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First patients receive carbon ion treatment at Italian cancer therapy centre

Treatment method based on GSI know-how / parts of the accelerator developed and supplied by GSI



At the Centro Nazionale di Adroterapia Oncologica (CNAO), Italy's National Hadron Therapy Centre for Cancer Treatment, a first batch of patients is receiving carbon ion treatment. The CNAO, which is located in the northern Italian city of Pavia, employs a treatment method developed at GSI Helmholtzzentrum für Schwerionenforschung GmbH in Darmstadt, Germany. Carbon ions are accelerated to high velocities in particle accelerators so that the particles can penetrate deep inside a patient's body, where they can destroy tumours. The treatment utilizes the so-called raster-scan method, by means of which the particle beam progressively scans the entire three-dimensional volume of the tumour with millimetre precision. The therapy has a very high cure rate and minimal side effects.

A number of project partners from various countries were involved in the design and installation of the facility at the CNAO. Scientists and engineers from GSI played a substantial role in its construction and commissioning, with parts of the accelerator facility, e. g. the linear acceleration unit, being developed and built by GSI. The raster-scan method used to carry out the particle beam irradiation was also developed at GSI.

Carbon ion therapy utilizing the raster-scan method is an extremely precise, highly effective and also very gentle form of treatment particularly suited for tumours situated deep within the body and in close proximity to sensitive organs such as the brainstem. It was used with great success at the GSI accelerator facility from 1997 to 2008, during which time some 450 patients were treated and the procedure first reached clinical maturity. The first purely clinical facility in this field was developed and built by GSI together with partners from industry. It is located at the Heidelberg Ion-Beam Therapy Centre (HIT) and went into clinical operation in 2009. In the meantime, almost 1,000 patients have been treated.

The CNAO facility is of similar design to the HIT setup and consists of two particle accelerators, connected in series, and three treatment rooms. The CNAO has been administering proton therapy to cancer patients since September 2011 and has now started providing carbon ion therapy as well. Carbon ions are relatively heavy and can destroy tumours that would withstand proton therapy or treatment with conventional forms of radiotherapy.

To date, carbon ion therapy is only provided at clinical facilities in Japan and at the Heidelberg Ion-Beam Therapy Centre. The start of clinical operation at the CNAO marks another major step towards establishing this pioneering form of cancer therapy and making it more readily available to a wider circle of patients.

Other facilities of this kind currently under construction include the MedAustron therapy centre in Wiener Neustadt, Austria, and the Shanghai Proton & Heavy Ion Hospital in China. Both will use the raster-scan method and, for the first stage of acceleration, a linear accelerator jointly developed by GSI and the Institute of Applied Physics at the Goethe University in Frankfurt, Germany.

CNAO treatment room.
CNAO accelerator.
Developed by GSI: CNAO linear accelerator.
CNAO building.
The CNAO linear accelerator was developed and built by GSI.
Photo: CNAO
Photo: CNAO
Photo: B. Schlitt, GSI
Photo: CNAO