Ion Beam Therapy Research Articles

Inhomogeneity detection within a head-sized phantom using tracking of charged nuclear fragments in ion beam therapy.

The highly conformal carbon-ion radiotherapy is associated with an increased sensitivity of the dose distributions to internal changes in the patient during the treatment course. Hence, monitoring methodologies capable of detecting such changes are of vital importance. We established experimental setup conditions to address the sensitivity of a monitoring approach based on secondary-fragment tracking for detecting clinically motivated air cavity dimensions in a homogeneous head-size PMMA phantom in 40 mm depth. The air cavities were positioned within the entrance channel of a treatment field of 50 mm diameter at three lateral positions. The measured secondary-fragment emission profiles were compared to a reference measurement without cavities. The experiments were conducted at the Heidelberg Ion-Beam Therapy Center in Germany at typical doses and dose rates. Significances above a detectability threshold of 2σ for the larger cavities (20 mm diameter and 4 mm thickness, and 20 mm diameter and 2 mm thickness) across the entire treatment field. The smallest cavity of 10 mm diameter and 2 mm thickness, which is on the lower limit of clinical interest, could not be detected at any position. We also demonstrated that it is feasible to reconstruct the lateral position of the cavity on average within 2.8 mm, once the cavity is detected. This is sufficient for the clinicians to estimate medical effects of such a cavity and to decide about the need for a control imaging CT. This investigation defines well-controlled reference conditions for the evaluation of the performance of any kind of treatment monitoring method and its capability to detect internal changes within head-sized objects. Air cavities with volumes from 0.31 cm3 to 1.26 cm3 were narrowed down around the detectability threshold of this secondary-fragment-based monitoring method.

Dosimetry in MRgPT: Impact of magnetic fields on TLD dose response during proton irradiation.

Proton beam therapy, when integrated with MRI guidance, presents complex dosimetric challenges due to interactions with magnetic fields. Prior research has emphasized the nuanced impact of magnetic fields on dosimetry. For thermoluminescent dosimeters (TLDs) the electron-return effect, alongside small air cavities surrounding the pellets, can lead to nonuniform dose distributions. Future MR-guided proton therapy will require reliable methods for end-to-end tests and dosimetric audits, which so far are often performed using TLDs equipped with phantoms. This implicates the necessity of accounting for theseinteractions. This study investigates the influence of magnetic fields on TLDs at two proton energies, using magnetic field strengths of 0, 0.25, and , aiming to clarify their impact on dose measurementaccuracy. The study was conducted at a synchrotron-based ion beam therapy beam line, enhanced by a resistive dipole magnet for creating magnetic fields up to to simulate MR-guided proton therapy. Individual correction factors were applied for TLD measurements. The impact of air gaps on the TLD signal was evaluated using three dedicated TLD holders with air gaps of 0.1, 0.25, and 0.5 mm surrounding the TLD pellets using the highest available proton energy of . Additionally, the influence of the magnetic field strength on the TLD response was evaluated for two proton energies of and . The study found no statistically significant variation in TLD dose response attributable to changes in the air gap or the presence of magnetic fields. A power analysis indicated an upper limit on a potential change in dose-response as small as 1.5%. The findings suggested that the impact of air gap variations and magnetic field strengths on the TLD response was below the detection threshold of TLD sensitivity. This emphasizes the suitability of TLDs for dose measurement in MR-guided proton therapy, indicating that additional correction factors may not be necessary despite the influence of magneticfields.

A comparison of the acoustic waves generated in proton and carbon ion therapy

Hadron therapy, which employs particles such as protons and carbon-ions, is a promising method of cancer treatment due to its unique ability to deliver maximum energy at the Bragg peak near the tumor, sparing surrounding healthy tissue. Ionoacoustic waves, generated by thermal expansion from electronic collisions and localized heating, can be detected to optimize dose delivery and verify particle range, thus improving treatment precision. These waves offer a unique opportunity for comparative studies of different particle therapies. In this study, a mathematical model and computational simulations are used to compare the characteristics of ionoacoustic waves generated in tissue by proton and carbon-ion beams. In particular, we assess the impact of the nuclear fragmentation tail on the ionoacoustic signals generated in carbon-ion therapy. Our approach will allow us to make some important observations to study the comparative effects of proton and carbon-ion therapy. The aim of this work is to perform a comprehensive comparative analysis of ionoacoustic waves from proton and carbon-ion treatments, focusing on their potential for in-vivo range verification. This research addresses the current gap in understanding the use of ionoacoustic signals for range verification in ion beam therapy, which is critical given the growing clinical application of carbon ion therapy and its under-explored acoustic properties. This study pioneers the feasibility of using acoustic imaging from carbon-ion beams to detect the Bragg peak position and measure tumor dose in real-time. Carbon-ion dose mapping and relative biological effectiveness (RBE) assessment can be facilitated by real-time signal monitoring. Our study aims to significantly advance the field by addressing the lack of a verification technique for carbon-ion beams, focusing on the considerable impact of the nuclear fragmentation tail on ionoacoustic signal waveforms, which provides crucial insights into the unique energy deposition properties of carbon-ions.

Nanodosimetric investigation of the track structure of therapeutic carbon ion radiation part 1: measurement of ionization cluster size distributions

At the Heidelberg Ion-Beam Therapy Center, the track structure of carbon ions of therapeutic energy after penetrating layers of simulated tissue was investigated for the first time. Measurements were conducted with carbon ion beams of different energies and polymethyl methacrylate (PMMA) absorbers of different thicknesses to realize different depths in the phantom along the pristine Bragg peak. Ionization cluster size (ICS) distributions resulting from the mixed radiation field behind the PMMA absorbers were measured using an ion-counting nanodosimeter. Two different measurements were carried out: (i) variation of the PMMA absorber thickness with constant carbon ion beam energy and (ii) combined variation of PMMA absorber thickness and carbon ion beam energy such that the kinetic energy of the carbon ions in the target volume is constant. The data analysis revealed unexpectedly high mean ICS values compared to stopping power calculations and the data measured at lower energies in earlier work. This suggests that in the measurements the carbon ion kinetic energies behind the PMMA absorber may have deviated considerably from the expected values obtained by the calculations. In addition, the results indicate the presence of a marked contribution of nuclear fragments to the measured ICS distributions, especially if the carbon ion does not cross the target volume.

2186: Dosimetric comparison of carbon ion and proton beam therapy for large primary renal cell cancer

2186: Dosimetric comparison of carbon ion and proton beam therapy for large primary renal cell cancer

Optically stimulated luminescence detectors for LET determination and dosimetry in ion beam therapy

Optically stimulated luminescence detectors (OSLDs) have been utilized for various dosimetry applications for many years. The use of Al2O3:C OSLDs for proton dosimetry began over a decade ago, taking advantage of the correlation between the ionization density of the radiation field and the ratio of intensities of the material’s two emission bands. The correlation allows for determining both linear energy transfer (LET) and dose in proton beams, with corrections for ionization quenching derived from the LET. However, the previous methodology for proton dosimetry and simultaneous LET determination with Al2O3:C OSLDs was cumbersome and occasionally associated with large uncertainties, while carbon beam dosimetry posed further challenges due to an elevated LET.This paper reviews the recent advancements in ion beam dosimetry and LET determination using OSLDs. Employing Al2O3:C,Mg OSLDs alongside improved, automatized read-out techniques, and the use of other radiation quality metrics than averaged LET, has removed most of the previous obstacles for ion beam dosimetry with OSLDs.The feasibility of simultaneous LET determination and dosimetry in ion beams is demonstrated through two case studies involving realistic proton and carbon ion therapy scenarios.

Current standards and the future role of hadrontherapy in the treatment of central nervous system tumors

IntroductionRadiation therapy is vital for treating central nervous system cancers (CNS), but traditional methods have limitations, especially in cases with high risks of side effects. Ion beam therapy, with its unique properties, offers a promising alternative for more precise and effective treatment, particularly in challenging scenarios.Materials and methodsThe presentation given at the symposium on hadrontherapy covered relevant literature for the utilization of ion beam therapy for pediatric CNS tumors, glioma, and meningeoma, as well as its role in re-irradiation. Emphasis was placed on new beam modalities, including carbon and helium ions, highlighting their potential benefits in improving treatment outcomes.ResultsThe results underscore the importance of preserving surrounding healthy tissue in pediatric malignancies’ radiation therapy. Proton irradiation achieves optimal target coverage while reducing radiation-induced side effects. Carbon ions show promise in glioma treatment, with ongoing trials validating their efficacy. Moreover, helium ion therapy demonstrates advantages in sparing normal tissue, making it a promising candidate for reintroduction into clinical routines. These findings highlight the potential of ion beam therapies in optimizing treatment outcomes while minimizing side effects, particularly in pediatric CNS tumors and gliomas.ConclusionResults support proton therapy for brain tumors, aiming to preserve cognitive function. Carbon ions could benefit select patients in primary treatment and for recurrent cases. Helium ion therapy combines advantages of protons and carbon ions, offering precise dose deposition and tissue sparing, making it suitable for clinical use.

An in-vivo treatment monitoring system for ion-beam radiotherapy based on 28 Timepix3 detectors

Ion-beam radiotherapy is an advanced cancer treatment modality offering steep dose gradients and a high biological effectiveness. These gradients make the therapy vulnerable to patient-setup and anatomical changes between treatment fractions, which may go unnoticed. Charged fragments from nuclear interactions of the ion beam with the patient tissue may carry information about the treatment quality. Currently, the fragments escape the patient undetected. Inter-fractional in-vivo treatment monitoring based on these charged nuclear fragments could make ion-beam therapy safer and more efficient. We developed an ion-beam monitoring system based on 28 hybrid silicon pixel detectors (Timepix3) to measure the distribution of fragment origins in three dimensions. The system design choices as well as the ion-beam monitoring performance measurements are presented in this manuscript. A spatial resolution of 4mm\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${{4}\\,\\hbox {mm}}$$\\end{document} along the beam axis was achieved for the measurement of individual fragment origins. Beam-range shifts of 1.5mm\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${1.5}\\,\\hbox {mm}$$\\end{document} were identified in a clinically realistic treatment scenario with an anthropomorphic head phantom. The monitoring system is currently being used in a prospective clinical trial at the Heidelberg Ion Beam Therapy Centre for head-and-neck as well as central nervous system cancer patients.

Zircoborate glass-ceramic composite reinforced with aluminum oxynitride: Microstructural evolution, physical properties, and charged radiation attenuation analysis

This study used the powder metallurgy method to create aluminum oxynitride (AlON)-reinforced zircoborate glass-ceramic composites. The solid-phase reaction method was used to synthesize AlON powder, which was then added to Zr-based glass-ceramic in different amounts (0, 4, and 8 % by weight) to make it stronger and harder. The prepared materials were characterized for their structural, physical, and radiation shielding properties. The density of GZr8 (AlON-free) had a value of 2.9 g/cm3, and the sintered glass-ceramic density with 4 % wt. AlON reinforcement (GZr8Al4) reached 3.05 g/cm3. The highest density of 3.11 g/cm3 was obtained for the GZr8Al8 sample with 8 % AlON wt. The Vickers hardness for GZr8, GZr8Al4, and GZr8Al8 was measured to be 4.89, 5.94, and 6.33 GPa, respectively. The AlON-reinforced GZr8 samples had fast neutron (FN) removal cross-sections of 0.0796 cm−1 and 0.0824 cm−1 for AlON content of 4 and 8 wt%, respectively. Generally, the coherent scattering cross-section (σcoh), incoherent scattering cross-section (σinc), and absorption cross-section (σabs) of thermal neutrons (TNs) increase from 0.047856 cm−1, 0.02072 cm−1, and 0.01498 cm−1, respectively for GZr8 to 0.53124 cm−1, 0.02074 cm−1, and 0.01795 cm−1, for GZr8Al8. AlON was proven to improve the ability of the Zr-based glass-ceramics to attenuate FNs and TNs. Stopping powers of electrons, protons, alpha particles and carbon ions increase with the AlON content of the materials. Comparatively, the range of charged radiation in AlON-rich samples is lower. The inclusion of AlON in the matrix of the Zr-based glass-ceramics makes it more efficient at absorbing charged radiation and can be used in ion beam or hadron therapy, ion beam analysis, or other charged radiation environments as an absorber.

Hypofractionated proton and carbon ion beam radiotherapy for sacrococcygeal chordoma (ISAC): An open label, randomized, stratified, phase II trial

IntroductionSacrococcygeal chordomas have high recurrence rates and are challenging to treat. MethodsIn this phase II prospective, randomized, stratified trial, the safety and feasibility of hypofractionated ion radiation therapy were investigated. The primary focus was monitored through the incidence of Grade 3–5 NCI-CTC-AE toxicity. Secondary endpoints included local progression-free (LPFS) and overall survival (OS). ResultsThe study enrolled 82 patients with primary (87 %) and recurrent (13 %) inoperable or incompletely resected sacral chordomas from January 2013 to July 2022, divided equally into proton therapy (Arm A) and carbon ion beam therapy (Arm B) groups, each receiving a total dose of 64 Gy (RBE) in 16 fractions, 5–6 fractions per week. Overall 74 % of patients received no previous surgery and 66 % of tumors were confirmed by a brachyury staining. The mean and median Gross Tumor Volume at the time of treatment (GTV) was 407 ml and 185 ml, respectively. The median follow-up of the surviving patients was 44.7 months, and the 2-year and 4-year OS rates were 96 % and 81 %, respectively. Factors such as smaller GTV and younger age trended towards better OS. The LPFS after 2-year and 4-year was 84 % and 70 %, respectively. Male gender emerged as a significant predictor of LPFS. There was no significant difference between the treatment groups. We observed five grade 4 wound healing disorders (6 %). ConclusionThe initial response rates were promising; however local control was not sustained. More comparative research on fractionation schemes is essential to refine treatment approaches for inoperable sacral chordoma.

Secondary neutrons in proton and light ion beam therapy: a review of current status, needs and potential solutions

The advantages of proton and light ion beam therapy compared to conventional photon radiation therapy are well-known, mainly thanks to the characteristic depth dose distribution of ions and their radio-biological effectiveness. Nevertheless, the use of ions implies different nuclear reactions that generate secondary particles, with neutrons among them. These secondary neutrons can travel far away from the treatment volume, their measurement is a challenging complex task, and their biological effects are particularly high for neutrons with energies in the MeV range. In this review, a comprehensive description of secondary neutron dosimetry in proton and light ion beam therapy is given. Many studies have been conducted on the quantification of the secondary neutron dose, most of them have been performed for proton beams, whereas for other ions like carbon, the available information is scarce. The main measurement campaigns are summarised, focusing on the type of detectors used. In line with the detectors’ advantages and limitations, measurements performed inside and outside anthropomorphic phantoms are considered. The role of Monte Carlo radiation transport simulations is discussed since many experimental detection techniques need additional simulations to provide dose estimates. A focus on the current challenges for the measurements of neutrons with energies above 20 MeV is given, as this is one of the main components of secondary neutrons produced by therapeutic ion beams. Finally, the potential clinical relevance of the available and needed secondary neutron dose data is discussed, in terms of its impact on the treatment of patients. For this, the relative biological effectiveness of neutrons and the potential risk of cancer induction re-incidence or secondary cancer due to secondary neutron doses play a key role.

Towards precise LET measurements based on energy deposition of therapeutic ions in Timepix3 detectors

Objective. There is an increasing interest in calculating and measuring linear energy transfer (LET) spectra in particle therapy in order to assess their impact in biological terms. As such, the accuracy of the particle fluence energy spectra becomes paramount. This study focuses on quantifying energy depositions of distinct proton, helium, carbon, and oxygen ion beams using a silicon pixel detector developed at CERN to determine LET spectra in silicon. Approach. While detection systems have been investigated in this pursuit, the scarcity of detectors capable of providing per-ion data with high spatial and temporal resolution remains an issue. This gap is where silicon pixel detector technology steps in, enabling online tracking of single-ion energy deposition. The used detector consisted of a 300 µm thick silicon sensor operated in partial depletion. Main results. During post-processing, artifacts in the acquired signals were identified and methods for their corrections were developed. Subsequently, a correlation between measured and Monte Carlo-based simulated energy deposition distributions was performed, relying on a two-step recalibration approach based on linear and saturating exponential models. Despite the observed saturation effects, deviations were confined below 7% across the entire investigated range of track-averaged LET values in silicon from 0.77 keV µm−1 to 93.16 keV µm−1. Significance. Simulated and measured mean energy depositions were found to be aligned within 7%, after applying artifact corrections. This extends the range of accessible LET spectra in silicon to clinically relevant values and validates the accuracy and reliability of the measurements. These findings pave the way towards LET-based dosimetry through an approach to translate these measurements to LET spectra in water. This will be addressed in a future study, extending functionality of treatment planning systems into clinical routine, with the potential of providing ion-beam therapy of utmost precision to cancer patients.

A quantitative assessment of Geant4 for predicting the yield and distribution of positron-emitting fragments in ion beam therapy

Objective. To compare the accuracy with which different hadronic inelastic physics models across ten Geant4 Monte Carlo simulation toolkit versions can predict positron-emitting fragments produced along the beam path during carbon and oxygen ion therapy. Approach. Phantoms of polyethylene, gelatin, or poly(methyl methacrylate) were irradiated with monoenergetic carbon and oxygen ion beams. Post-irradiation, 4D PET images were acquired and parent 11C, 10C and 15O radionuclides contributions in each voxel were determined from the extracted time activity curves. Next, the experimental configurations were simulated in Geant4 Monte Carlo versions 10.0 to 11.1, with three different fragmentation models—binary ion cascade (BIC), quantum molecular dynamics (QMD) and the Liege intranuclear cascade (INCL++) - 30 model-version combinations. Total positron annihilation and parent isotope production yields predicted by each simulation were compared between simulations and experiments using normalised mean squared error and Pearson cross-correlation coefficient. Finally, we compared the depth of the maximum positron annihilation yield and the distal point at which the positron yield decreases to 50% of peak between each model and the experimental results. Main results. Performance varied considerably across versions and models, with no one version/model combination providing the best prediction of all positron-emitting fragments in all evaluated target materials and irradiation conditions. BIC in Geant4 10.2 provided the best overall agreement with experimental results in the largest number of test cases. QMD consistently provided the best estimates of both the depth of peak positron yield (10.4 and 10.6) and the distal 50%-of-peak point (10.2), while BIC also performed well and INCL generally performed the worst across most Geant4 versions. Significance. The best predictions of the spatial distribution of positron annihilations and positron-emitting fragment production along the beam path during carbon and oxygen ion therapy was obtained using Geant4 10.2.p03 with BIC or QMD. These version/model combinations are recommended for future heavy ion therapy research.

Helium Ion Therapy for Advanced Juvenile Nasopharyngeal Angiofibroma.

Helium ion therapy (HRT) is a promising modality for the treatment of pediatric tumors and those located close to critical structures due to the favorable biophysical properties of helium ions. This in silico study aimed to explore the potential benefits of HRT in advanced juvenile nasopharyngeal angiofibroma (JNA) compared to proton therapy (PRT). We assessed 11 consecutive patients previously treated with PRT for JNA in a definitive or postoperative setting with a relative biological effectiveness (RBE) weighted dose of 45 Gy (RBE) in 25 fractions at the Heidelberg Ion-Beam Therapy Center. HRT plans were designed retrospectively for dosimetric comparisons and risk assessments of radiation-induced complications. HRT led to enhanced target coverage in all patients, along with sparing of critical organs at risk, including a reduction in the brain integral dose by approximately 27%. In terms of estimated risks of radiation-induced complications, HRT led to a reduction in ocular toxicity, cataract development, xerostomia, tinnitus, alopecia and delayed recall. Similarly, HRT led to reduced estimated risks of radiation-induced secondary neoplasms, with a mean excess absolute risk reduction of approximately 30% for secondary CNS malignancies. HRT is a promising modality for advanced JNA, with the potential for enhanced sparing of healthy tissue and thus reduced radiation-induced acute and long-term complications.

Organization and operation of multi particle therapy facilities: the Marburg Ion-Beam Therapy Center, Germany (MIT)

PurposeThe Marburg Ion-Beam Therapy Center (MIT) is one of two particle therapy centers in Germany that enables the treatment of patients with both protons and carbon ions. The facility was build by Siemens Healthineers and is one of only two centers worldwide built by Siemens (Marburg, Germany and Shanghai, China). The present report provides an overview of technical and clinical operations as well as research activities at MIT.MethodsThe MIT was completed in 2011 and uses a synchrotron for accelerating protons and carbon ions up to energies of 250 MeV/u and 430 MeV/u respectively. Three treatment rooms with a fixed horizontal beam-line and one room with a 45 degree beam angle are available.ResultsSince the start of clinical operations in 2015, around 2.500 patients have been treated at MIT, about 40% with carbon ions and 60% with protons. Currently around 400 patients are treated each year. The majority of the patients suffered from benign and malign CNS tumors (around 40%) followed by head and neck tumors (around 23%). MIT is actively involved in clinical studies with its patients. In addition to clinical operations, there is active research at MIT in the fields of radiation biology and medical physics. The focus is on translational research to improve the treatment of H & N carcinomas and lung cancer (NSCLC). Moreover, intensive work is being carried out on the technical implementation of FLASH irradiation for research purposes.ConclusionThe MIT is one of two centers worldwide that were built by Siemens Healtineers and has been successfully in clinical operation since 2015. The service provided by Siemens is guaranteed until 2030, the future after 2030 is currently under discussion.

Biological dose optimization incorporating intra-tumoural cellular radiosensitivity heterogeneity in ion-beam therapy treatment planning

Objective. Treatment plans of ion-beam therapy have been made under an assumption that all cancer cells within a tumour equally respond to a given radiation dose. However, an intra-tumoural cellular radiosensitivity heterogeneity clearly exists, and it may lead to an overestimation of therapeutic effects of the radiation. The purpose of this study is to develop a biological model that can incorporate the radiosensitivity heterogeneity into biological optimization for ion-beam therapy treatment planning. Approach. The radiosensitivity heterogeneity was modeled as the variability of a cell-line specific parameter in the microdosimetric kinetic model following the gamma distribution. To validate the developed intra-tumoural-radiosensitivity-heterogeneity-incorporated microdosimetric kinetic (HMK) model, a treatment plan with H-ion beams was made for a chordoma case, assuming a radiosensitivity heterogeneous region within the tumour. To investigate the effects of the radiosensitivity heterogeneity on the biological effectiveness of H-, He-, C-, O-, and Ne-ion beams, the relative biological effectiveness (RBE)-weighted dose distributions were planned for a cuboid target with the stated ion beams without considering the heterogeneity. The planned dose distributions were then recalculated by taking the heterogeneity into account. Main results. The cell survival fraction and corresponding RBE-weighted dose were formulated based on the HMK model. The first derivative of the RBE-weighted dose distribution was also derived, which is needed for fast biological optimization. For the patient plan, the biological optimization increased the dose to the radiosensitivity heterogeneous region to compensate for the heterogeneity-induced reduction in biological effectiveness of the H-ion beams. The reduction in biological effectiveness due to the heterogeneity was pronounced for low linear energy transfer (LET) beams but moderate for high-LET beams. The RBE-weighted dose in the cuboid target decreased by 7.6% for the H-ion beam, while it decreased by just 1.4% for the Ne-ion beam. Significance. Optimal treatment plans that consider intra-tumoural cellular radiosensitivity heterogeneity can be devised using the HMK model.

Apatite–Wollastonite (AW) glass ceramic doped with B2O3: Synthesis, structure, SEM, hardness, XRD, and neutron/charged particle attenuation properties

In the study, the influence of doping apatite-wollastonite (AW) glass-ceramics (GCs) with B2O3 on the structural, physical, microstructural, and light and heavy particle interaction properties is presented. Using the solid-state reaction and the cold isostatic press method, pristine AW, 10 wt% (AW-B10), and 20 wt% (AW-B20) B2O3-doped AW GCs were prepared. The prepared GCs were subject to structural, chemical compositional, and surface morphological investigation through standard experimental processes. Furthermore, the neutron (fast and thermal) and charged radiation (electron, proton, alpha, and carbon ion) interactional parameters of the GCs were obtained through standard theoretical models and software. The density of AW (2.91 gcm−3) increases to about 2.957 and 2.986 gcm−3 as B2O3 increases to 10 and 20 wt%, respectively. The presence of boron oxide supported the wollastonite phase to remain glass and suppressed crystallisation in the AW GCs. Doping AW with B2O3 improved the interaction probabilities of the GCs with fast and thermal neutrons, electrons, protons, alpha particles, and carbon ions. B-rich AW is thus potentially useful as a target material in human tissues for boron neutron capture therapy for the management of cancer and tumours, isolating or shielding specific tissues in ion beam therapy processes, and other techniques that require the exposure of human tissues to irradiation.

Dosimetric study for breathing-induced motion effects in an abdominal pancreas phantom for carbon ion mini-beam radiotherapy.

Particle mini-beam therapy exhibits promise in sparing healthy tissue through spatial fractionation, particularly notable for heavy ions, further enhancing the already favorable differential biological effectiveness at both target and entrance regions. However, breathing-induced organ motion affects particle mini-beam irradiation schemes since the organ displacements exceed the mini-beam structure dimensions, decreasing the advantages of spatialfractionation. In this study, the impact of breathing-induced organ motion on the dose distribution was examined at the target and organs at risk(OARs) during carbon ion mini-beam irradiation for pancreaticcancer. As a first step, the carbon ion mini-beam pattern was characterized with Monte Carlo simulations. To analyze the impact of breathing-induced organ motion on the dose distribution of a virtual pancreas tumor as target and related OARs, the anthropomorphic Pancreas Phantom for Ion beam Therapy (PPIeT) was irradiated with carbon ions. A mini-beam collimator was used to deliver a spatially fractionated dose distribution. During irradiation, varying breathing motion amplitudes were induced, ranging from 5to 15mm. Post-irradiation, the 2D dose pattern was analyzed, focusing on the full width at half maximum (FWHM), center-to-center distance (ctc), and the peak-to-valley dose ratio (PVDR). The mini-beam pattern was visible within OARs, while in the virtual pancreas tumor a more homogeneous dose distribution was achieved. Applied motion affected the mini-beam pattern within the kidney, one of the OARs, reducing the PVDR from 3.78 0.12 to 1.478 0.070 for the 15mm motion amplitude. In the immobile OARs including the spine and the skin at the back, the PVDR did not change within 3.4% comparing reference and motionconditions. This study provides an initial understanding of how breathing-induced organ motion affects spatial fractionation during carbon ion irradiation, using an anthropomorphic phantom. A decrease in the PVDR was observed in the right kidney when breathing-induced motion was applied, potentially increasing the risk of damage to OARs. Therefore, further studies are needed to explore the clinical viability of mini-beam radiotherapy with carbon ions when irradiating abdominalregions.

Evaluation of Helium Ion Radiotherapy in Combination with Gemcitabine in Pancreatic Cancer In Vitro.

Pancreatic cancer is one of the most aggressive and lethal cancers. New treatment strategies are highly warranted. Particle radiotherapy could offer a way to overcome the radioresistant nature of pancreatic cancer because of its biological and physical characteristics. Within particles, helium ions represent an attractive therapy option to achieve the highest possible conformity while at the same time protecting the surrounding normal tissue. The aim of this study was to evaluate the cytotoxic efficacy of helium ion irradiation in pancreatic cancer in vitro. Human pancreatic cancer cell lines AsPC-1, BxPC-3 and Panc-1 were irradiated with photons and helium ions at various doses and treated with gemcitabine. Photon irradiation was performed with a biological cabin X-ray irradiator, and helium ion irradiation was performed with a spread-out Bragg peak using the raster scanning technique at the Heidelberg Ion Beam Therapy Center (HIT). The cytotoxic effect on pancreatic cancer cells was measured with clonogenic survival. The survival curves were compared to the predicted curves that were calculated via the modified microdosimetric kinetic model (mMKM). The experimental relative biological effectiveness (RBE) of helium ion irradiation ranged from 1.0 to 1.7. The predicted survival curves obtained via mMKM calculations matched the experimental survival curves. Mainly additive cytotoxic effects were observed for the cell lines AsPC-1, BxPC-3 and Panc-1. Our results demonstrate the cytotoxic efficacy of helium ion radiotherapy in pancreatic cancer in vitro as well as the capability of mMKM calculation and its value for biological plan optimization in helium ion therapy for pancreatic cancer. A combined treatment of helium irradiation and chemotherapy with gemcitabine leads to mainly additive cytotoxic effects in pancreatic cancer cell lines. The data generated in this study may serve as the radiobiological basis for future experimental and clinical works using helium ion radiotherapy in pancreatic cancer treatment.

Imaging for ion beam therapy: current trends and future perspectives

PurposeSince the pioneering use of planar X-ray imaging in early experimental sites of proton and light ion cancer therapy, imaging has always been a cornerstone of ion beam therapy (IBT). This contribution highlights current trends and future perspectives of imaging in modern IBT.MethodsSeveral flavours of image guidance are under investigation to enhance IBT. A first class of in-room imaging techniques aims at providing insights on updated patient anatomy prior to or ideally during treatment. Owing to the unique characteristics of IBT, these methods do not only target a correct localization of the tumour and critical structures as in photon therapy, but also aim at extracting the tissue stopping properties for accurate (re)planning. A second class of techniques, predominantly performed during beam delivery, aims at capturing different secondary emissions induced by the irradiation to identify the beam stopping position and ideally reconstruct the dose delivery for inter- or intra-fractional treatment adaptation. Finally, a third class of imaging techniques is being explored to provide novel insights on the underlying biological mechanisms to open new opportunities for more effective and better tolerated treatments.Results and conclusions70 years after the worldwide first proton treatment, image guidance of IBT continues to be an evolving area which combines advanced instrumentation with progress in computational areas, including artificial intelligence, and beam delivery schemes. Especially on-site imaging opens new opportunities to innovate the IBT chain with daily treatment adaptation, real-time verification of in-vivo range and dose delivery along with biological guidance for treatment personalization.