute ofRadiological and MedicalSciences (KIRAMS)

Korean Heavy IonMedical Accelerator(KHIMA)

Busan(Korea) C 2015 S.Cyc ECR 1

Chang Yung-FaFoundation

Taipei(Taiwan)

C

Universiti SainsMalaysia (USM)

Penang(Malaysia)

C

King Abdulaziz City forScience and Technology(KACST)

Riyadh(Saudi Arabia)

Mayo Clinic Mayo Clinic HeavyCharged Particle facility

Rochester(USA)

C, p,(others tofollow)

To bedetermined 3+ 2 0

2+45-45

Radioresistantand inoperabletumors of allsites

Spotscanning 400 Dependent on vendor to satisfy the dose rate

of 2 Gy/min to a liter of water at patient

Irradiationmethod

Beamintensity

Typeof

accelerator

Typeof ionsouce

Targetdeseases

No. ofion

sourceInstitute / Hospital Name of facility Location

(Country)Ion

species

Sche-duledstartyear

1st beamfromaccel-erator

Treatment

rooms

Number ofirradiatin port

HIMAC

NIRS

Heavy ion radiotherapy worldwide

Chiba

Gunma

Hyogo

Lanzhou

Busan

(Darmstadt)

Lyon

Wiener Neustadt

Pavia

Heidelberg

RochesterYokohamaTosu

Shanghai

Heavy ion Heavy ion (under construction)

ProtonProton (under construction)

Heavy ion (planning)

Penang

Taipei

Riyadh

Wuwei


(Berkeley)

HIMAC

NIRS

2004 R&D for a hospital-based facility 2006 Start of clinical2007 Start of Program for the Human trials at IMP2009 Resources Development Open of 1st facility,2010 Open of 3rd facility, Gunma Heidelberg

1997 Start of clinical trials at GSI

2001 Open of 2nd facility, Hyogo 2003 Approval as medical by Japanese government

1984 Cancel of new project Start of HIMAC project1992 Shut down of Bevalac Cancel of Eurima project1994 Start of clinical trials with C

Historical trend of heavy ion radiotherapyUSA Japan Europe Other Asia

1940‘s Proposed by Dr. Robert Wilson

1975 The first clinical trial in the worldwith Ne at LBL

1980‘s　========== New research projects were proposed in many countries ==========

2010‘ new project Start of constructions of New facilities’ KIRAMS &of 4th & 5th projects other new facility

WobblerWobbler [Irradiation methods] Pencil-beam Scanning Pencil-beam Scanning


4. Government's strategy and the role of NIRS

HIMAC

NIRS

Strategy by Japanese government[Comprehensive 10-Year Strategy for Cancer Control, 1984-1993]

1984 HIMAC project at NIRS as the 1st medical dedicated heavy-ion accelerator in the world has been funded by Ministry of Education, Culture, Sports, Science and Technology (MEXT).

[2nd Comprehensive 10-Year Strategy for Cancer Control, 1994-2003]1994 Start of clinical trials with carbon ions at NIRS under prescribed clinical protocols.2001 The 2nd facility (Hyogo Ion Beam Medical Center) has been opened. 2003 Carbon ion therapy has approved as “advanced medicine” by Ministry of Health, Labour, and Welfare

(MHLW).[3rd Comprehensive 10-Year Strategy for Cancer Control, 2004-2013]

2004 “Workshop for popularization of the charged-particle radiotherapy” was held by MEXT and the summary report has been distributed.

2005 “The guideline for charged particle radiotherapy in Japan” has been authorized by the Japanese Society of medical Physics (JSMP).

2004-5 Design of a hospital-specified facility and development on prototypes of various components at NIRS was funded by MEXT.

2005-7 “Research on radiation protection for proton and heavy ion radiotherapy” was funded by MHLW.2006-10 Construction of the 3rd facility at Gunma University as a demonstration model was funded by MEXT.2007- “Program for the Human Resources Development Relating to Charged Particle Radiotherapy” has

been funded by MEXT.2007- Approved the construction of “the next-generation irradiation systems” at NIRS.2010 First treatment at Gunma University.2011 Start of clinical trials with the respiratory gated 3D scanning at NIRS.


HIMAC

NIRS

Gunma Univ.

Promotion section for carbon therapy

Working group for construction

Committee for medical

application

Committee for facility

construction

NIRSPresident

Promotion of carbon therapy section

Research Center for charged particle

therapy

Committee on promotion of carbon

therapy

Sub-committee for Gunma

Univ.

General strategy

Specific action plan

Example of framework for cooperation

Negotiation forSeparate agreements

•Cooperative research•Dispatch of Committee Members•Training of Staff•Technology transfer•Treatment of sending patients •Sharing of clinical data etc…

Sub-committeesfor each cooperation

President

MemorandumOf

Understanding


HIMAC

NIRS

Operation

Technology transfer

Technical guidance

Planning for Operation & Maintenance (O&M)

• Plan development• Unified work

through Basic Desing to O&M planning

• Establishment of hospital network

Example of construction procedure

Drafting of basic concept of whole facility and vision for operation

• Committee for formulation of basic concept

Basic Design• Selection of optimal companies for

basic design• Estimation of cost and conditions

Engineering, Procurement andConstruction (EPC) • Selection of

contractors

Organizer NIRS

Dispatch of Committee Members

Suggestion of model plan

Cooperative research

Training of Staff

Dispatch of Committee Members

Sharing of clinical data

Several months ~ a few year


Half ~ one year

2 ~ 4 years

HIMAC

NIRS

Q/A, Q/C, safety studies[Comprehensive 10-Year Strategy for Cancer Control, 1984-1993]








been funded by MEXT.2007- Approved the construction of “the next-generation irradiation systems” at NIRS.2010 First treatment at Gunma University. 2011 Start of clinical trials with the respiratory gated 3D scanning at NIRS.


HIMAC

NIRS

Exposure of medical staffs

Study report on radiation protection related to particle therapy (2005-2007)

Chief researcherTujii, H. National Institute of Radiological Sciences (NIRS)

Commitments Ì the National Institute of Radiological Sciences (HIMAC) Ì the Hyogo Ion Beam Medical Center (HIBMC) Ì the National Center Center Hospital East (NCCHE) Ì the Sizuoka Cancer Center (SCC) Ì the Proton Medical Research Center, Tsukuba University (PMRC)


HIMAC

NIRS

Behavior of a radiological technologist

ConclusionThe results of the experiment showed that the exposures of medical staffs and patient’s-family members, and the radioactivity concentration of the drain water from the lavatory which the patient used are far below the Japanese legal limits which are same as the recommendations of ICRP. We can conclude that the present legal control for the ordinary accelerator facilities is sufficient to the charged-particle radiotherapy facilities.


HIMAC

NIRS

Human resources development[Comprehensive 10-Year Strategy for Cancer Control, 1984-1993]










HIMAC

NIRS

Required human resourcesThe development of the human resources who operate the facilities is

one of the greatest problems.

•Diagnosis•Informed consent•Determination of the therapeutic policy•Assessment of therapeutic effect•Follow-up

Radiological technologist

Engineer, Technologist forequipments

Medical physicist

Radiological Oncologist

Heavy ion therapy•Treatment planning•Dosimetry•Quality control of equipments•Research and development of new equipments

•Preparation of equipments•CT scanning for treatment planning•Patient positioning•Irradiation

•Operation of equipments•Radiation protection•Support for research and development•Maintenance of equipments


HIMAC

NIRS

Joint 6 existing therapy facilities

Instruction

Association for Nuclear Technology in Medicine

University

Human resource

Program committee

MEXTfunding

Report

Government program for human resources

Road mapFY2006 2007 2008 2009 2010 2011

committee

Therapy facilities

Design of curriculam Instruction / Support / Evaluation

On the Job training

5yeas project “Program for the Human Resources Development Relating to Charged Particle Radiotherapy” by the Ministry of Education, Culture, Sports, Science and Technology (MEXT)


HIMAC

NIRS

Necessary network for patient selection

Nationalhospital

Medical college

Regionalcancer center

Treatment facility

Communication before the treatment- diagnosis data

(from hospital side)- clinical results

(from facility side)

Patients

Introduction

Information

Com

munity hospitals

Special Examination for heavy-ion therapy

Communication after the treatment- follow-up data(both side)

Regional core hospitals


NIRS

HIMAC

NIRS

Researches for advanced technology[Comprehensive 10-Year Strategy for Cancer Control, 1984-1993]










HIMAC

NIRS

Research topic of irradiation methods

II. a) ScanningI. a) Wobbler

I. b) Layer-stacking wobbler II. b) Scanning without respiratory gateHead, Prostate, Lung, Liver…

Target volume


Unexpected dose

III. Scanning with respiratory gate



HIMAC

NIRS

Clinical trial of new irradiation systemA fast 3D-scanning irradiation system as the next-generation irradiation technology of the heavy-ion beam is completed. The clinical trial of new treatment room has started since May 2011.

HIMAC

Hospital

New facility

2011 Gold Award


HIMAC

NIRS

S. Korea<Soul>

Korea Institute of Radiological and Medical Sciences

USA<Fort Collins>

Colorado State University

Taiwan<Taipei>

Chang Yung-Fa Foundation

China<Lanzhou>

Institute of Modern Physics

USA<Rochester>Mayo Clinic

International cooperation related heavy ion radiotherapy

China<Shanghai>

Shanghai Institute of Nuclear and Applied Physics

China<Beijing>

Tsinghua Univ.Yuquan Hospital

China<Beijing>

Institute of High Energy Physics

China<Daliang>

Daliang Univ.

　Germany　　　<Heidelberg>

University of Heidelberg

　Germany　　　<Darmstadt>

GSI

Austria　　　　　　　<Vienna>　　　　　

Vienna Univ. of Technology-atomic institute of the Austrian

Universities

Austria　　　　　　<Innsbruck>　　

Medical University of Innsbruck

Italy<Milan>

CNAO Foundation

Maleysia< Penang >

UNIVERSITI SAINS MALAYSIA

Russia<Dubna>

Joint Institute for Nuclear Research

… in process or negotiationHungary

<Debrecen>ATOMKIFrance

＜Lyon＞Etoile

　Romania　　　<Cluj-Napoca>Sapientia University

Saudi Arabia ＜Riyadh＞

King Abdulaziz City for Science and Technology

　China　　　<Shanghai>

Fudan Univ.


HIMAC

NIRS

NIRS’s roadmap (2011-15)I..Short term subject ( ~2015)i. Enlightenmentii.Personnel training for

operation staff at future facilities

iii.Research for more downsizing and optimizing

II. Long term subjectsi. More downsizingii.Increase acceptable patientsiii.Human resources development for related

fieldsiv.Support developments for revolutionary

technology

4. Research cooperation

3. Improvement of cooperation framework

2. Human resources development

1. Transfer of knowledge and technology

20152014201320122011ActionRealize the popularization of heavy-ion radiotherapy with• more excellent performance• enough safety• more cost effective

Goal

① Propose the specification of a future optimized facility② Improve the organization of human resources development

and continue personnel training③ Support for standarization and establish the rule for

technology transfer④ Continue the collaborations between related organizations

Propose the specification of a future optimized facility

Improve the knowledge transfer

Improve the organization of human resources development

Continues personnel training

Support for standarization

Establish the rule for technology transfer

Continues collaborations

MEXT ordered to make a roadmap for the next step of promotion,

Cooperation of related organizations in wide fields <Public organizations> <Private organizations>• Hospitals, medical universities and institutes, • Machine vendor, Building constructors, medical instruments suppliers• Private insurance companies, finance and investment companies• Local governments


Summary1. Feature of heavy ion radiotherapy

Heavy ion has physical and biological advantage; Ì Good concentrate dose distribution due to Bragg curve and lower multiple scattering.Ì Large relative biological effectiveness (RBE) at tumor.

2. Irradiation methods and necessary equipmentsThere are two historical trends in the world; Ì Passive ‘wobbler’ irradiation method Ì Pencil-beam scanning irradiation method.

3. Facilities worldwide Ì Presently, there are five facilities in operation.Ì Clinical results awaken a worldwide interest. More new facilities are under

construction in Europe and Asia.4. Government's strategy and the role of NIRS

The approaches for the promotion are based on 10-year Strategy by the government. Ì Technology transfer has been arranged. Ì Studies for the regulations were carried out.Ì Human resource development has been established.The international framework is in progress.

The 15th International Conference on Ion Sources9 - 13 September 2013

Makuhari Messe, Chiba, Japan

Organized by National Institute of Radiological SciencesFor further information will be delivered on http://www.nirs.go.jp/conf/icis13/

Documents

Technology trends of carbon-ion radiotherapy and NSIR's - Ansto