Carbon Ion Radiotherapy at the Gunma University Heavy Ion Medical Center: New Facility Set-up

Ohno, Tatsuya; Kanai, Tatsuaki; Yamada, S.; Yusa, K.; Tashiro, Mitsuru; Shimada, Hirofumi; Torikai, Kohei; Yoshida, Yukari; Kitada, Yoko; Katoh, Hiroyuki; Ishii, Takayoshi; Nakano, Takashi

doi:10.3390/cancers3044046

Cited by 105 publications

(83 citation statements)

References 10 publications

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“…In particular, particle therapy has attracted considerable interest, owing to its huge construction, equipment (X‐ray imaging system, CT) maintenance, and staffing costs, and requirement for an accelerator‐equipped treatment machine. We previously developed a carbon ion accelerator which is approximately 60% smaller than that in our center, which is now installed in Gunma University, Japan (25) . Several solutions to these problems have been suggested, the most important of which involve improvements in treatment workflow and direct effects on cost reduction.…”

Section: Discussionmentioning

confidence: 99%

Patient handling system for carbon ion beam scanning therapy

Mori¹,

Shirai²,

Takei³

et al. 2012

J Applied Clin Med Phys

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Our institution established a new treatment facility for carbon ion beam scanning therapy in 2010. The major advantages of scanning beam treatment compared to the passive beam treatment are the following: high dose conformation with less excessive dose to the normal tissues, no bolus compensator and patient collimator/ multi‐leaf collimator, better dose efficiency by reducing the number of scatters. The new facility was designed to solve several problems encountered in the existing facility, at which several thousand patients were treated over more than 15 years. Here, we introduce the patient handling system in the new treatment facility. The new facility incorporates three main systems, a scanning irradiation system (S‐IR), treatment planning system (TPS), and patient handling system (PTH). The PTH covers a wide range of functions including imaging, geometrical/position accuracy including motion management (immobilization, robotic arm treatment bed), layout of the treatment room, treatment workflow, software, and others. The first clinical trials without respiratory gating have been successfully started. The PTH allows a reduction in patient stay in the treatment room to as few as 7 min. The PTH plays an important role in carbon ion beam scanning therapy at the new institution, particularly in the management of patient handling, application of image‐guided therapy, and improvement of treatment workflow, and thereby allows substantially better treatment at minimum cost.PACS numbers: 87.56.‐v; 87.57.‐s; 87.55.‐x

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Section: Discussionmentioning

confidence: 99%

Patient handling system for carbon ion beam scanning therapy

Mori¹,

Shirai²,

Takei³

et al. 2012

J Applied Clin Med Phys

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“…52 More than 100 treatments have been successfully completed and , at present, neither acute nor late Grade 3 morbidities have been observed for 76 patients followed up for at least 6 months.…”

Section: New Facilities In Japan and New Treatment System At Nirsmentioning

confidence: 94%

Carbon‐ion radiation therapy for prostate cancer

Ishikawa

Tsuji²,

Kamada³

et al. 2012

Int J of Urology

104

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Abbreviations & Acronyms ADT = androgen deprivation therapy bNED = biological relapse free C-ion RT = carbon-ion radiotherapy CSS = cause-specific survival CT = computed tomography CTV = clinical target volume 3D-CRT = three-dimensional conformal radiation therapy DVH = dose-volume histogram Fr = fractions GHMC = Gunma Heavy Ion Medical Center GI = gastrointestinal GS = Gleason score GU = genitourinary Gy = gray GyE = gray equivalents HAMT = Highly Advanced Medical Technology HDR = high-dose-rate HIMAC = Heavy-Ion Medical Accelerator in Chiba IMRT = intensity modulated radiotherapy iPSA = initial serum prostate-specific antigen LET = linear energy transfer L/Q = linear-quadratic NIRS = National Institute of Radiological Sciences PSA = prostate-specific antigen PTV1 = initial planning target volume PTV2 = second planning target volume RBE = relative biological effectiveness RT = radiation therapy RTOG = Radiation Therapy Oncology Group SBRT = stereotactic body radiotherapy SOBP = spread-out Bragg peak UICC = Union for International Cancer Control Abstract: In 1994, carbon-ion radiotherapy was started at the National Institute of Radiological Sciences using the Heavy-Ion Medical Accelerator in Chiba. Between June 1995 and March 2000, two phase I/II dose escalation studies (protocols 9402 and 9703) of hypofractionated carbon-ion radiotherapy for both early-and advance-stage prostate cancer patients had been carried out to establish radiotherapy technique and to determine the optimal radiation dose. To validate the feasibility and efficacy of hypofractionated carbon-ion radiotherapy, a phase II study (9904) was initiated in April 2000 using the shrinking field technique and the recommended dose fractionation (66 gray equivalents in 20 fractions over 5 weeks) obtained from the phase I/II studies, and was successfully completed in October 2003. The data from 175 patients in the phase II study showed the importance of an appropriate use of androgen deprivation therapy according to tumor risk group. Since November 2003, carbon-ion radiotherapy for prostate cancer was approved as "Highly Advanced Medical Technology" from the Ministry of Health, Labor, and Welfare, and since then approximately 1100 patients have received carbon-ion radiotherapy as of July 2011. In this review, we introduce our steps thorough three clinical trials carried out at National Institute of Radiological Sciences, and show the updated data of carbon-ion radiotherapy obtained from approximately 1000 prostate cancer patients. In addition, our recent challenge and future direction will be also described.

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“…This unique property provides high local tumor control when used in radiotherapy. Carbon ions directly cleave double-stranded DNA at multiple sites even at low oxygen content, which allows access to hypoxic parts of tumors that would be resistant to low LET radiotherapy [28,29]. However, the dose of those energetic ions needs to be measured with great precision and accuracy, especially, while dealing with human body.…”

Section: Introductionmentioning

confidence: 99%