Facility and Patient Statistics: I continue to collect information about all operating or proposed facilities. Please send me your information. My latest published summary of the worldwide detailed patient statistics through 1997 is:

"World wide proton therapy experience in 1997." Author: J. M. Sisterson. CP475, Application of Accelerators in Research and Industry, eds. J. L. Duggan and I. L. Morgan, AIP Press, New York (1999), p959-962. Copies available on request.

ARTICLES FOR PARTICLES 27

November 30 2000 is the deadline for news for Particles 27, the January 2001 issue. Address all correspondence for the newsletter to:

Janet Sisterson Ph.D.                         Telephone: (617) 724-1942
Northeast Proton Therapy Center        Fax: (617) 724-9532
Massachusetts General Hospital        E-mail: jsisterson@partners.org
30 Fruit Street, Boston MA 02114

Articles for the newsletter should NOT exceed two pages in length.

The times and locations of the next PTCOG meetings are as follows:

Every now and again it seems worthwhile to focus attention on the status of an organization to determine whether it is fulfilling its function(s) well - and whether there are mid-course corrections of a minor or major kind which should be made. We intend to set aside some time at the next PTCOG meeting in Berlin to at least begin such a discussion – we may then continue the discussion at the following meeting in Boston, if it is indicated. These discussions will begin at the steering committee meeting and will continue at the business meeting.

The following questions seem appropriate:

Is PTCOG meeting the interests of:

experienced physicians in the field
experienced physicists in the field
students
those who are contemplating new facilities
current or prospective commercial and quasi-commercial vendors?

Is PTCOG providing adequate:

scientific discussion
educational experience
commercial interchange?

Are the venues for PTCOG meetings appropriate?

currently, roughly, cycling amongst: one meeting in North America, one in Europe, one elsewhere.

Is the frequency of meetings (presently, 2 times a year) appropriate? Proposals have been heard to:

cut back to once a year
compromise at one meeting roughly every 9 months.

Is the economic basis of PTCOG (everyone pays their way, meetings are break-even, no treasurer!) satisfactory?

should there be annual dues?
should we encourage industrial exhibits and raise money through them?

These, and any additional topics which the steering committee members may wish to raise, will be the subject of an extended steering committee meeting at the Berlin PTCOG. We look forward to seeing you there. If you are unable to be in Berlin but would like to contribute your thoughts and ideas, please send them to Janet Sisterson (jsisterson@partners.org).

Michael Goitein, chair
Janet Sisterson, secretary

Summary of the Steering Committee Meeting,
PTCOG XXXII
Tuesday April 18, Uppsala Sweden.

Present: E. Blomquist, W. Chu, M. Goitein, E. Grusell, J. Sisterson, J. Wilson, D. Nichiporov, J. Heese, H. Kluge, H. Tsujii, B. Gottschalk..

1) Future meetings:

There was much discussion about the details of the program for the Berlin PTCOG meeting. It was resolved to hold a "Public Steering Committee" session at this meeting to discuss the future of PTCOG in regards to the timing and focus of the meetings and issues regarding membership and finances. 

The half-yearly PTCOG meetings concern the present and future role of proton radiotherapy. The preliminary program includes:

• clinical physics of proton beams;
• proton beams in ocular oncology and macular degeneration;
• new developments in proton therapy;
• clinical results of proton beam radiotherapy.

ABOUT THE ORGANISERS: The meeting is organised by the Ion Beam Laboratory ISL of the Hahn-Meitner-Institut Berlin (HMI). The HMI, located in Berlin-Wannsee and formerly dedicated to nuclear research, is now one of Germany’s scientific research centers specialized in the investigation of structures of solid matter, new materials and manufacturing techniques for photovoltaic cells. The work ranges from basic research to practical applications. A research reactor provides neutron beams for the Berlin Neutron Scattering Center (BENSC) and the particle accelerator produces high energy protons up to heavy ions for the Ion Beam Laboratory ISL. The HMI operates in collaboration with the university clinic Benjamin Franklin in Berlin-Steglitz Germany’s only facility for proton beam treatments of ocular melanoma.

Location and transportation: The meeting takes place at the:

Hotel Steglitz International (SI), Albrechtstr. 2, 12165 Berlin, Germany
Phone: +49 (30) 790050 email info@steglitz.bestwestern.de,
Fax: +49 (30) 79005550 URL: www.si-hotel.com

The hotel is located close to:

U-Bahn station of line U9: Rathaus Steglitz
S-Bahn station of line S1: Rathaus Steglitz
stops of various bus lines

• If you arrive by train at station Zoologischer Garten, U-Bahn U9 takes you there directly.
• If you arrive by plane at Tegel airport, take bus X9 to station Zoologischer Garten and then U-Bahn U9 to Rathaus Steglitz.
• If you arrive at Schönefeld airport, take S-Bahn S45 and change at station Schöneberg to S-Bahn S1 with destination Rathaus Steglitz.
• You can check any kind of train connections directly through the web service http://bahn.hafas.de giving Rathaus Steglitz (S+U), Berlin as destination.

   
For early arrivals: An excursion is planned for the afternoon of September 23, either a visit to Potsdam, or a boat tour through Berlin.

Conference Fee: The conference fee is EUR 230 (DEM 460). The fee covers receptions, coffee breaks and 2 lunches (September 25 and 26). The price for the conference dinner is included in the conference fee. For an accompanying person the cost for the conference dinner is EUR 50 (DEM 100). You may combine the payment with that of the conference fee.

Payment

• Payment with Euro/Master-Card, Visa and American Express
• Send a cheque payable to Hahn-Meitner-Institut
• Payment in cash or with travellers cheques at the registration desk
• Transfer the conference fee to the bank account of HMI: The bank account of HMI is with Berliner Sparkasse. The account number is 105 000 4007. German banks are identified by bank numbers. For the Berliner Sparkasse it is 100 500 00. From abroad also the so-called swift code of the bank BELA DEBE might be useful. In any case, add the keyword PTCOG, and your name and institution, otherwise we are not able to find your payment.

Deadline for Accommodation in the Conference Hotel: Rooms are reserved at the conference hotel Steglitz International for a special rate of DEM 160 per night for a single and DEM 200 for a double room. Please add DEM 22 per person to include breakfast. Please book directly with the hotel using the keyword HMI. The deadline for the hotel registration is July 31, 2000.

J. Heese (chairman), H. Kluge (chairman), M. Fitzek, M. Nausner, I. Reng

For further questions please contact the conference secretary:
Mrs. G. Liar de Martin Phone: +49 30 8062 2415
Hahn-Meitner-Institut / ISL Fax: +49 30 8062 2097
Glienicker Str. 100 Email: ptcog@hmi.de
14109 Berlin, Germany URL: http://www.hmi.de/events

 

Announcement of the

7^th Workshop on Heavy Charged Particles in Biology and Medicine
and WE - Heraeus-Seminar 246
GSI, Darmstadt Germany
September 28 - 30, 2000

This workshop will be held after the PTCOG meeting in Berlin. Aim of this workshop will be to understand and discuss the complex dependence of RBE on physical and biological parameters, to compare it to the existing cellular and clinical data, and to dicuss the integration of clinical RBE from charged particles (protons to carbon) and neutrons into treatment planning comparing different model calculations as well as using standard values.

The workshop will consist of overviews as invited talks and poster contributions. There will be ample room for discussion.

Aim of the conference is to give a meeting point for ophthalmologists, radiotherapists and medical physicists about the status and future perspectives of the treatment of ocular pathologies with proton beams.

Particular care will be devoted to the treatment of tumoral pathologies, like uveal and iris melanomas and of macular degeneration. The status of the existing facilities and new projects will be presented. The treatment planning development will be matter of discussions intercomparing the different clinical experience.

The conference will have four different main sessions:

• ocular pathologies
• radiotherapy approach
• treatment planning
• clinical dosimetry.

Oral and poster contributions have to be presented before July 31^st 2000 (no more than 100 words, no figures). A book of abstract will be distributed during the workshop. Proceedings of the conference will be published by Physica Medica.

Thursday, October 12^th: Ophtalmology – Radiotherapy
Friday, October 13^th: Overview of facilities – Clinical Dosimetry – Treatment planning

Registration fee: before August 15^th 2000: 300.000 ITL: after August 15^th 2000: 400.000 ITL

Modality of payment: should be directed to Istituto Scientifico Europeo by:

Credit card (VISA, Mastercard/Eurocard, American Express): please, note name of cardholder, expiration date and n° of card!!
International Bank Draft (Banca Popolare di Intra, filiale di Novara – CAB:10100 – ABI:05548 – c/c:55600/0)

Hotel Baia Verde (at the sea) single (195.000 ITL/night) double (260.000 ITL/night)
Hotel Jolly (center of the city) single (160.000 ITL/night) double (195.000 ITL/night)

U. Amaldi – TERA Foundation, Novara, I E. Balestrazzi – Clinica Oculistica, Aquila,
P. Chauvel – Centre A. Lacassagne, Nizza, F L. Conte – Ospedale di Circolo, Varese, I
B. Damato – Royal Univ. Hospital, Liverpool, UK E. Egger – PSI, Villigen, CH
S. Lo Nigro – Università di Catania, I A. Reibaldi – Clinica Oculistica, Catania, I
R. Santoni – Università di Firenze, I D. Vinciguerra – INFN-LNS, Catania, I
M. Zingirian – Clinica Oculistica, Genova, I L. Zografos – Hopital "J. Gonin", Lausanne, CH
A. Kacpereck – Clatterbridge Center for Onc., Bebington, UK

R. Cirio – INFN, Torino – ISE, Arona, I A. Crespi – Ospedale S. Gerardo, Monza, I
G. Cuttone – INFN-LNS, Catania, I A. Hegedus – ISE, Arona, I
G. Nicoletti – Clinica Oculistica, Catania, I G. Privitera – Policlinico, Univ. di Catania, I
L. Raffaele – Policlinico, Univ. di Catania, I G. Ruggieri – INF-LNS, Catania, I
M.G. Sabini – INFN-LNS, Catania, I

Agnes Hegedus (Istituto Scientifico Europeo – ISE)
Piazza S. Carlo, 1 – 28041 Arona (NO), Italy
Tel: +39-0322-249700 / Fax: +39-0322-240800
Email: ise@tera.it http://www.tera.it/ise/catania.html

PTCOG Information/News/Reports:

The following reports and articles were received by July 2000.

The principle of calculation of the dose-volume curves in Chapter 1 is controversial and should serve to stimulate discussion. At this stage, it is not recommended that the graphs and tables (page 153-163, and references to this section, as well as appendix P3.1 and P3.2 and drawing (a) on page 280) are used for patient management, rather that they should be checked, as suggested in the book, against all existing dose-volume models. B. J. Smit, Dept. of Radiotherapy, Tygerberg Hospital, University of Stellenbosch, Private Bag, Tygerberg 7505, South Africa

The Northeast Proton Therapy Center (NPTC) is a state-of-the-art proton beam therapy facility under construction at Massachusetts General Hospital in Boston, USA. The therapy equipment (a cyclotron, two gantries, and a fixed horizontal beam) is being built by Ion Beam Applications (IBA) of Belgium under a contract with the MGH which is jointly and roughly equally funded by the MGH and the National Cancer Institute. The contract was let in April, 1994 with a date for the first patient treatment originally envisioned for September, 1998.

The NPTC building is completed and functions well. The great majority of the equipment is on site and has been installed for some time (the cyclotron put out its first beam in June, 1997 and has generally worked well since then). The missing element is the therapy control system (TCS) – a sophisticated computer control system which was mandated by the hospital’s specifications for automated and very efficient operation. This, in turn, was at least partly motivated by the need to transfer the existing and flourishing clinical program at the Harvard Cyclotron Laboratory as soon as the NPTC became operational.

IBA’s first approach to the design and coding of the TCS ran into difficulties and the development had to be out-sourced to a company specializing in control system software development. This introduced a substantial delay into the project. However, the news is now very positive. The design, coding and unit testing of the software is substantially completed, as is the software integration phase (a complex matter of cumulatively assembling software modules and testing the software/hardware interfaces). It is anticipated that before the end of August it should be possible to begin the series of extensive tests of the entire system (software plus hardware combined) which goes under the name of "Verification and Validation." One aspect of the Validation tests is to confirm that treatments can be accurately delivered using the new version (version 1) of the TCS. (Beam experiments have been possible for a long time under the original version 0.) The other critical aspect of the equipment which, we anticipate, will be confirmed in the Validation testing is the day-to-day operational reliability of the entire system.

Once Validation tests are complete, the test results will be submitted to the FDA for per-market clearance – the so-called 510(k) process. Shortly thereafter, acceptance tests will be performed, followed by a period of clinical commissioning, leading up to a first patient treatment on the first gantry. We anticipate that the machine should be accepted by the end of this year, and that the first patient treatment should take place by the end of the first quarter of 2001. The clinical program at HCL will then be transferred to the NPTC over the next several months. Michael Goitein, Northeast Proton Therapy Center, Massachusetts General Hospital, 30 Fruit Street, Boston, MA 02114.

News from ITEP, Moscow, Russia:

Michael Lomanov, Institute of Theoretical and Experimental Physics, B. Cheremushkinskaya 25, Moscow 117259, Russia.

Hadron-therapy still remains extremely expensive, and the lion's part of necessary expensives is not on accelerator, but on GANTRYs and other medical part. So, it is necessary to search the way for lower investment costs on a medi-co-technical part. With this purpose we tender a new System <AG> of an irradiation of an upright posed patient by a horizontal beam of protons or multicharge ions.

We fulfilling a fixation of patient in a thin-wall Shell, which is looking like cylinder, cut up on two halves along (Fig.1). A hermetic bag 2 filled on by small-sized plastic pellets is put in a horizontally posed inferior half 1 of the Shell. The patient 3 is put down on a bag. Than pump 4 suck out an air from the bag and the bag becomes solid. Further we cover the patient over by second bag 5, and the second half 7 of Shell, and after we connect both halves of Shell in a unit. Such hardened bags are stored in a "library" and used for fixing given patient daily. The well-known American firm MED-TEC inc. guarantees a safety of the relief of the surface of bags within 6-7 weeks

The Shell is established on the Mobile Stand (Fig.2). The upper and lower backs 8 of the Shell, are put in girder 9. Turning the girder about horizontal axis 10, we turn up the Shell in vertical position. The girder is moved up- and downward along a vertical mount 11 of the Stand. During a rotational-scanning irradiation, the Shell with patient is rotated around of a vertical axis and moved in horizontal and vertical directions under a fixed or scanning horizontal narrow beam of particles 12. The design of the Stand allows to place the Shell with patient not only vertically, but also in horizontal or in any intermediate position.   In these cases is carry out an irradiation with a method of linear scanning.

The patients are prepared for an irradiation (including fixation, centration, serial horizontal CT-tomography) simultaneously and separately in six Preparatory procedural rooms, placed outside of a zone of irradiation. The computer aided transport system automatically delivers the next patient from Preparatory procedural room to Radiative one and back together with his Mobile Stand, without infringement of quality of fixation and centration (for example, on a guide 13 or magnetic pillow). Besides, through Radiative room, the Stands with patients are transported always two by two, in one direction, by the method which one we have termed as the pendulum conveyer.

Throughput of the <AG>-system is up to 1000-1200 patients per one year, and it carry out a rotational-scanning or linear-scanning irradiation of tumours of any forms, sizes and localizations. <AG> can work with any medical accelerator of protons/ions needlessly either constructive alteration or adaptaton. The area of 300 sq.m. is necessary for accommodation <AG>- system (without rooms for the accelerator and the stuff). The cost price of a serial copy of system will make about 1 million bucks, including cost of horizontal computer tomographs of an original construction in any of Preparatory procedural rooms. B. Astrakhan, Russian Cancer Research Center RAMS, 24, Kashirsckoye schosse, 115478 Moscow, Russia (astrakob@online.ru.).

 Robert Rathbun Wilson 1914-2000.

Robert Rathbun Wilson died on January 16 2000 at his home in Ithaca, New York at the age of 85. He has been one of the most important figures in the history of the development of particle accelerators. He is probably best known for leading the team that designed and built the highly successful Fermi National Accelerator Laboratory – Fermilab. As well as accomplishing this enormous technical feat, Wilson conceived and created the attractive and unusual environment in which Fermilab is located. Robert Wilson was also an accomplished artist and some of his sculptures are displayed on the grounds of Fermilab, as well as at Harvard University and the Northeast Proton Therapy Center, Massachusetts General Hospital.

While Robert Wilson accomplished many bigger and better things in his productive life, to the proton radiation therapy community, he is probably best known for the seminal paper (R. R. Wilson (1946). Radiological use of fast protons. Radiology 47, 487-91) which was written while he was a member of the Physics Department at Harvard University. This paper was intended to "acquaint medical and biological workers with some of the physical properties and possibilities of such rays. To be as simple as possible, let us consider only high-energy protons: later we can generalize to other particles."

The paper summarizes the properties of proton beams that could be used to advantage in medical applications and predicts that accelerators under construction at that time should easily be able to produce sufficient current for medical applications. Not only does this paper describe the properties of proton beams, but it also suggests the use of "a rotating wheel of variable thickness, corresponding to the tumor thickness between the source and the patient" to cover the whole volume with the "very high ionization density which obtains over the last few millimeters" when treating large tumors. It also suggests that "the exposure can be monitored precisely simply by placing a shallow ionization chamber between source and patient. Absolute determinations of the dosage can be determined by measuring ionization currents in gases of the elements of tissue or in a gas which mocks up the molecular formula of tissue."

Robert Wilson was invited to address the Second International Symposium on Hadrontherapy held at CERN in 1996 – fifty years since he wrote that profound paper. In his talk (Advances in Hadrontherapy, Excerpta Medica, Int. Cong. Series 1144. Eds: U. Amaldi and B. Larsson, Elsevier, pp ix-xiii, 1997), he described how he came to write the paper describing the properties of proton beams when his immediate mission then had been to just find the penetration of 150 MeV protons in various materials for radiation protection purposes. In discussing what led him to investigate the penetration of protons in tissue-like material, he states " I found the range in brass was going to be several inches while a few inches of lead would fix everything. That was the solution and I should have then gone on to other problems in designing the machine, but I did not stop. Why? There was no reason I should go on to anything beyond that, since I had done the job as far as the engineering design of that machine. Fifty years later I do not know why I did not stop. I suppose the first reason was just simple curiosity to find out a little bit more………………So I went on, and instead of just talking about the penetration of particles, I jumped into the almost obvious thing that I could see next: because one could hurt people with protons, one could probably help them too. So I tried to work out every detail I could from the scattering to the Bragg curve………………"

Such lively curiosity, imagination, scientific competence and humanity will be sorely missed.

Janet Sisterson

The following Table was presented in October 1999 by Skip Rosenthal, MGH at the Workshop on Treatment Planning Systems, PTCOG XXXI. Information was provided by: S. Rosenthal, A. Mazal, M. Collier, T. Lomax, S. Nill, and D. Miller. This Table is a new feature of Particles, and will be updated each issue. Please send corrections/additions to Janet Sisterson.

Proposed NEW FACILITIES for PROTON & ION BEAM THERAPY - July 2000

July 2000