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Lauzacco, Italy

Rossi S.,CNAO Foundation
Physica Medica | Year: 2015

The National Centre for Oncological Hadrontherapy (CNAO, sited in Pavia, Italy) completed at the end of 2013 the clinical trial phase achieving the CE label from the notified body of the Italian Health Ministry and obtained the authorisation to treat patients within the national health system. Nowadays more than 400 patients completed the treatments, two thirds of them with carbon ions, and recently started the treatment of pathologies located within moving organs. For the first time in the world carbon ions delivered with active scanning, coupled with breathing synchronisation and rescanning modalities have been applied to treat patients affected by tumours of the liver and by pancreatic cancers.The path to reach the final CE label required a wide-ranging experimental activity that went through dosimetry measurements of the hadron beams, in-vitro and in-vivo radiobiology essays and treatments of 150 patients, all enrolled in one of the 23 clinical trials approved by the Ethical Committee of CNAO and then authorized by the Italian Ministry of Health. The results of the trials were very positive in terms of safety and reliability of the procedures. The follow-up period is still short, but preliminary good results are observed in particular in terms of limited toxicity, that on the whole is less than expected.The paper gives a status report on the experimental phase that completed the CE certification process and then outlines the ongoing activities with also indications on the future trends and the most interesting R&D programmes pursued at CNAO. © 2015 Associazione Italiana di Fisica Medica. Source

Cerutti F.,CERN | Ferrari A.,CERN | Mairani A.,CNAO Foundation | Sala P.R.,National Institute of Nuclear Physics, Italy
CERN-Proceedings | Year: 2013

FLUKA is a general purpose tool for calculations of particle transport and interactions with matter. It handles all hadrons, ions, and electromagnetic particles. The FLUKA applications range from LHC or cosmic energies down to hadron-therapy and microdosimetry. It is the standard tool at CERN for beam-machine interactions and radioprotection. All FLUKA models and algorithms are object of a long and constant development that benefits to a wide range of applications. The present paper will focus on selected new developments in the nuclear interaction models, namely: hadronic interactions in the few GeV energy range and their effect on neutrino induced reactions; interactions of α particles below 150 MeV/A; improvements in the latest stages of nuclear reactions. Source

Rossi S.,CNAO Foundation
Nuclear Physics News | Year: 2013

The CNAO (Italian acronym that stands for National Centre for Oncological Hadrontherapy) began its clinical activity in September 2011 with the launch of the experimental treatments with beams of protons. In November 2012 the first patient was treated with carbon ions. On both occasions it was an absolute novelty in the panorama of Italian healthcare. © 2013 Copyright Taylor and Francis Group, LLC. Source

Riboldi M.,Polytechnic of Milan | Riboldi M.,Bioengineering Unit | Orecchia R.,CNAO Foundation | Orecchia R.,Oncology and Radiotherapy Institute | And 3 more authors.
The Lancet Oncology | Year: 2012

A key challenge in radiation oncology is accurate delivery of the prescribed dose to tumours that move because of respiration. Tumour tracking involves real-time target localisation and correction of radiation beam geometry to compensate for motion. Uncertainties in tumour localisation are important in particle therapy (proton therapy, carbon-ion therapy) because charged particle beams are highly sensitive to geometrical and associated density and radiological variations in path length, which will affect the treatment plan. Target localisation and motion compensation methods applied in x-ray photon radiotherapy require careful performance assessment for clinical applications in particle therapy. In this Review, we summarise the efforts required for an application of real-time tumour tracking in particle therapy, by comparing and assessing competing strategies for time-resolved target localisation and related clinical outcomes in x-ray radiation oncology. © 2012 Elsevier Ltd. Source

Kamada T.,Japan National Institute of Radiological Sciences | Tsujii H.,Japan National Institute of Radiological Sciences | Blakely E.A.,Lawrence Berkeley National Laboratory | Debus J.,University of Heidelberg | And 9 more authors.
The Lancet Oncology | Year: 2015

Charged particle therapy is generally regarded as cutting-edge technology in oncology. Many proton therapy centres are active in the USA, Europe, and Asia, but only a few centres use heavy ions, even though these ions are much more effective than x-rays owing to the special radiobiological properties of densely ionising radiation. The National Institute of Radiological Sciences (NIRS) Chiba, Japan, has been treating cancer with high-energy carbon ions since 1994. So far, more than 8000 patients have had this treatment at NIRS, and the centre thus has by far the greatest experience in carbon ion treatment worldwide. A panel of radiation oncologists, radiobiologists, and medical physicists from the USA and Europe recently completed peer review of the carbon ion therapy at NIRS. The review panel had access to the latest developments in treatment planning and beam delivery and to all updated clinical data produced at NIRS. A detailed comparison with the most advanced results obtained with x-rays or protons in Europe and the USA was then possible. In addition to those tumours for which carbon ions are known to produce excellent results, such as bone and soft-tissue sarcoma of the skull base, head and neck, and pelvis, promising data were obtained for other tumours, such as locally recurrent rectal cancer and pancreatic cancer. The most serious impediment to the worldwide spread of heavy ion therapy centres is the high initial capital cost. The 20 years of clinical experience at NIRS can help guide strategic decisions on the design and construction of new heavy ion therapy centres. © 2015 Elsevier Ltd. Source

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