ENLIGHT: THE EUROPEAN NETWORK FOR LIGHT ION HADRON THERAPY

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Nuovi approcci per la adroterapia basati su 100 anni di radioterapia e collaborazione. New approaches for Hadron Therapy leveraging 100 years of Radiotherapy and collaboration

ItLa lotta contro il cancro è una priorità assoluta per la nostra società. In particolare, c'è un urgente bisogno di sviluppare terapie contro il cancro che possano curare tumori altrimenti difficili da trattare. Oggigiorno circa il 50% dei pazienti riceve la radioterapia (RT) come parte del trattamento. L'utilizzo di fasci di particelle accelerate, protoni, ioni carbonio e altri ioni - adroni carichi - per trattare i tumori è la prossima frontiera nella lotta contro questa malattia. In adroterapia (in inglese Hadron Therapy, HT), chiamata anche terapia con particelle, terapia con fasci di ioni, i tumori vengono irraggiati con ioni da 70 a 430 MeV/u. Nonostante i 250 mila pazienti già trattati in tutto il mondo con protoni e 40 mila con ioni carbonio, l'HT è ancora un campo giovane e sono necessarie ulteriori ricerche e tecnologie di accelerazione nuove, economiche e compatte per rendere questa terapia più prontamente disponibile per tutti.EnThe battle against cancer is a top priority for our society. In particular, there is an urgent need to develop cancer therapies that can kill tumours otherwise difficult to treat. Nowadays about 50% of the cancer patients receive radiotherapy (RT) as part of their treatment. Employing beams of accelerated particles, protons, carbon, and other ions - charged hadrons - to destroy tumours is the next frontier in fighting this disease. In Hadron Therapy (HT) - also called Particle Therapy, Ion Beam Therapy - tumours are irradiated with 70-430 MeV/u ions. Despite the 250,000 patients already treated worldwide with protons and 40,000 with carbon ions, HT is still a young field and more research as well as novel, cost-effective and compact accelerator technologies are needed to make this therapy more readily available to all

South East European International Institute for Sustainable Technologies (SEEIIST)

The South East European International Institute for Sustainable Technologies (SEEIIST) was proposed in 2016 at the World Academy of Art and Science, with the objective of building a facility for charged particle cancer therapy for the South Eastern European countries. SEEIIST will offer the world-class research needed to reduce or even revert the brain drain that is causing a shortage of talent and economic losses in South East Europe. There is no particle therapy in South-East Europe in spite of a growing number of cancers being diagnosed. The facility beam time will be shared 50:50 between treating patients and performing research with a wide spectrum of different light ions beyond the presently used protons and carbon ions, which will make the facility unique in the world. SEEIIST Project is presently in a Conceptual to a Design Phase, implemented with the support of the EU and the involvement of CERN and GSI. The next phase of the project realization will include a final technical design for the facility, a structure and a business plan for the organization and the definition of conditions for the site selection

Phase I/II trial evaluating carbon ion radiotherapy for the treatment of recurrent rectal cancer: the PANDORA-01 trial

<p>Abstract</p> <p>Background</p> <p>Treatment standard for patients with rectal cancer depends on the initial staging and includes surgical resection, radiotherapy as well as chemotherapy. For stage II and III tumors, radiochemotherapy should be performed in addition to surgery, preferentially as preoperative radiochemotherapy or as short-course hypofractionated radiation. Advances in surgical approaches, especially the establishment of the total mesorectal excision (TME) in combination with sophisticated radiation and chemotherapy have reduced local recurrence rates to only few percent. However, due to the high incidence of rectal cancer, still a high absolute number of patients present with recurrent rectal carcinomas, and effective treatment is therefore needed.</p> <p>Carbon ions offer physical and biological advantages. Due to their inverted dose profile and the high local dose deposition within the Bragg peak precise dose application and sparing of normal tissue is possible. Moreover, in comparison to photons, carbon ions offer an increase relative biological effectiveness (RBE), which can be calculated between 2 and 5 depending on the cell line as well as the endpoint analyzed.</p> <p>Japanese data on the treatment of patients with recurrent rectal cancer previously not treated with radiation therapy have shown local control rates of carbon ion treatment superior to those of surgery. Therefore, this treatment concept should also be evaluated for recurrences after radiotherapy, when dose application using conventional photons is limited. Moreover, these patients are likely to benefit from the enhanced biological efficacy of carbon ions.</p> <p>Methods and design</p> <p>In the current Phase I/II-PANDORA-01-Study the recommended dose of carbon ion radiotherapy for recurrent rectal cancer will be determined in the Phase I part, and feasibilty and progression-free survival will be assessed in the Phase II part of the study.</p> <p>Within the Phase I part, increasing doses from 12 × 3 Gy E to 18 × 3 Gy E will be applied.</p> <p>The primary endpoint in the Phase I part is toxicity, the primary endpoint in the Phase II part is progression-free survival.</p> <p>Discussion</p> <p>With conventional photon irradiation treatment of recurrent rectal cancer is limited, and the clinical effect is only moderate. With carbon ions, an improved outcome can be expected due to the physical and biological characteristics of the carbon ion beam. However, the optimal dose applicable in this clincial situation as re-irradiation still has to be determined. This, as well as efficacy, is to be evaluated in the present Phase I/II trial.</p> <p>Trial registration</p> <p><a href="http://www.clinicaltrials.gov/ct2/show/NCT01528683">NCT01528683</a></p

Collaboration: The Force That Makes the Impossible Possible

Over the last three decades, the landscape of cancer treatment with radiotherapy has never stopped improving. ENLIGHT – the European Network for Light Ion Hadron Therapy – has been an active participant in the huge changes that have taken place, in particular in Europe. At the end of the 90s when I arrived at CERN, it appeared clear that an improvement in communication, sharing and exchange, while keeping a common goal, was needed to bring together international experts from accelerator physics, imaging, medical physics, radiobiology and clinical medicine. ENLIGHT network was most aptly launched at CERN, since CERN is renowned as a place for global collaboration. The network has come a long way since the kick-off meeting at CERN in 2002 when only about 70 specialists from different disciplines took part and continues to grow and flourish with now over 1000 participants, accounting for over 100 institutions, from around 40 countries around the globe