Novel Technologies for Cancer

Therapy and Research

BIOMEDICAL TECHNOLOGY FORUM

Vahagn Nazaryan, Ph.D.

Medical Physicist / Assistant Professor

Cynthia Keppel, Ph.D.

Scientific and Technical Director / Professor

Hampton University Proton Therapy Institute

JLab, June 15, 2010
Outli

 Introduction to proton therapy

 Dosimetric Advantages Unique Challenges Delivery Techniques

 HUPTI Research
We have come a long way...

1933-37
 The goal

 deliver lethal doses of radiation to 

tumor killing cancer

Radiation Therap

 minimize or eliminate healthy tissu

injury.
Treatment Delive

Proton 

patient

source
% ABSORBED

150

125

Treatment Delivery protons vs. x-ra

% ABSORBED DOSE 100 755025

0 5 10 15 20 25 30 

0

DE
Advantages of irradiation with Proto

 Deliver less dose in front of the tumor

 Deliver maximum dose to the tumor reg NO DOSE behind the tumor Protons destroy tumor more effectiv

x-rays or electrons – protons are ~2000 timethan electrons
Beam Delivery Techniqu

 Scattering

 Double Scattering Single Scattering

 Uniform Scanning Modulated Scanning
Spread-out Bragg Pe
Beam Delivery - Scatteri

Range modulatprovides out Brag(uniform dose)
Uniform Scanni

Narrow proton beam is scanned laterally 

by scanning magnets for each energy layer•Scanning area cover full field•Dose delivered layer by layer•Beam shaping by

patient

Proton source

Magnets

•Beam shaping by• Block in lateral direction• Compensator in range
Cure vs. Complicatio

For x-rays A reduction of dose by 5% reduction of dose by 5% lowers the lowers the 

chances of cure significantly, from 65% 

15%

 On the other hand an increase of dose 

may kill all the cancer but increases th

of complications from 10% to 80%.

Due to excellent healthy tissue sparing pr

allow to increase the dose without such 

risks of complications
COMPLETED PROTON PATIENTS BY DIAG

From Inception to December 2004

Prostate 65%

Choroidal Melanoma 1.5%

Pituitary 0.8%

Acoustic Neuroma 0.

Head & Ne

Astrocytoma 1.4

Other Brain 3

Craniopharyn

Meningioma 1.5%

Prostate 65%

Head & NeOther Pelv

Orbital 0.6%

Paraspinal Tu

Chordoma/Chon

Sarcoma 1.1%

Other Chest 4.0%

AVM 1.5%

Other Abdominal 1.4%

SNVM 4.2% (100% = 10,300)

A brief tour of the treatment proces

(courtesy of Loma Linda) 

•Treatment rooms use gantries 

to deliver the proton beam. The 90-ton, three-story gantries can be rotated 360 degrees to deliver the beam at the precise angle prescribed by the physician. 

PSI
Simulating therapy machin

•Most of the ~40 ft. tallgantry is concealed by and floor of the treatmethe patient only sees ththe proton nozzle rotattreatment
Septum

Cyclotro

235 MeV 

Cyclotron

Degrader
NORTHEAST PROTON 

THERAPY CENTER

NPTC of Mas General Hospital

Boston (2001)

protons (≤ 235 MeV) 

cyclotron (IBA)

2 gantries + 2 fixed beams

Proton Therapy in the USA (5 centers)9 new projects have been 

announced ( )

Seattle Cancer Care Alliance

Northern Illinois University 

Midwest Proton Radiaton Institute

Bloomington (IN) (2003)

protons (≤ 210 MeV) from cyclotron

1 gantry + 1 fixed beam + 1 experimental

M.D. Anderson Canc

Houston (TX) (2

protons (≤ 235 MeV) from 

3 gantries + 1 fixed beam + 

LOMA LINDA 

UNIVERSITY CENTER

Los Angeles (1992)

protons (≤ 250 MeV) from synchrotron

3 gantries + 2 fixed beams

Oklahoma City

Hampton UniversityPTI
$11,000,000 in concret

What will the Hampton center look 

Insid
Hampton University Proton Therapy Instit

~$200M projectConstruction started 7/2007, First patient expected 8/2010Largest and most advanced in the nation / worldAt maximum capacity, will treat >150 patients / day4 gantries, fixed beam room, dedicated research line
Hampton University Proton Therapy Institu

99% equipment on site for all 5 treatment roomsBeam line installation completeGantry superstructures completeFirst beam delivered from cyclotron March 2009Currently delivering test beam to treatment rooms

•HUPTI has accfitst treatment roFebruary•On track to treaAugust 2010
A brief tou

Currently Commissioning First Ro

generate the treatment prescription
A brief tou

Imaging Syst

PET/CT imaging unit from Philips is being insta

generate the treatment prescription
• Radiation Biology (in collaboration with EVM

• Proton Tomography• Neutron Shielding Materials Research (

Collaboration Opportunities – Applied Re

• Neutron Shielding Materials Research (

collaboration with Veritas Medical Solutions)

– Hybrid and Light-weight solutions

• Radiobiologicaly Optimized Therapy 

Simulations (in collaboration with Varian MediSystems)
• Dedicated Imager for Proton Radiotherapy 

Guidance and Monitoring

(in collaboration wi

• Respiration Gating Technologies 

(in collabo

Collaboration Opportunities – Instrumen

• Respiration Gating Technologies 

(in collabo

with Philips Healthcare

)

• Development of QA Tools

(in collaboration w
Current Status 

The facility is a $225 million, stateof-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 remaining 35% includes breast, lung, pediatric, and other cancers.First patient – August 2010

Put Hampton 

“on the map” a“on the map” aend medical de
• HUPTI website 

http://www.hamptonproton.org/

• Scientific and Technical Director 

Cynthia Keppel, keppel@jlab.org

Where to get more 

information.....

• Vahagn.Nazaryan@hamptonproton.org• The National Association for Proton Therapy; http://Pr

therapy.org

• Loma Linda University Medical Center

http://www.llu.edu/proton/

• Particle Therapy Co-Operative Group; http://ptcog.we
Thank You!

Questions?