Presentation is loading. Please wait.

Presentation is loading. Please wait.

Collaboration UMC St Radboud - RISO

Published byRebekah Walter Modified over 10 years ago

Similar presentations

Presentation on theme: "Collaboration UMC St Radboud - RISO"— Presentation transcript:

1 Collaboration UMC St Radboud - RISO
André Minken Collaboration UMC St Radboud - RISO

2 Highlights Approach project team Report/conclusions project team
Time frame CPAC Indications and number(s) of patients

3 Advantages proton therapy
Proton dose distribution is highly conformal Integral dose reduces by a factor of 2 to 3 No exit dose Sharp penumbra (until ±17cm)‏ Protons are direct ionizing ‏ 3

4 initiatives in: Groningen, Maastricht, West-Nederland

5 Proton Therapy Center – MD Anderson CC, Houston
PTC-H 3 Rotating Gantries 1 Fixed Port 1 Eye Port 1 Experimental Port Pencil Beam Scanning Port Passive Scattering Ports Experimental Port Accelerator System Hitachi, Ltd. M. Bues (MDACC)‏ Large Field Fixed Eye Port

6 Single room solution

7 initiatives in: Groningen, Maastricht, West-Nederland

8 initiatives in: Groningen, Maastricht, West-Nederland
Protons in Eastern part of the Netherlands

9 Contact CPAC RISO 2008 RISO internal discussion
Possibilities and pitfalls State of the art proton therapy

10 ”RISO will not succeed on its own…”
Internal meeting RISO 2008 ”RISO will not succeed on its own…” Collaboration with academic partner in the Eastern part of the Netherlands Second step: extension to other participants Contact with UMC St.Radboud (june 2009): installation of project team

11 Proton treatment in East of the Netherlands
Project team Proton treatment in East of the Netherlands Paul Bouma,RTO RISO, o.a. Head and neck oncology Jan Bussink, RTO UMCN, o.a. Pulmonary oncology Geert Jansssens, RTO UMCN, o.a. Pediatric oncology Hans Kaanders, RTO UMCN Karin Muller, RTO RISO, o.a. GE oncology Henk Huizenga, head Med Phys UMCN Martina Kunze-Busch. Med Phys UMCN Martijn Kusters, Med Phys resident UMCN André Minken, head Med Phys RISO René Monshouwer, Med Phys UMCN Rik Westendorp, Med Phys RISO

12 Agenda project team Juli 3, 2009, Nijmegen Agenda:
kick-off meeting Huizenga, Monshouwer en Minken discussion on subjects and timeframe September 28, 2009, Deventer, guest dr. M. Engelsman, head of medical physics Francis H. Burr protoncentrum in Boston. Introduction (dr. A. Minken)‏ Radiotherapy planning of protons, (dr. M. Engelsman)‏ Dosimetrical aspects of protonplanning (dr. H. Huizenga)‏ Indications (K. Muller)‏

13 December 4, 2009 Nijmegen Agenda: Background protonaccelerators (dr. M. Kusters)‏ Concept Dielectric Wall Accelerator (dr. R. Monshouwer)‏ Overview of national timeframe (dr P. Bouma)‏ Boston visit, highlights (dr G. Janssens)‏ Februari 12, 2010 protoncourse Leiden All aspects of “conventional” protonfacilities Februari 17, 2010 visit CPAC Deventer Prof. R. Mackie, S. Guse en G. Oliveira DWA-protonaccelerator: technical steps Product development: timeframe

14 Report: UMC St. Radboud - RISO in april 2010
June 2010, Nijmegen, Regional meeting September 2010, Nijmegen, National meeting

15 Conclusions report Feasible, critical evaluation of resources, comparison with photon techniques Collaboration State of the art Indications Number of patients Scientific input: universities Nijmegen and Twente

16 State of the art techniques
Comparison with IMRT not 3D-CRT Pretreatment imaging on high level Set up and fixation Imaging on treatment machine IMPT (active scanning)‏ Learn from experienced users Patching around OARs Movement compensation Fixations Treatment planning techniques 16

17 Comparison with IMRT not 3D-CRT Proton therapy, a small step ahead?
Source: Anthony J. Lomax et al. Radiotherapy and Oncology 51 (1999)

18 Target delineation Pretreatment imaging on high level
Steenbakkers et al. Radiother Oncol ; 77:182-90 Upstream / downstream / field combination PProtons: Reduced proximal and zero distal dose T 18

19 IMPT (active scanning)‏
Passive scattering Spot scanning

20 CPAC timeframe fixed beam 120-150 MeV (2013)‏
+3 years gantry based systeem 200 MeV

21 “Signalement Gezondheidsraad” Proton treatment Indications
Standard Potential Model based Reduction of second malignancies Standaardindicaties, zoals de zojuist genoemde oogmelanomen, schedelbasistumoren en kindertumoren. Potentiele indicaties, waarbij door dosisescalatie een betere tumorcontrole gegeven kan worden. Onderverdeeld in een groep waarin er nu geen ERT mogelijk is en een groep waarbij er RCT nodig zijn. PAB gaat hier zometeen veel verder op in. Op modellen gebaseerde indicaties, waarbij het gaat om de bijwerkingen te verminderen 21

22 Signalement Proton treatment Potential indications
Als er nu onvoldoende klinisch bewijs is en RCT niet de meeste geschikte methode is om het nut aan te tonen, hoe dan te werk? Definieren van groepen die baat zouden kunnen hebben bij protonen Deze indicaties in de klinische praktijk te evalueren POO: vergelijken met historische controles 22

23 Region: Eastern part of the Netherlands
Number of patients Region: Eastern part of the Netherlands patient population: 16% of the Netherlands Start with Fixed-beam MeV End situation rotating 200 MeV beam

24 Number of Patients 120 – 150 MeV 200 MeV RCT’s Standard 57 Potential 8
10 187 Model based 284 655 Second malignancies 101 117 450 839 1016

25 Conclusions CPAC offers a potential chance for proton therapy in the eastern part of the Netherlands at reasonable costs Collaboration RISO & UMC St. Radboud MST ARTI Isala klinieken Scientific input universities Nijmegen and Twente

26 In het tijdschrift Medische oncologie stond een artikel over protonentherpaie wat afsloot met de opmerking dat er nu een goedkopere versneller in aantocht was met maar 1 gantry die geschikt is voor relatief dunbevolkte gebieden. Een mooie introduktie voor ons beleidsplan. 26

27

28 Tumormovement 10 D C B A Setup Error move ment
C B A Setup Error move ment Isodoses: 50%, 80%, 95% en 100% Courtesy of M. Engelsman

29 Spread-Out Bragg Peak (SOBP)‏ (poor rich man’s IMRT)‏
Raw Bragg Peak (RBP)‏ Spread-Out Bragg Peak (SOBP)‏ (poor rich man’s IMRT)‏ 5 mm Dose Dose 20 MeV = 0.5 cm 100 MeV = 9 cm 200 MeV = 30 cm Depth Depth 29 29

30 Photon versus Proton + Less dose + Skin sparing 30 30

31

32

33 4 groepen indicaties Standaard indicaties Potentiële indicaties
Rapport GR 4 groepen indicaties Standaard indicaties Potentiële indicaties Op modellen-gebaseerde indicaties Verkleining van het risico op secundaire tumoren

Download ppt "Collaboration UMC St Radboud - RISO"

Similar presentations

Cirrone G. A. P. , Cuttone G. , Raffaele L. , Sabini M. G

Cirrone G. A. P. , Cuttone G. , Raffaele L. , Sabini M. G
Motion in Radiotherapy

Motion in Radiotherapy
Dept of Radiation Oncology MGH

Dept of Radiation Oncology MGH
Monte Carlo Based Implementation of an Energy Modulation System for Proton Therapy G.A.P. Cirrone Qualified Medical Physicist PhD Laboratori Nazionali.

Monte Carlo Based Implementation of an Energy Modulation System for Proton Therapy G.A.P. Cirrone Qualified Medical Physicist PhD Laboratori Nazionali.
A Symposium on a new development of Proton Radiotherapy Nijmegen, September 17th, 2010 We want to contribute to optimal treatments for patients close to.

A Symposium on a new development of Proton Radiotherapy Nijmegen, September 17th, 2010 We want to contribute to optimal treatments for patients close to.
RapidArc plan verification using ArcCHECK™

RapidArc plan verification using ArcCHECK™
Energy deposition and neutron background studies for a low energy proton therapy facility Roxana Rata*, Roger Barlow* * International Institute for Accelerator.

Energy deposition and neutron background studies for a low energy proton therapy facility Roxana Rata*, Roger Barlow* * International Institute for Accelerator.
Experience, Expertise and a Commitment to Excellence™

Experience, Expertise and a Commitment to Excellence™
Slice Thickness Interpolation: The effect of interpolated slice thickness on the 2D vs 3D gamma results are shown in Table 3 for the QA data set only.

Slice Thickness Interpolation: The effect of interpolated slice thickness on the 2D vs 3D gamma results are shown in Table 3 for the QA data set only.
Anatomy-based MLC Field Optimization for the Treatment of Gynecologic Malignancies Myriam Bouchard M.D. Nadeau S, Germain I, Raymond P.E., Harel F, Beaulieu.

Anatomy-based MLC Field Optimization for the Treatment of Gynecologic Malignancies Myriam Bouchard M.D. Nadeau S, Germain I, Raymond P.E., Harel F, Beaulieu.
PAUL SCHERRER INSTITUT Future directions and current challenges of proton therapy Tony Lomax, Oxford, 2008 Future directions and current challenges of.

PAUL SCHERRER INSTITUT Future directions and current challenges of proton therapy Tony Lomax, Oxford, 2008 Future directions and current challenges of.
University of Florida, Jacksonville, FL

University of Florida, Jacksonville, FL
Para-spinal Tumors Encircling the Spinal Cord IMRT Comparison of Several Target Definitions.

Para-spinal Tumors Encircling the Spinal Cord IMRT Comparison of Several Target Definitions.
Targeting Issues For Proton Treatments Of The Prostate SJ Rosenthal Ph.D., JA Wolfgang Ph.D., Sashi Kollipara Department of Radiation Oncology Massachusetts.

Targeting Issues For Proton Treatments Of The Prostate SJ Rosenthal Ph.D., JA Wolfgang Ph.D., Sashi Kollipara Department of Radiation Oncology Massachusetts.
Lotte Verbunt Investigation of leaf positioning accuracy of two types of Siemens MLCs making use of an EPID.

Lotte Verbunt Investigation of leaf positioning accuracy of two types of Siemens MLCs making use of an EPID.
Part 1 Introduction to Radiotherapy and External Beam Radiation Deepak Khuntia, MD Vice President, Medical Affairs Varian Medical Systems.

Part 1 Introduction to Radiotherapy and External Beam Radiation Deepak Khuntia, MD Vice President, Medical Affairs Varian Medical Systems.
Stereotactic Body Radiation Therapy (SBRT): The optimal indication for operable tumors in inoperable patients D.Katsochi 1, S.Kosmidis 1, A.Fotopoulou.

Stereotactic Body Radiation Therapy (SBRT): The optimal indication for operable tumors in inoperable patients D.Katsochi 1, S.Kosmidis 1, A.Fotopoulou.
Volumetric Modulated Arc Therapy (VMAT)

Volumetric Modulated Arc Therapy (VMAT)
TWO FIELD BREAST PLAN VS. OPTIMIZED CONFORMAL BREAST PLAN: COMPARISON OF PLAN PARAMETERS Authors: Borko Basarić, Ozren Čudić, Milan Teodorović, Borislava.

TWO FIELD BREAST PLAN VS. OPTIMIZED CONFORMAL BREAST PLAN: COMPARISON OF PLAN PARAMETERS Authors: Borko Basarić, Ozren Čudić, Milan Teodorović, Borislava.
A (Quick) Survey of (Some) Medical Accelerators Dr. Todd Satogata Brookhaven National Laboratory SUNY Stony Brook PHY 684 – September 5, 2007  The NASA.

A (Quick) Survey of (Some) Medical Accelerators Dr. Todd Satogata Brookhaven National Laboratory SUNY Stony Brook PHY 684 – September 5, 2007  The NASA.

Similar presentations

Ads by Google