Review of clinical experience with ion beam radiotherapy

Abstract

ABSTRACT. The article describes both the early development of oncology as a core discipline at the University of Heidelberg Hospital and the first steps towards ion beam treatment, from the pilot project carried out in co-operation with the Gesellschaft fü r Schwerionenforschung Darmstadt to the initial start-up of clinical service at the Heidelberg Heavy Ion Centre (HIT). We present an overview, based on data published in the literature, of the available clinical evidence relating the use of ion beam therapy to treat major indications in active particle centres. A rationale for the use of particle therapy in each of these indications is given. In view of the limited availability of data, we discuss the necessity to conduct clinical trials. We also look forward towards the next activities to be undertaken at the HIT.

Alpha Particle Emitter Radiolabeled Antibody for Metastatic Cancer: What Can We Learn from Heavy Ion Beam Radiobiology?

“…Modern day interest in heavy ion beam therapy has led to a number of new centers, including the Hyogo Ion Beam Medical Center (2002) and the Gunma Heavy Ion Medical Center (2010) in Japan and the Heidelberg Ion-Beam Therapy (HIT, 2009) in Germany as well as several other facilities under construction in Australia, Italy and China [14]. Most of these proton and carbon ion beams are for the treatment of locally advanced tumors or in the regions that are difficult to operate or treat by other treatment modalities, such as uveal melanoma, head and neck cancer, bone cancer, advance prostate cancer, and inoperable lung cancer [15,16]. The radiobiological basis of such treatments was first established in the 1960s mainly by Barendsen and more recently studied in light of the molecular mechanisms underlying DNA damage responses to high LET radiation.…”

Sarcomas

“…In several series from different particle therapy centers in North America, Europe, and Japan, favorable local control rates could be achieved with radiation treatment employing protons, helium, or carbon ions. For skull base chordomas, 5-year local control rates of 60-80 % are reported, which are lower than for chondrosarcomas at this site but better than the average outcome for skull base chordoma reported in the literature (Munzenrider and Liebsch 1999 ;Noel et al 2001 ;Schulz-Ertner et al 2007a ;Jensen et al 2011 ;Ares et al 2009 ). A recent meta-analysis on skull base chordomas treated with surgery and adjuvant radiotherapy considered 23 observational studies published between 1999 and 2010 including 807 patients (Di Maio et al 2011 ).…”

“…The prognosis is exceptionally poor with rapid progression into metastatic disease. Data for a benefi cial effect of chemotherapy or radiation therapy on prognosis is lacking (Inwards and Hogendoorn 2013 ).…”

“…Dedifferentiated chondrosarcomas often show an "enchondroma-like" component as well as an aggressive component with cortical destruction on plain radiographs, refl ecting the histologic bimorphism of this entity (Inwards and Hogendoorn 2013 ). On MR imaging, the welldifferentiated component presents the typical features of a chondrogenic tumor, whereas the dedifferentiated component shows intermediate to low instead of high signal intensity on T2-weighted images and diffuse instead of peripheral enhancement following intravenous contrast administration.…”

Test bench to commission a third ion source beam line and a newly designed extraction system

“…1) with carbon ions and protons. 1 The increasing interest in the treatment with helium ions, especially for paediatric tumours, in addition with the requirement for fast switching between carbon ions, protons, and helium ions triggered the design of a third independent spectrometer line and a new ion source.…”