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Proton Therapy for Cancer Patients
June 4, 2014   
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Prof. Marek Jeżabek, director of the Henryk Niewodniczański Institute of Nuclear Physics, a Cracow-based research center run by the Polish Academy of Sciences, talks to Karolina Olszewska about a project he is coordinating to launch a zl.250 million radiotherapy center in Poland.

Your project, called the National Center for Hadron Radiotherapy, will cost almost a quarter of a billion zlotys. The new center will not only conduct research but also provide cutting-edge proton beam cancer therapy for patients including small children. Why is this needed?

The National Center for Hadron Radiotherapy project comprises two phases. In the first phase, the Cyclotron Center Bronowice will be launched [in Cracow’s Bronowice district], and in the second stage—referred to as Gantry—the center will equipped with two pieces of apparatus for administering treatment to patients undergoing proton radiotherapy. “Gantry” [a device for rotating the radiation delivery apparatus around the patient during radiation therapy] is a term used to describe the radiotherapy station with a swivel arm. Each of the two such stations comprises a big concrete bunker with an irradiation arm inside. The devices weigh about 100 tons; the magnets that steer the protons alone weigh more than 10 tons. Thanks to these dimensions, the proton beam can be directed to the patient’s body with great precision—in order to destroy cancer cells, and at the same time do as little damage to healthy tissue as possible.

The project began in 2006 and is co-financed by the National Center for Research and Development (NCBiR). The total net value of the project is almost zl.250 million.

The National Center for Hadron Radiotherapy will coordinate research related to radiation therapy, medical physics, and radiobiology. It will also develop clinical and scientific infrastructure for hadron therapy in Poland. Construction will be completed in September 2015.

Why was your institute chosen to run this project?

We have a cyclotron at the institute that we use for proton radiotherapy for ocular melanoma. For two years this treatment has been financed by the National Health Fund [the institution in charge of transferring government funds to hospitals and all other public health centers in Poland]. We were able to launch treatment of this cancer because we enlisted the help of doctors from the Jagiellonian University’s Medical College hospital [in Cracow]—one of Poland’s best teams of oncologists working under Prof. Bożena Romanowska-Dixon and specializing in the therapy of the melanoma of the eye.

A third, very important, partner of the project is the Cracow branch of the Marie Skłodowska-Curie Institute of Oncology in Warsaw, where radiation oncologists can put the opportunities we have created to use.

In 2012, a Proteus C-235 cyclotron produced by Belgian company IonBeam Application was installed at the institute along with associated apparatus. This accelerates protons to a maximum energy of 230 MeV.

Why is proton radiotherapy useful?

International statistics, for countries such as the United States, Germany, or France, show that about 10 percent of cancer patients who qualify for radiotherapy require proton therapy. Protons are charged particles that can be applied very precisely in a desired site, particularly when targeting cancer. By properly adjusting the energy of the protons and the angle at which they are directed at the patient’s body, we can achieve very good results—destroying cancer cells. Our treatment is in most cases concentrated just where it’s needed. This is a great advantage of proton therapy. It is used to treat conditions such as brain tumors, tumors of the central nervous system, but also those located close to vital organs. It should be used when exposing the area around the tumor to radiation would be very dangerous for the patient and should be minimized. This is especially important in the case of children. While treating patients, we cannot harm their young bodies. In pediatric oncology, proton radiotherapy is an especially important and useful tool.

Will children diagnosed with cancer be able to receive treatment fast at the center?

The demand for such treatment is enormous, and the treatment of pint-sized patients is time-consuming. It requires more preparation, so for a long time it prevents the device from being used for other purposes. If only one workstation were available, patients would be waiting too long, which, in the case of cancer, is unacceptable. With two workstations we will be able to largely meet the needs of patients in Poland while also focusing on treating children.

Will the facilities at the center be available to anyone who wants to carry out research there?

We’ve set up an international committee composed of experts from several international laboratories. They provide us with advice on what kind of experiments are worth carrying out. Research conducted in our center will, in a significant way, make it possible to broaden knowledge in both nuclear physics and radiobiology and related sciences. Researchers will have an opportunity to use protons to conduct research and development work. They will also be able to test components of various detectors, which means instruments that measure the traces or energy of particles. A huge research field is opening up for medicine too. Gantry-type devices with a scanning beam are state-of-the-art equipment that appeared internationally just two or three years ago. With this equipment available in Poland, our scientists will gain the opportunity to conduct research meeting the highest international standards.

Will the center also provide services to industry?

Only for super-hi-tech projects, for example those that benefit science—such as research into how new crystals behave under the influence of protons, which in the future may be used for the construction of various measuring devices. Another example is the analysis of failures in superfast electronics used in various devices or sites exposed to radiation, or—as in this case—irradiation. Space technology is another example—because cosmic rays damage electronic components mounted on spacecraft or satellites, and this involves communication, telephony, and GPS equipment. This industry also needs information about how components behave under the influence of radiation.

A total of 15 institutions have teamed up to work on the establishment of the National Center for Hadron Radiotherapy.

The Henryk Niewodniczański Institute of Nuclear Physics is coordinating the project. Other members of the consortium include the Institute of Oncology in Warsaw, along with its branches in Cracow and Gliwice; cancer centers in Kielce and Poznań; the Jagiellonian University (Faculty of Biochemistry, Biophysics and Biotechnology; Medical College) in Cracow; the University of Warsaw; University of Silesia in Katowice; the Medical University of Warsaw; the AGH University of Science and Technology in Cracow; the Warsaw University of Technology; and the National Center for Nuclear Research in Świerk near Warsaw.

These institutions will take part in research carried out using equipment available at the new center. The universities will be able to educate their students there, while the clinical centers will be able to send patients for treatment there.
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