Accelerator technique proton and carbon treatment of tumors;

1. Radiation oncology at JINR in briefDzhelepov Laboratory of Nuclear ProblemsJoint Institute for Nuclear Research, Dubna, Russia Accelerator techniqueproton and carbon treatment of tumors; New types of detector systems for spectrometric computed tomography (CT), for combined magnetic resonance tomography (MRT)/positron emission tomography (PET). Dr. D.V. Kamanin, ICSTI Conference 20 May 2010, Baku

2. HADRON THERAPY IN WORLD AND IN RUSSIA There are 25 centers of the proton therapy and 4 centers of carbon therapy at the world now. More than 60 thousand patients were treated with application of hadron therapy during last 50 years, 60 % of them were treated over last 10 years and 90% of total patients now treated in the hospital based facilities. 2.3 million of tumor patients there are in Russia 450 thousands of new patients are appeared per year. The proton therapy is recommended 50 thousands of patients per year in Russia.

3. NANOTECHNOLOGIES IN HADRON THERAPY a) carbon ions b) X-rays Photo of irradiated human cells taken at the fluorescent microscope. Fluorescent markers (-H2AX) demonstrate nanostructured double-strand lesions of DNA molecules caused by carbon ions and occasional structure by x-rays. At the heart of carbon therapy is the nanotechnology where nanostructure of local radiation damages is produced along trajectories of ions with characteristic cross dimension of a few nanometers and a root-mean-square distance between the damages several hundred nanometers, covering the structure of DNA molecules in the tumor cells with a probability of 80%. The arising two-strand lesions of DNA molecules are irreversible because of high linear energy transfer (LET) for particles stopped in the tumor, while the structure of radiation damages in normal tissues at low LET ensures less than 10–20% probability of complications in these tissues, producing damages that allow cell functioning to be restored after irradiation.

4. JINR Medical-Technical Complex on proton beams of synchrocyclotron 1967 – First investigations at cancer treatment;1968 –1974 – 84 patients were treated by proton beams on synchrocyclotron; 1975 –1986 – Upgrade of synchrocyclotron, creation of Medic-Technical Complex (MTC) of hadron therapy in JINR;1987– 1996 – 40 patients were radiated by proton beams; 1999 –Creation of radiological department in Dubna hospital; 2000 – 2010 – 620patients were treated by proton beam. During last years around 100 patients per year were radiated by proton beam in JINR Medical-Technical Complex in frame of research program of Medical Radiological Research Center of Russian Medical Academy of Science.

5. JINR treatment by medical proton beams Diseases treated Meningiomas – 112 pts Chordomas, chordosarkomas – 19 pts Gliomas – 33 pts Acoustic Neurinomas – 7 pts Astrocytomas – 24 Paragangliomas – 5 pts Pituitary Adenomas – 17 pts AVMs – 60 pts Brain and other metastasis – 53 pts Other head and neck tumours – 134 pts Melanomas – 7 pts Skin diseases – 42 pts Carcinoma metastasis of the lung – 9 pts Breast cancer – 44 pts Prostate Adenomas – 1 pt Sarcomas – 9 pts Other – 19 pts

6. JINR MTC WITH PROTON BEAMS Prostate treatment equipment 3D conformal proton beam treatment were realized in Russia only in JINR. Cancer treatment in cabin №1

7. CANCER TREATMENT ON PHASOTRON BEAMS Plan of proton treatment of brain cancer tissue (right), NMR tomogram before treatment (left) NMR tomogram after 3 months later (down)

8. DUBNA CYCLOTRON CENTER OF PROTON THERAPY Dubna Center of Radiation Medicine (CRM) involves: Cyclotron Center of Proton Therapy, PET center, Department of convention radiotherapy with electron linac, Diagnostic department, Proton therapy clinic. The scheme of accelerator equipment of Dubna CRM. The Center of proton therapy has 3 treatment cabins, 1 with the gantry and 2 rooms with the fixed beams. About 1000 patients per year will be treated there.

9. Modified Cyclotron C235 JINR-IBA collaboration develops a medical cyclotron for the proton therapy. This year it is planned to complete its construction and assembling and in 2011 to carry out the beam tests. After that the accelerator could be installed in the Dubna hospital Centre of proton therapy. The main modernization efforts are directed on optimization of the magnetic system oriented on an increase of the axial betatron frequency. Azimuthal angle variation Simulation of magnetic field.

10. CARBON CANCER TREATMENT The carbon 12C6+ ion beams at intensity of 109 pps are efficiently used for cancer treatmentespecially for patients with radioresistant tumor targets. The construction of C400 is planed to start in September 2010 in the framework of Arhade project (France, Caen) COMPACT SUPERCONDUCTING CYCLOTRON C400 FOR HADRON THERAPY

11. Present status of X-ray technique World market of medical x-ray technique is about 13 bln. $/year

12. Schemes of X-ray detector systems Cr compensated GaAs

13. Development and production of pixel semiconductor detectors GaAs pixel detector with pixel size of 50 mand 65536 channels of electronics

14. X-ray computer tomograph detectors X ray images obtained at different wavelengths for iodine, calcium and air Scheme at transition from standard gray X-ray picture to color picture of separate structures

15. SPECTROMETRY X-RAY DETECTION IN COLOR RADIOGRAHY

16. Novel Micropixel Avalanche Photodiodes (MAPD) with super high pixel density Application of MAPD in nanoindustry:laser location, lines of optical transformation of information, systems of optical reading information of ultrahigh density, luminescence of quantum dotteds, investigation of human cells, investigation of DNA molecules. Medical applications: PET and combined PET/MRT

17. MAPD APLICATION FOR POSITRON EMISSION TOMOGRAPHY(PET)AND COMBINED PET/MRT

18. Welcome to JINR (Dubna)