Participants of the first Raptor meeting, Ljubljana, 1.-3. July 2018; Heinz Deutschman, Medphoton, Salzburg, Avstrija,Thomas Bortfeld, Massachussets General Hospital, Boston, USA, Marco Donetti, CNAO, Pavia, Italy, Marcus Stock, MEDAUSTRON, Wien, Austria, Martin Janson, Raysearch, Stockholm, Sweden, Christian Richter, Oncoray, Dresden, Germany, Kristjan Anderle, Cosylab, d.d., Antje Knopf, University Medical Center Groeningen, Francesca Albertini, Paul Scherer Institut, Zuerich, Switzerland, Anthony Lomax, Paul Scherer Institut, Zuerich, Switzerland, Mark Pleško, Cosylab, d.d., Katia Parodi, Ludvig Maximillian Universitaet Muenchen, Germany, Robert Jeraj, FMF, University of Ljubljana, Stine Korreman, Proton center, Aarhuis, Danmark, Shinichiro Mori, National institute of radiological sciences, Tokio, Japan, Uli Webber, GSI, Darmstadt, Nemčija, Rok Gajšek, Cosylab, d.d., Andrej Studen, FMF, UL and IJS
Photograpfhy: Kristjan Anderle (Cosylab, d.d.)
Publish Date: 14.12.2020
Category: ERC & MSCA, Interdisciplinary research, Our contribution to sustainable development goals
Sustainable development goals: 3 Good health and well-being (Indicators)
Hadron therapy is an advanced radiotherapy method. As with all radiotherapies, hadron therapy attacks cancer cells using ionising radiation. Ionising radiation can consist of various particles – from electromagnetic radiation known as gamma radiation, electron radiation or beta radiation, to light-nuclei radiation and helium particle radiation, known as alpha radiation. Conventional radiation therapy employs gamma radiation, photons whose losses in matter are well described by the exponential curve. This means that the radiation dose will be highest where the radiation enters the body. As tumours are usually hidden deep in the body, a good portion of the dose is received by otherwise healthy tissues. This problem is solved by hadron therapy.
The Medical Physics research group (FMF UL, UMC, IO, JSI), together with Cosylab d.d. and research partners from major hadron therapy centres around the world, obtained funding from the European Commission for the RAPTOR initiative, and the European Training Network (MSCA ETN) in the field of hadron therapy for the introduction of innovative methods for reliable cancer treatment using hadron therapy.
The working medium in hadron therapy is the accelerated nuclei of light atoms – hydrogen, helium, carbon. Hydrogen is a special case, as its nuclei are comprised of a single particle – a proton. A special form of therapy based on hydrogen nuclei is therefore also called proton therapy. Due to the simple structure of irradiators, their technical requirements are also slightly lower in proton therapy than for other nuclei, and thus proton therapy is spreading faster than hadron therapy. It nevertheless involves a financially and technically complex technology, which is a reason for there being very few such centres around the world. There are currently 109 centres in use, 37 under construction and 29 in the planning stage.
The advantage of hadron therapy is the so-called Bragg peak, i.e. a steep rise in the deposited dose just before the point where the accelerated nucleus stops in the body. The advantage is twofold – the radiation entry dose is lower than the dose at the Bragg peak, and at the same time there is no radiation behind the stopping point. Theoretically, appropriate accelerator settings support point-by-point dose deposition in the body with a very small portion of the dose distributed outside the planned range. Hadron therapy is thus significantly better than conventional therapy in the treatment of children to avoid side effects associated with a dose deposited outside the affected area, and in the treatment of cancers surrounded by radiation-sensitive tissues.
However, due to its accuracy hadron therapy is more subject to radiation-related uncertainties. Even with insignificant errors in the estimation of the matter that radiation encounters on the way to the target site, significant deviations can occur in the radiation dose received. Instead of depositing energy at target points, the radiation can deposit it elsewhere, which reduces the treatment success and increases the dose received in healthy tissue. Research efforts in proton therapy are therefore focused on adapting the settings of irradiation devices to the current geometry of the irradiated body, which is called adaptive therapy.
The Medical Physics research group, consisting of researchers from two most prominent healthcare organisations in Slovenia, the University Clinical Centre in Ljubljana and the Institute of Oncology in Ljubljana, and the two most prestigious institutions in the field of physics, the Faculty of Mathematics and Physics of the University of Ljubljana and the Jožef Stefan Institute, is involved in the development of methods for as accurate application of hadron therapy in cancer treatment as possible. In 2018 and working in conjunction with Cosylab d.d., it started to collaborate within RAPTOR, which is derived from rapid adaptive particle therapy, to which the research group invited the following prominent research centres in hadron therapy: the Massachusetts General Hospital from Boston (USA), the OncoRay Institute from Dresden, Paul Scherrer Institute from Switzerland, Raysearch from Sweden, MedAustron radiation centre from Austria, CNAO centre from Italy, and Ludvik Maximillian Universitaet from Munich. After a series of scientific meetings, we were selected as a project of the European Commission within the European Training Network MSCA ETN and the Marie Skodlowska Curie MSCA scheme in 2020, with the aim of conducting additional research in the selected field and enabling the education of foreign and Slovenian students in hadron therapy and modern methods of its application. In addition to research and pedagogical work, an intensive exchange of students between participating organisations will also take place as part of the 3-year project, which will enable the dissemination of knowledge from foreign therapeutic centres to Slovenia, which is especially important in light of the planned establishment of such a centre in Slovenia.