European developments in radiotherapy with beams of large radiobiological effectiveness.

This paper reviews the European activities in the field of tumour therapy with beams which have a Radio Biological Effectiveness (RBE) larger than 1. Initially neutron beams have been used. Then charged pions promised better cure rates so that their use was pursued in the framework of the ;Piotron' project at the Paul Scherrer Institute (Switzerland). However both approaches did not meet the expectations and in the 80s the EULIMA project became the flagship of these attempts to improve the effects of the delivery of radiation doses of large RBE with respect to photons, electrons and even protons. The EULIMA ion accelerator was never built and it took more than ten years to see the approval, in Heidelberg and Pavia, of the construction of the HIT and CNAO ;dual' centres for carbon ions and protons. In 2008 they will start treating patients. The developments that brought to these construction projects are described together with the special features of these two facilities. The third European dual centre is being built by Siemens Medical Systems in Marburg, Germany, while other facilities have been approved but not yet fully financed in Wiener Neustadt (Austria), Lyon (France) and Uppsala (Sweden). Finally the collaboration activities of the European Network ENLIGHT are presented together with the recent involvements of European industries in the construction of turn-key dual centres and the development of a new accelerator concept for hadrontherapy, the ;cyclinac'.

[1]  Manjit Dosanjh,et al.  Status of hadron therapy in Europe and the role of ENLIGHT , 2007 .

[2]  C. Tobias.  Pretherapeutic investigations with accelerated heavy ions. , 1973, Radiology.

[3]  J. Heimans,et al.  Radiologic findings in patients treated with boron neutron capture therapy for glioblastoma multiforme within EORTC trial 11961. , 2005, International journal of radiation oncology, biology, physics.

[4]  U. Studer,et al.  Late results in patients treated with Pi‐mesons for bladder cancer , 1993, Cancer.

[5]  Hans Blattmann,et al.  Tumor therapy with heavy charged particles , 2008 .

[6]  M. Scholz,et al.  Calculation of Heavy Ion Inactivation Probabilities Based on Track Structure, X Ray Sensitivity and Target Size , 1994 .

[7]  D. Schardt,et al.  Magnetic scanning system for heavy ion therapy , 1993 .

[8]  Oliver Jäkel,et al.  Results of carbon ion radiotherapy in 152 patients. , 2004, International journal of radiation oncology, biology, physics.

[9]  J. Castro.  Heavy Ion Therapy: Bevalac Epoch , 1993 .

[10]  J. H. Lawrence,et al.  A Preliminary Report on the Use of Fast Neutrons in the Treatment of Malignant Disease1 , 1940 .

[11]  Michael Benedikt,et al.  `Riesenrad’ ion gantry for hadrontherapy: Part III☆ , 1999 .

[12]  L. Sabatier,et al.  Assessment of DNA damage induced by high-LET ions in human lymphocytes using the comet assay. , 2000, Mutation research.

[13]  Daniele Davino,et al.  LIBO—a linac-booster for protontherapy: construction and tests of a prototype , 2004 .

[14]  Koji Noda,et al.  DEVELOPMENT FOR NEW CARBON CANCER-THERAPY FACILITY AND FUTURE PLAN OF HIMAC , 2006 .

[15]  H. Blosser,et al.  Design study of a superconducting cyclotron for heavy ion therapy , 2002 .

[16]  U. Ratzinger,et al.  The IH-structure and its capability to accelerate high current beams , 1991, Conference Record of the 1991 IEEE Particle Accelerator Conference.

[17]  E. Pedroni,et al.  The 200-MeV proton therapy project at the Paul Scherrer Institute: conceptual design and practical realization. , 1995, Medical physics.

[18]  Eros Pedroni,et al.  Treating Cancer with Protons , 2002 .

[19]  Michael Benedikt,et al.  Optical design of a beam delivery system using a rotator , 1996 .

[20]  M Raju,et al.  Heavy Particle Radiotherapy , 1980 .

[21]  T. Haberer,et al.  Die Konzeption der Heidelberger Ionentherapieanlage HICAT , 2004 .

[22]  Wolfgang Enghardt,et al.  The spatial distribution of positron-emitting nuclei generated by relativistic light ion beams in organic matter , 1992 .

[23]  M Goitein,et al.  The relative costs of proton and X-ray radiation therapy. , 2003, Clinical oncology (Royal College of Radiologists (Great Britain)).

[24]  J. Debus,et al.  The application of PET to quality assurance of heavy-ion tumor therapy , 1999, Strahlentherapie und Onkologie.

[25]  S Rossi,et al.  Characteristics of a betatron core for extraction in a proton-ion medical synchrotron , 1997 .

[26]  Michael Benedikt,et al.  A NEW CONCEPT FOR THE CONTROL OF A SLOW- EXTRACTED BEAM IN A LINE WITH ROTATIONAL OPTICS, PART II* , 1999 .

[27]  Mayer Ramona,et al.  Epidemiological aspects of hadron therapy: A prospective nationwide study of the Austrian project MedAustron and the Austrian Society of Radiooncology (OEGRO) , 2004 .

[28]  F. J. M. Farley,et al.  Feasibility studies of the EULIMA Light Ion Medical Accelerator , 1992 .

[29]  Anders Brahme,et al.  Design of a centre for biologically optimised light ion therapy in Stockholm , 2001 .

[30]  S. Sato,et al.  PROPOSAL FOR CARBON-BEAM FACILITY FOR THE CANCER THERAPY IN JAPAN , 2004 .

[31]  M Scholz,et al.  Treatment planning for heavy-ion radiotherapy: calculation and optimization of biologically effective dose. , 2000, Physics in medicine and biology.

[32]  F. Ballarini,et al.  Models of chromosome aberration induction: an example based on radiation track structure , 2004, Cytogenetic and Genome Research.

[33]  H. Kawai,et al.  Global spill control in RF-knockout slow-extraction , 2004 .

[34]  M Crescenti.  RF empty bucket channelling combined with a betatron core to improve slow extraction in medical synchrotrons , 1998 .

[35]  M Scholz,et al.  RBE for carbon track-segment irradiation in cell lines of differing repair capacity. , 1999, International journal of radiation biology.

[36]  P. Pommier,et al.  A "one-day survey": as a reliable estimation of the potential recruitment for proton- and carbon- ion therapy in France. , 2004, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[37]  W. Gläser,et al.  The new neutron source FRM II , 2002 .

[38]  Michael Benedikt,et al.  Proton-Ion Medical Machine Study (PIMMS), 1 , 1999 .

[39]  Anders Brahme,et al.  Recent advances in light ion radiation therapy. , 2004, International journal of radiation oncology, biology, physics.

[40]  Mikael Karlsson,et al.  Number of patients potentially eligible for proton therapy , 2005, Acta oncologica.

[41]  M Pugliese,et al.  Inactivation of human normal and tumour cells irradiated with low energy protons. , 2000, International journal of radiation biology.

[42]  A. Wambersie,et al.  Proceedings of the EULIMA workshop on the potentical value of light ion beam therapy held in : Centre Antoine-Lacassagne Nice-France November 3-5, 1988 , 1989 .

[43]  Nzhde Agazaryan,et al.  The biological effectiveness of antiproton irradiation. , 2006, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[44]  M. Torikoshi,et al.  Diagnostic imaging by energetic radioactive particle beams: applications in Bragg Peak cancer therapy. , 1997, Nuclear physics. A.

[45]  J. Loeffler,et al.  Proton Beam Radiation Therapy , 2006, Cancer investigation.

[46]  Roberto Orecchia,et al.  Medical aspects of the National Centre For Oncological Hadrontherapy (CNAO-Centro Nazionale Adroterapia Oncologica) in Italy. , 2004, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[47]  G. Cuttone,et al.  A novel superconducting cyclotron for therapy and radioisotope production , 2006 .