More than half of all cancer patients receive definitive radiotherapy (RT), usually with x-rays. Particle beam radiation therapy (PBRT) with low linear energy transfer (LET) protons is increasingly being used based on the assumption they can reduce complications and improve local control. High-LET PBRT, e.g., with carbon ions, may provide additional physical dose distribution advantages over low-LET RT. In addition, carbon and neon may yield an increased level of effectiveness against radioresistant and hypoxic (poorly oxygenated) tumor cells, which represent the most RT- and chemotherapy-resistant aggressive tumor cells. Adult patients with advanced tumors of the lung, head and neck, brain, esophagus, and pancreas may especially benefit from the advantages of high-LET ions, but the studies conducted to date have not been definitive. To justify the development of an expensive PBRT facility with high-LET ions, definitive studies (i.e., randomized trials) are needed to prove that high-LET ion beam RT results in improved outcomes compared to treatment with low- LET protons or advanced x-ray based therapy such as intensity modulated radiation (IMRT) or stereotactic body radiotherapy (SBRT). The North American Particle Therapy Alliance (NAPTA) brings together experts in radiation oncology, medical and accelerator physics, magnet design, and radiobiology with international consultants from the existing ion beam facilities in Germany, Italy, and Japan. The main objective of NAPTA is to build a future for ion therapy in the U.S. by integrating and developing the required clinical, biological and technical expertise. In this initil two-year funding period, we will: 1) form a network of teams with a common vision for R&D and clinical studies involving PBRT; 2) enhance clinical PBRT research by developing the infrastructure for treating all patients within common protocols shared by all partner institutions 3) facilitate the development of new, low-cost, compact/efficient designs for ion accelerators, ion gantries, treatment planning systems, and imaging technology; and 4) facilitate the development of new knowledge in radiobiology related to PBRT, by integration of currently ongoing projects and startup of collaborations with access to existing facilities with protons and ions.
Our proposal addresses the important question of whether radiation therapy with ions such as carbon results in better outcomes in cancer therapy than protons or x-rays alone. This needs to be answered before very expensive ion beam technology becomes widely adopted. If the potential benefits due to biologic and dose distribution advantages are confirmed, ion beam therapy would be very cost effective. Our proposal offers the possibly least expensive strategy for answering this important health-related question.
|Volz, Lennart; Piersimoni, Pierluigi; Bashkirov, Vladimir A et al. (2018) The impact of secondary fragments on the image quality of helium ion imaging. Phys Med Biol 63:195016|
|Lazar, Ann A; Schulte, Reinhard; Faddegon, Bruce et al. (2018) Clinical trials involving carbon-ion radiation therapy and the path forward. Cancer 124:4467-4476|
|Ramos-Méndez, José; Schuemann, Jan; Incerti, Sebastien et al. (2017) Flagged uniform particle splitting for variance reduction in proton and carbon ion track-structure simulations. Phys Med Biol 62:5908-5925|
|Censor, Yair (2017) Can Linear Superiorization Be Useful for Linear Optimization Problems? Inverse Probl 33:|
|Penfold, Scott; Zalas, Rafa?; Casiraghi, Margherita et al. (2017) Sparsity constrained split feasibility for dose-volume constraints in inverse planning of intensity-modulated photon or proton therapy. Phys Med Biol 62:3599-3618|
|Piersimoni, P; Ramos-Méndez, J; Geoghegan, T et al. (2017) The effect of beam purity and scanner complexity on proton CT accuracy. Med Phys 44:284-298|
|Held, Kathryn D; Blakely, Eleanor A; Story, Michael D et al. (2016) Use of the NASA Space Radiation Laboratory at Brookhaven National Laboratory to Conduct Charged Particle Radiobiology Studies Relevant to Ion Therapy. Radiat Res 185:563-7|
|Roach 3rd, Mack; Schulte, Reinhard; Mishra, Kavita et al. (2016) New Clinical and Research Programs in Particle Beam Radiation Therapy: The University of California San Francisco Perspective. Int J Part Ther 2:471-473|