1. The Australian Hadron Therapy and Research Facility

2. Cancer Statistics About one third of us will have cancer About one third of us will have cancer About two thirds of cancers are in people over 65 About two thirds of cancers are in people over 65 Source CRUK

3. Cancer - Information Cancer is a very threatening condition but there have been great advances in therapy Cancer is a very threatening condition but there have been great advances in therapy “ Radiotherapy remains a mainstay in the treatment of cancer. Comparison of the contribution towards cure by the major cancer treatment modalities shows that of those cured, 49% are cured by surgery, 40% by radiotherapy and 11% by chemotherapy”. RCR document BFCO(03)3, (2003). Thanks to Roger Dale

4. Aim for Tumor Control: Deliver sufficiently high dose to the tumor so as to Deliver sufficiently high dose to the tumor so as to destroy it Maintain the dose to the surrounding healthy tissues Maintain the dose to the surrounding healthy tissues within such limits so that they do not undergo serious or even irreversible damage or complications Radiation and Hadron Therapy Possible technologies for Tumor Control Electromagnetic Radiation – X-rays, Gamma Rays, Bremsstrahlung Protons Light Ions – Li 6, C 12, O 16, Ne 20

5. A comparison of the physical interaction of Carbon beams, He beams, Proton beams and traditional X-rays.

7. Radio Biological Effectiveness

13. Ocular Melanoma

14. Patients During Treatment - Hyogo

15. Status Today, more than 120,000 patients have been treated with hadron beams!! Centres in operation or under constructions USA12 in operation, 13 under development Germany4 France1 Switzerland1 Italy2 Sweden2 UK2 Austria1 under construction Canada1 Japan5 China1, 1 under construction South Africa1 AustraliaNIL

16. High Performance Hadron Therapy Centres with Carbon and Proton beams Heidelberg Ion Therapy, Germany Marburg, Germany CNAO, Pavia, Italy MedAustron, Wiener Neustadt, Austria Shanghai Hyogo Ion Beam Medical Centre HIMAC, Chiba Gunma University Heavy Ion Medical Centre

17. Specifications for the Ion Beams from the Accelerator Maximum penetration depth in the human body of approximately 32 cm Minimum penetration depth of 3.5 cm Sufficient current to provide 2 grays of radiation to a targeted tumour in about 2 – 3 minutes. With these principal requirements the hadron beams must be variable in energy for C 12 beams,120 - 430 MeV/u and for protons, 60 - 250 MeV beam currents of 0.1 – 6 mA (p) and 0.03 – 1.5 mA (C) treatment beam sizes 4 to 10 mm 2 (H and V) capable of raster scanning, to 20 ×20 cm 2 (H and V).

18. Generic and Comprehensive Design by CERN

21. CNAO – Synchrotron and Injection System

22. Characteristics of the Synchrotron based on PIMMS

24. Third Order Resonance Extraction Q h = 1.6667 Cycle ≥ 1 s Spill Time ≥ 0.1 s The key is uniform current within extracted beam

25. MedAustron Notes Synchrotron is the same as CNAO External ion sources Proposed treatment rooms different for Australia Complex above would butt up against a major hospital Novel shielding design to be utilised

27. Kiel Facility, Shanghai, Marburg

28. The revised treatment rooms (proposed) are as follows :- Treatment room 1 would have horizontal proton and carbon beams Treatment room 2 would have the same Treatment room 3 would have horizontal and vertical proton and carbon beams Treatment room 4 would initially be provided for research but ultimately would utilise a superconducting proton carbon gantry when this technology is established. Treatment Rooms A proton gantry is not in the first installation

29. Optics for the vertical beamline

30. Scanning Magnets and Beam Monitors

31. FacilityPerson Years Australian Synchrotron230 MedAustron240 CNAO324 HIT80 Prospective Australian Hadron240 Table 5 Comparison of Construction Staff Numbers

32. ItemMedAustronCNAOHITAus HadronAus Syn Accelerator$95 M$106 M $90 M Medical$21 M$14 M $15 M Supplementary $2.4 M $22 M Buildings$80 M$69 M$42 M$76 M Staff$30 M$47 M $30 M Total$225 M $160 M$234 M$157 M Table 6Costs of Construction MedAustron costs are current values CNAO have been inflated to present day values HIT costs are original – about 2007 Australian Synchrotron costs are for the accelerators, buildings and staff but not the beamlines Equipment costs such as magnets become less expensive with time

33. Ion source linacsynchrotronbeam lines + gantry PIMMS Proton Ion Medical Machine Study β - 3 Our Partners

34. Operational Details The facility is capable of 20,000 fractions per year Currently for combined carbon/proton facilities there is an average requirement per patient of approximately 18 fractions in Europe, 13 in Japan Annual patient numbers are therefore at this time 1100 The Japanese are reducing required fractions numbers therefore annual numbers may increase The anticipated charge per patient for a complete treatment is $35,000 Annual operating costs are $23 M

35. Australian Patient Numbers 600 Australian patients per year with no other option 50 paediatric patients per year 90% of the total would have some benefit but of these 4000 patients per year would have better outcomes with either carbon or proton beams Of the 40,000 Australian cancer patients requiring radio therapy each year, there are