Proton therapy

In proton therapy is a therapy for the treatment of cancers, that malignant tumors. Proton beams are produced thereby, for example, in a synchrotron or a cyclotron, and accelerated and shot at the target tumor. The method is particularly used in patients in whom conventional X-ray irradiation can not be sufficiently utilized, either because the tumor is too deep in the body or is but surrounded by sensitive organs. Proton therapy allows an optimized dose distribution within the irradiated region.

Proton therapy is the most commonly used form of so-called particle therapy, for example, includes the irradiation with the carbon ions heavier.

Operation

Proton therapy made ​​possible by their accuracy in the treatment of tumors in sensitive areas of the body. The accelerator provides protons ( of up to 60 % the speed of light ) as well collimated beam can be precisely directed onto the previously calculated location in the tumor tissue. Upon penetration into the human body, the beam is slowed down so that the protons most of their energy directly in the tumor stove discharged ( Bragg peak). The ionizing effect of the protons leads to damage to the tumor cells, in particular their DNA.

By three-dimensionally precise end position, the proton that can be achieved radiation dose in the target is higher than when using the conventional X-ray radiation and the photons generated by linear accelerators. In contrast to other forms of radiation therefore decreases the risk of side effects of proton therapy. Surrounding healthy tissue is largely spared (see also radiation therapy).

Medical evaluation

Worldwide, in about 50 years so far ( end of 2012) 90,000 patients treated with various indications. It has been reported in the relevant literature. The assumption of costs by the national health insurance varies from one fund to another. For some cash an individual examination is carried out. Some radiation centers have separate arrangements with certain insurance companies. From an assumption of costs, for example breast cancer and brain metastases are excluded. However, the cost, for example, patients with unresectable hepatocellular carcinoma, cerebral arteriovenous malformation, and chondrosarcomas and chordomas of the skull base are adopted.

The list of treatments worldwide up to now has been taken from the Particle Therapy Co-Operative Group constantly up to date.

Existing facilities

The first proton therapy center in Western Europe since 1984 at the Paul Scherrer Institute (PSI) in Villigen in Switzerland in operation. By the end of 2012, about 6,000 patients have been treated with eye tumors with protons. The world's only been gantry for the irradiation of deep-seated tumors, which is equipped with the so-called spot -scanning technique - At PSI is - in addition to the four gantries at RPTC in Munich. The tumors are thereby scanned in three dimensions with an approximately 7 mm wide proton beam. Until the end of 2012, more than 850 patients were irradiated in February 2007 with a novel superconducting compact cyclotron. The PSI is also the only European center that experience with intensity modulated proton therapy has. The first patient with a chordoma of the spine was treated with this method already in 1999 at PSI.

In Germany there are three proton therapy facilities: the Rinecker Proton Therapy Center ( RPTC ) in Munich with four gantries and the eye tumor therapy at the ion beam laboratory ISL at the Helmholtz Centre Berlin (until 2008 Hahn- Meitner Institute) in Berlin. There over 2000 (as of end of 2012) were treated eye tumor patients since 1998. The RPTC in Munich is the first clinically -driven proton therapy center in Europe, the patients treatment started there in March 2009. Furthermore, patients were treated with carbon ions from 1997 to 2008 as part of a pilot project at GSI in Darmstadt. The follow-up project at the University Hospital Heidelberg, the Heidelberg Ion-Beam Therapy Center (HIT ), (based on synchrotron ) was opened in November 2009. On HIT since patients are treated with protons and carbon ions mainly in the context of clinical trials. HIT is the first plant in the world that can apply both protons and carbon ions with the scanning technique. For research purposes, in addition, other ions such as helium and oxygen ions are available.

The first hospital- based proton therapy center in the world was opened in 1990 in California at Loma Linda University Medical Center ( LLUMC ). In clinical routine over 16,000 patients have been treated with more than 50 different types of tumors and other diseases there so far. With each year from 1000 to 1500, patients are here with a powerful synchrotron (250 MeV, Optivus ) more treatments performed as in all other proton therapy centers worldwide. For the treated prostate cancer patients of LLUMC, the world's largest aftercare program exists on the basis of patient self- organization Brotherhood Of The Balloon, which has over 4,000 members (as of May 2009).

There is proton therapy centers in eleven other countries ( end of 2008).

Future locations of therapy centers in Germany, Austria and Switzerland

At several locations in Germany the construction of proton therapy centers will also be considered, for example in the Rhine / Main / Saar area by the hospital in Offenbach am Main or the University Hospital of the Saarland, in Cologne / Bonn / Aachen, University Hospital Dresden, and Berlin, eating, and in the region of Hamburg / Schleswig -Holstein.

Projects and locations:

Recent Developments

The development of smaller and cheaper particle accelerator promises to make available to this therapy an increasing number of cancer patients. For example, working on the development of a superconducting cyclotron in table size.