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European Network for Light Ion Therapy ENLIGHT

European Network for Light Ion Therapy ENLIGHT. Manjit Dosanjh ENLIGHT Coordinator & CERN. Hadron therapy history …. …in 1997. 22,000 patients since the beginning (18,300 protons). First patient. Today. 1954 Berkeley. 51,000 patients (44,000 protons, 2900 carbon ions). .

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European Network for Light Ion Therapy ENLIGHT

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  1. European Network for Light Ion Therapy ENLIGHT Manjit Dosanjh ENLIGHT Coordinator & CERN ENLIGHT, ESF Workshop-Oxford

  2. Hadron therapy history … …in 1997 22,000 patients since the beginning (18,300 protons) First patient Today 1954 Berkeley 51,000 patients(44,000 protons, 2900 carbon ions). ENLIGHT, ESF Workshop-Oxford

  3. Numbers of potential patients From studies in Austria, France, Germany and Italy X-ray therapy every 10 million inhabitants 20,000 pts/year Proton therapy 12% of X-ray patients 2,400 pts/year Therapy with Carbon ions for radio-resistant tumour 3% of X-ray patients 600 pts/year TOTAL for hadron therapy for 10 M 3,000 pts/year ENLIGHT, ESF Workshop-Oxford

  4. linacs for carbon ions and protons p p p C C PIMMS at CERN in 1996 - 2000 CERN–TERA–MedAustron Collaboration for optimized medical synchrotron 400 MeV/u synchrotron Resonance sextupole RF cavity Sextupole horiz. chromaticity Sextupole vert. chromaticity Circumference C = 76.84 m Tune horizontal Qx = 1.67 Tune vertical Qz = 1.72 Betatron core Sextupolevert. chromaticity 16 Bending Magnets 3 extraction systems: betatron core 1/3 resonance RF knock-out Sextupole horiz. chromaticity Electrostatic septum Extraction septum Injection septum ENLIGHT, ESF Workshop-Oxford

  5. Why collaborate? • Hadrontherapy to improve cancer treatment & outcome • Very complex in all aspects of undertaking, therefore • Create common multidisciplinary platform • Share knowledge • Share best practices • Harmonise data • Provide training, education • Identify challenges •  innovate ENLIGHT, ESF Workshop-Oxford

  6. ENLIGHT challenges • A heterogeneous group - different disciplines plus networking • How to balance between basic research and the clinical needs? • Many partners. How to give space to each and make progress with the main objectives? • How to strike a balance between agenda of the single centres and the common ENLIGHT goals? • Can we show ion therapy is more effective? Will practice validate the theory? ENLIGHT, ESF Workshop-Oxford

  7. ENLIGHT++ ingredients • Clinical Studies • Radiobiology • Treatment planning for Intensity Modulated Particle Therapy • Adaptive ion therapy and treating of moving organs • Novel in-beam PET systems • Feasibility study for innovative gantry designs • Information and Communication Technologies for Hadron therapy • ………..Future acclerator designs?? + networking ENLIGHT, ESF Workshop-Oxford

  8. What happened? ENLIGHT was established in 2002 ENLIGHT was composed of: Centres in Heidelberg, Lyon, and Pavia, CERN, EORTC, ESTRO, GSI, Karolinska, MedAustron, TERA, Czech Rep, Spain • Main achievements: • Creation of a European Hadrontherapy Community • Common multidisciplinary platform with a shared vision • Catalysed the transition from research to the clinical environment, 5 centres approved in Europe • Served as a vehicle for education and dissemination ENLIGHT, ESF Workshop-Oxford

  9. European situation in 2008 • The first two dual Carbon/proton centres in Heidelberg and Pavia are foreseen to start operation in 2008/9….. • Approved: Marburg (Germany), Etoile (France), MedAustron (Austria) and ARCHADE (France) • Sweden, Belgium, Netherlands, Spain, UK ……… Clear desire for continuing the network focusing on new and on un- completed research topics and helping new initiatives…. ENLIGHT, ESF Workshop-Oxford

  10. From ENLIGHT… to ENLIGHT++ In 2006 ENLIGHT++: + one “plus” for more hadrons (specifically protons), ++ the second “plus” refers to more Countries (17 countries, with >60 Institutions) ENLIGHT++ goes beyond being a network: Main Objective: Being more INCLUSIVE and becoming a RESEARCH network ENLIGHT, ESF Workshop-Oxford

  11. ENLIGHT 2008 European Commission funding project (Framework programme 7) Training 25 young researchers - 5.6 million euro project Research in optimizing 8.5 million euro project ENLIGHT, ESF Workshop-Oxford

  12. PARTNER • 25 researcher positions • 21 PhDs and 4 Post-doc • Positions posted: www.cern.ch/PARTNER • Will start 1st October 2008

  13. ULICE Infrastructure project (8.5M Euros) 3 Pillars:Transnational access, Research and Networking Start at the beginning of 2009

  14. HEALTH- 2009-1.2-4: Novel imaging systems for in vivo monitoring and quality control during tumour ion beam therapy. Single stage application. Collaborative project (small or medium-scale focused research project) The focus should be to develop novel imaging instruments, methods and tools for monitoring, in vivo and preferably in real time, the 3-dimensional distribution of the radiation dose effectively delivered within the patient during ion beam therapy of cancer. The ions should be protons or heavier ions. The system should typically be able to quantify the radiation dose delivered, to determine the agreement between the planned target volume and the actually irradiated volume, and for decreasing localisation uncertainties between planned and effective positions (e.g. of tissues or organs), and between planned and effective dose distribution during irradiation. It should aim at improving quality assurance, increasing target site (tumour) to normal tissue dose ratio and better sparing normal tissue. 2.9.2008 Manjit Dosanjh ENLIGHT, ESF Workshop-Oxford

  15. 1. What do we have? In-beam PET Advantages • In-beam PET allows fora control of tumour irradiations by means of ion beams • an in-vivomeasurement of the ion range • the validation of the physical model of the treatment planning • the evaluation of the whole physical process of the treatment from planning to the dose application deviationsbetween planned and actually applied dose distributions ENLIGHT, ESF Workshop-Oxford

  16. 2. What do we have? In-beam PET Disadvantages and open problems PET is not applicable to - real time monitoring: ▪ too slow ▪T1/2(15O) = 2 min, T1/2(11C) = 20 min ▪ dose specific activity: ~ 1000 - 7000 Bqcm-3 Gy-1 - quantitative imaging, precise dose quantification, feedback to treatment planning and to IGRT ▪ limited angle artefacts ▪ degradation of activity distributions by the metabolism ▪ degradation of activity distributions bymoving organs ▪ inaccurate prediction of activity distributions from treatment planning due to unknown nuclear reaction cross sections ENLIGHT, ESF Workshop-Oxford

  17. 3. What do we need? Aim of this FP7-project - Development and proof of principle new solutions for ▪non-invasive, real-time, in-vivo monitoring ▪quantitative imaging ▪precise dose quantification ▪feedback to treatment planning ▪ real-time feedback to IGRT for moving organs - Preserve the leading European position in the field ENLIGHT, ESF Workshop-Oxford

  18. ENLIGHT MeetingNovel Imaging Systems WP1: Time-of-flight in-beam PET (F. Sauli, M. Rafecas) WP2: In-beam single particle tomography (W. Enghardt, D. Dauvergne) WP3: PT in-vivo dosimetry and moving target volumes(K. Parodi, G. Baroni) WP4: The combination of in-vivo dosimetry, treatment planning, and clinical relevance (D. Georg, B. Jones) WP5: Monte Carlo Simulation of in-vivo dosimetry (I. Buvat? , G. Battistoni) ENLIGHT, ESF Workshop-Oxford

  19. ENLIGHT MeetingNovel Imaging Systems WP1: Time-of-flight in-beam PET (TERA, INFN, IFIC/CSIC, IN2P3, OncoRay, CERN, PoliAnnecy, Oxford) WP2: In-beam single particle tomography (TERA, IBA, ICX, IFIC/CSIC, In2P3,Etoile,OncoRay) WP3: PT in-vivo dosimetry and moving target volumes(GSI, HIT , Oncoray, PoliMilano, Oxford, IBA, Etoile, IFIC/CSIC, INFN,TERA, Siemens?, Marburg?) WP4: The combination of in-vivo dosimetry, treatment planning, and clinical relevance (BHTC, MUVienna, Oxford, INFN, Siemens, Etoile, Marburg) WP5: Monte Carlo Simulation of in-vivo dosimetry (CERN, INFN, Ciemat, IFIC, PoliAnnecy, HIT, OncoRay, IN2P3, Etoile, IBA) ENLIGHT, ESF Workshop-Oxford

  20. FIRST LIST SECOND LIST TERA INFN IFIC/CSIC IN2P3 OncoRay CERN PoliAnnecy Oxford IBA ICX Etoile GSI HIT PoliMilano Siemens Marburg BHTC MUVienna Ciemat -------------- TERA/CNAO/PoliMilano/UBern INFN IFIC-CSIC/Ciemat IN2P3/CEA? OncoRay CERN Oxford IBA ICX Etoile/PoliAnnecy/Archade? GSI HIT/Marburg Siemens BHTC MUVienna ------------------ Manjit Dosanjh ENLIGHT, ESF Workshop-Oxford 2.9.2008

  21. Conclusions ENLIGHT++ continues to catalyse • Common interdisciplinary environment • Creation of maximum possible uniformity • Inter-facilities uniformity and comparison • Ease of exchange of information. • Harmonization of data………….. ENLIGHT, ESF Workshop-Oxford

  22. Outlook • Particle therapy will cover the full spectrum of radiotherapeutical indications • One particle therapy facility for 10 million inhabitants • Treatments will be fully accepted by the health insurance systems ENLIGHT, ESF Workshop-Oxford

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