1. Proton Therapy for Hampton Roads
“HUPTI – Advances in Technology
Treating Cancer”
Vahagn Nazaryan, Ph.D.
Medical Physicist / Assistant Professor
Hampton University Proton Therapy Institute
October 16, 2010
2. About Proton Therapy
Cancer is the (2nd) largest cause of disease-related death in
the USA and other developed nations.
Cure achieved for ~45% of all cancer patients using available
therapeutic strategies: chemotherapy (5%), surgery (22%),
and radiation treatment (12%, 18% in combination with
surgery). changing
Disease is well-localized in 2/3 of patients at time of diagnosis
50% of USA cancer patients receive radiation treatment, most
with external beam.
Proton therapy is widely recognized as the most effective
external beam method in the selective destruction of cancer
cells.
Because…….
3. Prostate Cancer
Cancer of the prostate is the most commonly
diagnosed cancer in men. In 2004, approximately
230,110 US men were diagnosed with prostate cancer,
and approximately 29,900 died from the disease.
From 1992 to 1999, the average annual incidence of
prostate cancer among African American men was
59% higher than among Caucasian men and the
average annual death rate was more than twice that of
Caucasian men.
Many treatment options are associated with
undesirable side effects (impotence, incontinence,
others)
5. Radiation Therapy
The goal
deliver lethal doses of radiation to the
tumor killing cancer
minimize or eliminate healthy tissue
injury.
6. What is a Proton?
www.ethereal.org
Molecules Atoms
Protons and
www.innovation.gov.au Neutrons
Proton is a particle with a diameter of 0.00000000000006
inches and mass of 0.00000000000000000000000006 oz.
It has a positive charge 1.
8. Treatment Delivery protons vs. x-rays
150
125
DOSE
DOSE
% ABSORBED
% ABSORBED
100
75
50
25
DEPTH IN CM
0
0 5 10 15 20 25 30 35
9. Advantages of irradiation with Protons
Deliver minimal dose in front of the tumor
Deliver maximum dose to the tumor region
NO DOSE behind the tumor
Protons destroy tumor more effectively than
x-rays or electrons – protons are ~2000 times heavier
2000
than electrons
10. Cure vs. Complications
For x-rays
x-
A reduction of dose by 5% lowers the
chances of cure significantly from 65% to
15%
On the other hand an increase of dose by 5%
may kill all the cancer but increases the risk
of complications from 10% to 80%.
Due to excellent healthy tissue sparing protons
allow to increase the dose without such high
risks of complications
11.
12. A brief tour…
Most of the ~40 ft. tall, 90
ton, gantry is concealed by
the walls and floor of the
treatment room--the patient
only sees the front of the
proton nozzle rotating prior to
treatment
The gantry supports all
equipment necessary for
controlling and monitoring
patient treatment.
Rinecker Proton Therapy
Centre (Munich) MPRI (IUCF)
14. Proton Therapy in the USA
(5 centers) NORTHEAST PROTON
THERAPY CENTER
5 new projects have been NPTC of Mas General Hospital
Boston (2001)
announced ( ) protons (≤ 235 MeV)
cyclotron (IBA)
2 gantries + 2 fixed beams
Seattle
Cancer
Northern
Care
Illinois
Alliance
University
UPenn
Medical
Midwest Proton Radiaton Institute
Bloomington (IN) (2003) Center
protons (≤ 210 MeV) from cyclotron
1 gantry + 1 fixed beam + 1 experimental
Hampton Jacksonville,
University FL (IBA
PTI cyclotron)
LOMA LINDA
UNIVERSITY CENTER
Los Angeles (1992)
protons (≤ 250 MeV) from synchrotron Oklahoma M.D. Anderson Cancer Center
Houston (TX) (2004)
3 gantries + 2 fixed beams City
protons (≤ 235 MeV) from synchrotron
3 gantries + 1 fixed beam + 1 experimental
15. Hampton University Proton Therapy Institute
~$200M project
Construction started 7/2007,
First patient expected 8/2010
Largest and most advanced in
the nation / world
At maximum capacity, will
treat >150 patients / day
4 gantries, fixed beam room,
dedicated research line
16. Hampton University Proton Therapy Institute
99% equipment on site for all 5
treatment rooms
Beam line installation complete
Gantry superstructures complete
First beam delivered from
cyclotron March 2009
Currently delivering test beam to
treatment rooms
•HUPTI has accepted the
fitst treatment room in
February
•On track to treat patients in
August 2010
17. A brief tour –
Currently Commissioning First Room
generate the treatment prescription
18. A brief tour –
Imaging System
PET/CT imaging unit from Philips.
generate the treatment prescription
19. Collaboration Opportunities – Applied
Research
Radiation Biology (in collaboration with EVMS, NASA)
Proton Tomography
Neutron Shielding Materials Research (in
collaboration with Veritas Medical Solutions)
Hybrid and Light-weight solutions
Radiobiologicaly Optimized Therapy
Simulations (in collaboration with Varian Medical
Systems)
20. Collaboration Opportunities – Instrumentation
Dedicated Imager for Proton Radiotherapy
Guidance and Monitoring (in collaboration with TJNAF)
Respiration Gating Technologies (in collaboration
with Philips Healthcare)
Development of QA Tools (in collaboration with CIRS)
21. Current Status …
The facility is a $225 million, state-
of-the-art treatment and research
center.
Nation's 7th proton therapy facility,
the largest in the world (98,000 sq.ft ),
also a hotel and conference center
HUPTI will treat over 2,000
patients per year, including 65%
prostate cancer treatments. The Put Hampton Roads
remaining 35% includes breast, lung, “on the map” as a high-
high-
pediatric, and other cancers.
end medical destination.
First patient – August 2010
22. Where to get more
information…..
HUPTI website
http://www.hamptonproton.org/
Scientific and Technical Director Cynthia
Keppel, keppel@jlab.org
Vahagn.Nazaryan@hamptonproton.org
The National Association for Proton Therapy; http://Proton-
therapy.org
Loma Linda University Medical Center
http://www.llu.edu/proton/
Particle Therapy Co-Operative Group; http://ptcog.web.psi.ch/