1. Present & Future of Accelerators for Hadrontherapy A. Faus-Golfe IFIC-IFIMED 10-11 June 20091IFIMED'09 Symposium

2. 2 “Hadrontherapy” is a collective word “hadrons” are made of quarks carbon ion = 6 protons + 6 neutrons atom Proton or neutron quark “u” or “d” electron “e” It covers therapy with beams of particles made of quarks: neutrons protons pions helium, lithium, boron, carbon, oxygen … ions antiprotons 10-11 June 2009IFIMED'09 Symposium

3. The Early years The Present of Hadrontherapy Proton Facilities Ion Facilities The Future and the Dreams Outline 10-11 June 20093IFIMED'09 Symposium

4. The Early years The Present of Hadrontherapy Proton Facilities Ion Facilities The Future and the Dreams Outline 10-11 June 20094IFIMED'09 Symposium

5. The Early years At the beginning most of the patients have been treated in research facilities, where parasitic beams were devoted for relatively short periods to the treatments. Only in the nineties dedicated based facilities have entered in use. 10-11 June 20095IFIMED'09 Symposium

6. 6 Neutrontherapy at Berkeley 1935:Ernest and John Lawrence at the control of the 27-inch cyclotron R. Stone at the 60- inch cyclotron Single dee is 5-inch diameter 10-11 June 2009IFIMED'09 Symposium

7. 7 Protontherapy Hymer Friendell Bob Wilson Percy Bridgeman 1943 - Harvard Founder and first director of Fermilab - 1990 1946 R.R. Wilson proposes the use of protons for teletherapy 1954 First irradiations in Berkeley 1961 New Harvard cyclotron irradiates patients 10-11 June 2009IFIMED'09 Symposium

8. 8 Protontherapy in Europe The modified synchrocyclotron Bőrje Larsson at Uppsala “On the Application of a 185 MeV Proton Beam to Experimental Cancer Therapy and Neurosurgery” Doctoral dissertation - 1962 (1931-1998) 10-11 June 2009IFIMED'09 Symposium

9. 9 Ion therapy – 1974-92 Cornelius Tobias 1918 - 2000 SuperHILAC Bevatron UNILAC 10-11 June 2009IFIMED'09 Symposium

10. 10 30 years of pioneering protontherapy in physics labs Lawrence Berkeley LaboratoryUSA1954 Uppsala Sweden1957 Harvard Cyclotron Laboratory (*)USA1961 Dubna Russia1964 Moscow Russia1969 St. Petersburg Russia1975 Chiba Japan1979 Tsukuba Japan1983 Paul Scherrer InstituteSwitzerland1984 (*) 9,116 patients were treated with protons before the laboratory closes in 2002 10-11 June 2009IFIMED'09 Symposium

11. 11 1992-1994: the turning years 1993 Como, Italy First International Symposium on Hadrontherapy 1992: Loma Linda treats first patient with protons 1993:MGH selects IBA for first commercial centre 1993:At GSI the ‘pilot project’ is approuved 1994: HIMAC treats the first patient with C ions 10-11 June 2009IFIMED'09 Symposium

12. The Early years The Present of Hadrontherapy Proton Facilities Ion Facilities The Future and the Dreams Outline 10-11 June 200912IFIMED'09 Symposium

13. The Present of Hadrontherapy Nowadays proton therapy is a mature field, many firms are competing to offer more and more reliable proton facilities and also the production of accelerators for light-ion therapy is rapidly increasing 10-11 June 200913IFIMED'09 Symposium

14. Hadrontherapy in the world 10-11 June 200914IFIMED'09 Symposium

15. The Present Accelerator Technology  Proton Therapy  Cyclotron based  Synchrotron based  Ion Therapy  Synchroton based 10-11 June 200915IFIMED'09 Symposium

16. The Early years The Present of Hadrontherapy Proton Facilities Ion Facilities The Future and the Dreams Outline 10-11 June 200916IFIMED'09 Symposium

17.  5 companies offer turn-key centres PT center in operation PT is booming 10-11 June 200917 IFIMED'09 Symposium

18. The Accelerator is a very small part of a PT center  A Proton therapy system is much more than an accelerator  It is most often a complex, multi-room treatment system  The treatments rooms are larger than the cyclotron/synchrotron vault  Half of the total investment is for the equipment 10-11 June 200918IFIMED'09 Symposium

19. A typical Cyclotron PT center Cyclotron Irradation systems: Rotating Gantries Irradation systems: Fixed Beam Transport 4 m 10-11 June 200919IFIMED'09 Symposium

20. Cyclotons marked the PT Cyclotron Proton Therapy Centers 10-11 June 200920IFIMED'09 Symposium

21. Cyclotrons for PT  In the 90’s the consensus was that the best accelerator for PT was a synchrotron  However today the majority of the PT centers use the cyclotron technology (IBA, Varian, Still Rivers…)  Over these 15 years, users appreciated the advantages of cyclotrons:  Simplicity  Reliability  Lower cost and size  Most importantly the ability to modulate rapidly and accurately the proton beam current  But fixed energy… 10-11 June 200921IFIMED'09 Symposium

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25. Synchrotrons for PT  Slow Cycle Synchrotron  Variable energy operation  Modified Flat-Top operation  Easy dose management  Relatively low intensity  Some PT centers use the synchrotron technology (Hitachi, Mitsubishi…), but all the IT centers use synchrotron  Possibility of PT/IT with the same accelerator 10-11 June 200925IFIMED'09 Symposium

26. PT/IT centers in Japan based on synchroton H: HITACHI M: MITSUBISHI 10-11 June 200926IFIMED'09 Symposium

27. A typical Synchroton PT center 7 m Courtesy of HITACHI (Slow Cycle) 10-11 June 200927IFIMED'09 Symposium

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31. PT Centers in Europe PSI Villigen CPO Orsay PNPI St. Petersburg NCRH Krakow TSL Uppsala INFN-LNS Catania RPTC Munich WPE Essen Worth mentioning: IFIMED Valencia, ATREP Trento … 10-11 June 200931IFIMED'09 Symposium

32. The Early years The Present of Hadrontherapy Proton Facilities Ion Facilities The Future and the Dreams Outline 10-11 June 200932IFIMED'09 Symposium

33. Synchrotrons for IT  Slow Cycle Synchrotron  Variable energy operation  Modified Flat-Top operation  Easy dose management  Relatively low intensity  All IT centers use the synchrotron technology  Possibility of PT/IT with the same accelerator 10-11 June 200933IFIMED'09 Symposium

34. A typical Synchrotron IT center 22 m 10-11 June 2009 34IFIMED'09 Symposium Courtesy of SIEMENS

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38. IT Centers in Europe HIT Heilderberg CNAO Pavia Med-AUSTRON Viena ETOILE Lyon PTC Marburg NRoCK Kiel Worth mentioning: RPTC-2 Koeln, MAASTRO The Netherlands, BHTC Belgium, Nordic Light Ion Project Sweden… 10-11 June 200938IFIMED'09 Symposium

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41. The Early years The Present of Hadrontherapy Proton Facilities Ion Facilities The Future and the Dreams Outline 10-11 June 200941IFIMED'09 Symposium

42. Cyclotron Alternatives 10-11 June 2009 42 IFIMED'09 Symposium

43. Cyclotron Alternatives The energy can be varied 1-2 ms in the full range by changing the power pulses sent to the 16-22 accelerating modules 10-11 June 2009 43IFIMED'09 Symposium

44. Cyclotron Alternatives Carbon Booster for Therapy in Oncology Cyclinac for Carbon ions 10-11 June 2009 44 IFIMED'09 Symposium

45. Cyclotron Alternatives 10-11 June 2009 45 IFIMED'09 Symposium

46. Synchrotron Alternatives 10-11 June 200946IFIMED'09 Symposium

47. Alternative Accelerators RF Linacs: energy control in the accelerator itself:  S-Band:  ACLIP Side Couple LINAC (3GHz, 20 MeV/m, 30 MeV injection Energy, 62 MeV final energy) INFN Catania  IDRA project (3 GHz, 30 MeV injection Energy) TERA Foundation/ADAM  X-Band:  US High-gradient collaboration (injection energy 70 MeV, 250 MeV final energy) SLAC 10-11 June 200947IFIMED'09 Symposium

48. Alternative Accelerators 10-11 June 2009 48 IFIMED'09 Symposium

49. Alternative Accelerators Dielectric Wall Accelerators 10-11 June 2009 49 IFIMED'09 Symposium

50. Alternative Accelerators 10-11 June 200950IFIMED'09 Symposium

51. Alternative Accelerators 10-11 June 200951IFIMED'09 Symposium

52. Thanks for your attention I acknowdledge: U. Amaldi, T. Haberer, S. Peggs, Y. Jongen, K. Noda, L. Calabretta, V. Vaccaro, A.Sessler, S. Rossi…. for supplying most of the material that I have used for this talk. 10-11 June 200952IFIMED'09 Symposium

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