Reviews of Accelerator Science and Technology: Medical Applications of Accelerators

321 Pages·2009·40.92 MB·English

by  Alexander W. Chao

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Published by
World Scientific Publishing Co. Pte. Ltd.
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British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library.
REVIEWS OF ACCELERATOR SCIENCE AND TECHNOLOGY
Volume 2: Medical Applications of Accelerators
Copyright © 2009 by World Scientific Publishing Co. Pte. Ltd.
All rights reserved. This book, or parts thereof, may not be reproduced in any form or by any means, electronic or
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ISBN-13978-981-4299-34-3
Printed in Singapore by Mainland Press.
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Contents
Editorial Preface .................................................................. vii
Physical and BiologicalBasis of Proton and of Carbon Ion Radiation Therapy
and Clinical Outcome Data
Herman Suit, Thomas F. Delaney and Alexei Trofimov ............................... 1
The Production of Radionuclides for Radiotracers in Nuclear Medicine
Thomas J. Ruth ................................................................. 17
Proton Radiation Therapy in the Hospital Environment: Conception, Development,
and Operation of the Initial Hospital-Based Facility
James M. Slater, Jerry D. Slater and Andrew J. Wroe ............................... 35
Microwave Electron Linacs for Oncology
David H. Whittum ............................................................... 63
Heavy-Particle Radiotherapy: System Design and Application
H. Tsujii, S. Minohara and K. Noda ............................................... 93
High Frequency Linacs for Hadrontherapy
Ugo Amaldi, Saverio Braccini and Paolo Puggioni ................................... 111
Medical Cyclotrons
D. L. Friesel and T. A. Antaya.................................................... 133
Synchrotrons for Hadrontherapy
Marco G. Pullia ................................................................. 157
Beam Delivery Systems for Particle Radiation Therapy: Current Status and
Recent Developments
J. M. Schippers.................................................................. 179
Laser Acceleration of Ions for Radiation Therapy
Toshiki Tajima, Dietrich Habs and Xueqing Yan ..................................... 201
FFAGs as Accelerators and Beam Delivery Devices for Ion Cancer Therapy
Dejan Trbojevic ................................................................. 229
The Dielectric Wall Accelerator
George J. Caporaso, Yu-Jiuan Chen and Stephen E. Sampayan ........................ 253
The Supercollider: The Texas Days — A PersonalRecollection of Its Short Life
and Demise
Stanley Wojcicki................................................................. 265
A Man for All Seasons: Robert R. Wilson
Edwin L. Goldwasser............................................................. 303
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ReviewsofAcceleratorScienceandTechnology
Vol.2(2009)vii–viii
(cid:1)c WorldScientificPublishingCompany
Editorial Preface
This is the second volume of the journal Reviews of Accelerator Science and Technology. While
the previous volume gave an overview of the accelerator field, this volume (and all later ones) is
focusedonaspecificsub-field.ThethemeofthisvolumeisMedical Applications of Accelerators.We
chose this theme because of its enormous importance to human health and its deep impact on our
society.
Ever since the discovery of x-raysmore than a century ago, people began to contemplate using
them for medical purposes. The invention of particle accelerators in the early 20th century created
a whole new world for producing energetic x-rays, electrons, protons, neutrons and other particle
beams. Immediately these beams found applications in medicine. There are two important yet
distinct medical applications. One is that accelerators produce radioisotopes for various medical
tests in nuclear medicine and positron emission tomography (PET) used to diagnose millions of
patients each year. The other is that accelerators produce particle beams for radiation therapy for
the treatment of cancer. The particle beams can be x-rays (generated by high-energy electrons),
protons, neutrons or heavy ions such as carbon. Today there are more than 5,000 accelerators
routinely used in hospitals all over the world for nuclear medicine and cancer therapy.
Thegreatpotentialofacceleratorapplicationsinmedicinecanhardlybeexaggerated.Takepro-
ton therapy as an example. Because the Braggpeak of protons in the human body is much sharper
than for x-rays, treatment can be localized, tumor targeting accuracy improved, and the irradia-
tion of sensitive neighboring tissues and side effects reduced. However, despite these indisputable
advantages the number of proton therapy patients is much smaller than the number treated using
x-rays. Each year several million cancer patients receive x-ray treatment. In contrast, the number
of patients treated by protons, neutrons and ions over the past several decades is less than 50,000.
The reason is simple — an x-ray therapy machine can readily fit in a hospital room, whereas a
proton (or ion) therapy facility occupies an entire building. If future proton therapy machines can
be made as small and cheap as x-ray machines so that every hospital could afford one, this would
revolutionize oncology!
This volume contains fourteen articles, all written by distinguished scholars. The first three
articles are overviews by physicians (Suit et al., Ruth, and Slater et al.). They review the status
of radiation therapy, radioisotopes in nuclear medicine and hospital-based facilities, respectively.
The following six articles describe in detail various types of accelerators used in medicine: electron
linacs for x-ray therapy (Whittum), accelerator systems for heavy particle radiotherapy (Tsujii
et al.), high frequency linacs for hadrontherapy (Amaldi et al.), medical cyclotrons (Friesel et al.),
synchrotronsforhadrontherapy(Pullia),andbeamdelivery systems(Schippers). They arefollowed
by three articles discussing future medical accelerators: laser acceleration of ions (Tajima et al.),
FFAG (Trbojevic) and the dielectric wall accelerator (Caporaso et al.). There is also an important
article on the Superconducting Super Collider (Wojcicki), which is a continuation of the first part
published in Volume 1.
In each volume we dedicate one article to a prominent figure of the accelerator community.
In Vol. 1, it was Pief Panofsky. In this volume, it is Robert Wilson. Wilson is selected because
of his 1946 seminal paper “Radiological use of fast protons” that began the whole field of proton
therapy. This important event in accelerator history is described in Slater’s article. But Wilson is
vii
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viii Editorial Preface
chosen for much deeper reasons. From his unique close association with Wilson over many years,
Ned Goldwasser in his article vividly portrays Wilson as a charismatic and imaginative leader. His
articleisnotachronologicalbiographyofWilson,norisitintendedtobe,butabeautifulpiecethat
presents an illuminating sketch of a great man. We feel it fits perfectly in this volume.
Alexander W. Chao
SLAC National Accelerator Laboratory,USA
[email protected]
Weiren Chou
Fermi National Accelerator Laboratory,USA
[email protected]
Editors
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ReviewsofAcceleratorScienceandTechnology
Vol.2(2009)1–15
(cid:1)c WorldScientificPublishingCompany
Physical and Biological Basis of Proton and of Carbon Ion
Radiation Therapy and Clinical Outcome Data
HermanSuit∗,ThomasF.Delaney† andAlexeiTrofimov‡
Department of Radiation Oncology,
Massachusetts General Hospital and Harvard Medical School,
Boston, MA, USA
∗[email protected]
†[email protected]
‡atrofi[email protected]
There is a clear basis in physics for the clinical use of proton and carbon beams in radiation therapy, namely, the
finiterangeoftheparticlebeam.Therangeisdependentonthebeaminitialenergy,densityandatomiccomposition
of tissues along the beam path. Beams can be designed that penetrate to the required depth and deliver a uniform
biologically effective dose across the depth of interest. The yield is a superior dose distribution relative to photon
beams. There is a potential clinical advantage from the high linear energy transfer (LET) characteristics of carbon
beams.Thisisbasedonaloweroxygenenhancement ratio(OER)andaflatter ageresponsefunction.However,due
to uncertainties relating OER with relative biological effectiveness (RBE), there is no clinical evidence to date that
carbon ion beams have an advantage over proton beams. We strongly support performance Phase III clinical trials
of protons vs carbon ion beams designed to feature a singlevariable, LET. Dose fractionation would be identical in
botharmsanddosedistributionwouldbesimilarforthesitestobetested.Forsitesforwhichthecarbonbeamhasa
demonstrated importantadvantage incomparative treatment planningdue to the narrowerpenumbra wouldnot be
selectedfortheclinicaltrials.
Keywords:Protons;carbonions;beams;radiationtherapy.
1. Introduction therapy by moving from x-ray to proton and carbon
ion beams. This is evident from the 61,112 patients
The intent in implementation of a new radiation
treated by protons and the 5342 patients by car-
treatment method is to increase the probability
bonionbeams asofMarch2009(M.Jermann,a per-
of eradication of the irradiated tumor with no
sonal communication, 2009). These treatments have
increase or preferably a lesser risk of treatment-
beendeliveredat26protonand3carboniontherapy
related morbidity. This goal has been realized in
centers. Further, many proton and carbon ion cen-
multiple steps throughout the history of radiation
ters are being planned or under construction. Here,
oncology by technical advances that have provided we assess the relative merits of these two particle
progressivelyimproving distributions of the dose. In beams for radiation therapy by considering some of
parallel, major clinical gains have been made by the relevant physics, radiation biology and clinical
combining radiation with other treatment modali- outcome data. This is not based on data from clini-
ties, viz. surgery, chemicals and biological/genetic cal trials, as there are none.
agents. There have been earlier reviews of particle
At present, high interest is directed to the pos- beamradiationtherapy,suchasRefs.8,17,26,50,63
sibility of important gains in curative radiation and 65.
aM.JermannistheSecretaryoftheParticleTherapyCo-operativeOncologyGroup.Seealsohiswebsite,PTCOG.web.psi.ch.
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