Clinical trials using carbon ions begin at CNAO
On November 13th, for the first time at the Centro Nazionale di Adroterapia Oncologica [CNAO], a hadrontherapy centre in Italy, a beam of carbon ions was used to treat a cancer patient. The patient, affected by a salivary gland carcinoma, successfully completed the therapy last week, and three new patients are now enrolled in the framework of clinical trials approved by the Italian Health Ministry.
The CNAO is a clinical facility created and financed by the Italian Ministry of Health and conceived to supply hadrontherapy treatments to patients recruited all over the Country.
In hadrontherapy, beams of strongly interacting particles such as protons or carbon ions are used to treat cancer. Hadrontherapy, in particular with carbon beams, may be useful in cases where tumors are responding poorly to conventional radiotherapy. Because beams of protons or ions can be very precisely targeted, they are well suited to treating deep-seated tumors or those located close to critical organs.
CNAO started treating patients with proton beams in September 2011, and so far 42 patients have been treated with protons in the framework of five different clinical trials. This is the centre’s first clinical trial with carbon ions. Carbon ions are heavy relative to protons and can destroy tumorous cells that protons would leave intact. CNAO is the second centre in Europe to provide such ion beams for cancer therapy, after the Heidelberg Ion-Beam Therapy Centre [HIT] began clinical trials in 2009.
The protons and carbon ions beams are produced by an accelerator complex built by CNAO in collaboration with many Institutions. The main accelerator is a synchrotron that is capable of producing protons with energies up to 250 MeV and carbon ions with maximum energies of 400 MeV/u. The beams are directed into the patient and with millimetric precision hit the tumor sparing at best the healthy tissues around it.
The main contributions to the development of the technology have been given by the Italian Institute of Nuclear Physics [INFN], that shared the co-direction of the construction and participated in 15 technical tasks, and by CERN that contributed to the definition of the basic lattice design of the synchrotron (the Proton Ion Medical Machine Study [PIMMS]) and to the development of some special systems. Besides INFN and CERN many other Italian and international Institutions contributed to the success of the realization. The complete list is available on the CNAO website, together with more detailed information on the CNAO facility. The CNAO is one of the more than 50 institutes that make up the European network for light ion hadrontherapy [ENLIGHT]. Created in 2002 to foster effective collaborations between medical doctors, biologists, physicists and engineers, ENLIGHT promoted the realization of projects financed by the EC like ULICE, a project devoted to research, networking and opening of the existing facilities (HIT and CNAO) to the European scientific and medical communities.
At CNAO, further protons and carbon ions trials are planned for the next months and for the 2013, with the aim to complete the experimentation and get the CE marking of the CNAO infrastructure. From 2014 the routine running of the facility will start and in few years the full operation will be reached with the goal to treat about 2000 patients per year.
