More Applications and Research Interests
We are constantly evolving and focusing on innovation. We believe that in the rapidly changing world of medicine, radiotherapy and in particular particle therapy, innovation must be at the forefront of our thinking. At Advanced Oncotherapy, we continue to look for change and continue to look for what we believe will be the future game changers.
Investigation on FLASH therapy using a high frequency linac for protons
Recent in-vivo studies demonstrate that electrons delivered at high dose rates within 0.5 s (FLASH) to cancerous tissues provide the same level of tumour control as with conventional therapy, whilst sparing normal tissues to a much greater extent. Currently, electron linacs and proton passive scattering are used to deliver FLASH-like doses. In a study presented by Dr Kolano at PTCOG 2019, we investigated the possibility of using proton pencil beam scanning (PBS) for uniform FLASH irradiations using a pulsed proton linac and considered the beam parameters needed to achieve FLASH dose rates. The study indicates that with appropriate pulse scheme, spot weight and spacing, LIGHT is designed to deliver doses in the FLASH regime in excess of 40 Gy in less than 0.5 s.
Improved targeting with proton imaging
The high sensitivity of proton beams to tissue changes makes adaptation more important than in conventional radiotherapy. This requires imaging information relating to the interaction of the beam with the patient's tissue. The conventional approach of X-ray imaging results in uncertainties which can be reduced when using proton beam imaging. The patient is imaged with a higher energy beam than used for treatment and the stopping powers deduced from the image are scaled to the correct treatment energy. This allows for a significant reduction in uncertainties in the dose deposition of the hadron beam. As part of the PRaVDA Consortium, we are committed to supporting the development of new concepts and instrumentation to provide accurate information about the proton beam's dose, energy and profile before and during treatment. Please see our collaboration on the PRaVDA project as an illustration.
Use of heavier ions, including helium
Although proton therapy is already demonstrating its potential advantages over X-ray radiotherapy, the complete advantages are not yet fully exploited by current proton therapy systems. Circa 170,000 patients have been treated with proton therapy, which is the most common type of light ion therapy and has been practiced the longest. The use of heavier particles such as Helium and Carbon ions is slowly gaining traction. This interest is based on the greater conformity and destructive power of those particles, and their greater radiobiological effectiveness.
Greater potential for hypo-fractionation
Possibly the most important future frontier for charged particle therapy is hypofractionation. It has the real potential to improve patient outcomes and life quality. Today, hypofractionation is not able to be fully realised with legacy proton therapy systems. In parallel, proton therapy should continue to improve conformity through scanned microbeams and physical collimation. Scanned beams are preferable. Improvements in patient modelling, dose calculation accuracy and target motion solutions will also serve to build confidence for increased hypofractionation using protons.