Medical Radiology and Radiation Safety. 2019. Vol. 64. No. 2. P. 61–69

DOI: 10.12737/article_5ca6027479faf5.57356528

A.V. Agapov¹, V.N. Gaevsky¹, E.V. Kizhaev³, Ya.V. Kurgansky^1,2, E.V. Luchin¹, G.V. Mytsin¹, A.G. Molokanov¹, M.A. Tseytlina¹, S.V. Shvidky¹, K.N. Shipulin¹

Experience of Proton Radiotherapy at the Joint Institute for Nuclear Research, Dubna

1. Joint Institute for Nuclear Research, Dubna, Russia. E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. ;
2. MSU-9, Dubna, Russia;
3. Russian Medical Academy of Continuous Professional Education, Moscow, Russia

A.V. Agapov – Researcher;
V.N. Gaevsky – Leading Engineer;
E.V. Kizhaev – Head of Dep., Dr. Sci. Med., Prof.;
Ya.V. Kurgansky – Head of Dep.;
E.V. Luchin – Senior Researcher, PhD Med.;
G.V. Mytsin – Head of Dep., PhD Tech.;
A.G. Molokanov – Senior Researcher, PhD Tech.;
M.A. Tseytlina – Research Assistant, PhD Med.;
S.V. Shvidky – Deputy Head of Dep., PhD Tech.;
K.N. Shipulin – Researcher

Abstract

First experiments on using proton beams for radiotherapy of malignant tumours at the 680 MeV proton synchrocyclotron of the V.P. Dzhelepov Laboratory of Nuclear Problems of the Joint Institute for Nuclear Research (DLNP JINR) have been initiated by Prof. V.P. Dzhelepov and were started in 1967. 28 patients with different types of superficially located malignancies, such as skin melanomas, metastases of cancer to peripheral nodes, larynx cancers and so on, were treated during the period of 1967–1971.

Then the method of scanning rotation irradiation of deep-seated tumours was developed and started to use at DLNP JINR. 50 patients with esophagus cancer, larynx cancer and metastases of malignant tumors were treated with that technique.

During the period of 1974–1984 the synchrocyclotron was modified to the Phasotron with the increase of output current. At the same time, a multi-room Medico-technical complex for hadron radiotherapy of cancer patients was constructed. It allows tumour treatment with wide and narrow horizontal beams of protons (70–660 MeV), negative pions (30–80 MeV), high-energy neutrons (mean energy 350 MeV), and with their combinations. The complex includes also the standard gamma-therapy unite Rokus-M with 60Co source for external irradiation. The unique equipment has been developed and constructed, including full-scale PET, X-ray CT for topometry of patients in sitting position, and proton CT.

A new round of the development started in December 1999 when a specialized radiological department of patient capacity of 25 beds was opened in Dubna. Since 2000 regular sessions have been conducted in research of proton therapy efficiency in irradiation of patients with neoplasms located in the head, neck and other parts of the body. 1283 patients have received courses of radiotherapy at the Phasotron beams by the end of 2018.

The technique of 3D conformal proton radiotherapy in which the maximum of the formed dose distribution conforms most accurately to the shape of the irradiated target has been realized and put into operation. In this way, the maximum sparing effect is achieved in normal tissues and organs surrounding the tumor.

The statistical analysis of the proton treatment results of two classes of neoplasms treated with the JINR proton beam (arterio-venous malformation) of the brain and the skull base (chordomas and chondrosarcomas) are presented.

A new project of the development and construction of a modern superconducting cyclotron SC202 dedicated for proton radiotherapy was prepared recently by the staff of the DLNP JINR and Institute of Plasma Physics Chinese Academy of Sciences (Hefei, China). It is supposed that the accelerator will become the base of a new Proton Therapy Centre in Dubna. It will consist of two treatment rooms: the first one will be equipped with static wide horizontal proton beam and a therapeutic chair, and the second one is planned to provide with gantry for a pencil proton beam dynamic scanning and a positioner for supine patient position during irradiation.

Key words: proton therapy, synchrocyclotron, 3-D conformal radiotherapy, boluses, aperture collimators, brain, head and neck tumours, JINR, Dubna

REFERENCES

1. Dzhelepov VP, Komarov VI, Savchenko OV. Formation of a proton beam with an energy of 100–200 MeV. JINR Commun 16-3491. 1967. (Russian).
2. Salamov RF. Preparation and realization of the treatment using medical proton beam of the LNP JINR. Medical proton beam of the LNP JINR. Ed. Ruderman AI, Vaynberg MSh. JINR Commun Р -5646. 1971:25-32. (Russian).
3. Dzhelepov VP, Goldin LL. The use of available and the possibility of creating new domestic accelerators of heavy charged particles for radiation therapy. JINR Commun 9-4560. 1969. (Russian).
4. Konnov BA, Shustin VA, Melnikov LA, Tigliev GS, Badmaev KN, Bobrov YuF, et al. First experience on the use of 1000-MeV proton beam in radiation therapy. Proceedings of the First International Seminar on the Uses of Proton Beams in Radiation Therapy Moscow. 1979;3:50-7. (Russian).
5. High-energy proton beams and radiation therapy of malignant tumors. Ed. Dzhelepov VP and Ruderman AI. JINR Commun 9035. 1975. (Russian).
6. Dzhelepov VP, Savchenko OV, Astrakhan BV, Ruderman AI. Six-Compartment Clinicophysical Facility of JINR. Medical Radiology. 1987;32(8):81. (Russian).
7. Abasov VM, Andreev GA, Astrakhan BV, Gavrilova TS, Klochkov II, Kutuzov SA, et al. Technidues on-line with the computer for rotary scanning irradiation of deeply lying tumours. JINR Commun 18-80-156. 1980. (Russian).
8. Boreyko VF, Grebenyuk VF, Zorin VP, Mytsin GV, Savchenko OV. A positron emission tomograph based on composite scintillators. Instr Exper Tech. 1998;5:131-6. (Russian).
9. Abasov VM, Andreev GA, Astrakhan BV, Zorin VP, Klochkov II, Kutuzov SA, et al. A simple version of X-ray computerized tomograph for receiving topometric information. JINR Commun 13-87-702. 1987. (Russian).
10. Alekseev GI, Zorin VP, Ivanov IA, Klenev GI, Mytsin GV, Molokanov AG, et al. Proton tomograph for the proton therapy facility. JINR Commun 18-91-435. 1991. (Russian).
11. Savchenko OV. Status and prospects of new clinical methods of cancer diagnostics and treatment based on particle and ion beams available at JINR. JINR Commun 2-7195. 1996. (Russian).
12. Agapov AV, Gaevsky VN, Gulidov IA, Iglin AV, Luchin EI, Mytsin GV, et al. Technique of 3D conformal proton therapy. Part Nucl Lett 2005;2(6):80-6. (Russian).
13. Budyashov YuG, Karpunin VO, Kolonuto PE, Mitsyn GV, Molokanov AG, Shvidky SV. A system for proton beam control during radiotherapy. Part Nucl Lett 2006;3(1):59-60. (Russian).
14. Bois AZ, Milker-Zabel S, Huber P, Schlegel W, Debus J. Linac-based radiosurgery or hypofractionated stereotactic radiotherapy in the treatment of large cerebral arteriovenous malformations. Int J Radiat Oncol Biol Phys. 2006;64:1049-54.
15. Menezes AH, Traynelis VC. Tumors of the craniovertebral junction. Neurological surgery. Philadelphia. WB Saunders. 1996:3041-3072.
16. Gurskiy SV, Karamysheva GA, Karamyshev OV, Kostromin SA, Morozov NA, Samsonov EV, et al. Research and development of a compact superconducting cyclotron SC200 for proton therapy. Proceedings of IPAC2016. 2016:1262-4.

For citation: Agapov AV, Gaevsky VN, Kizhaev EV, Kurgansky YaV, Luchin EV, Mytsin GV, Molokanov AG, Tseytlina MA, Shvidky SV, Shipulin KN. Experience of Proton Radiotherapy at the Joint Institute for Nuclear Research, Dubna. Medical Radiology and Radiation Safety. 2019;64(2):61-9. (Russian).

DOI: 10.12737/article_5ca6027479faf5.57356528

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