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Bateman JJ, Buchanan E, Corsini R, Farabolini W, Korysko P, Garbrecht Larsen R, Malyzhenkov A, Ortega Ruiz I, Rieker V, Gerbershagen A, Dosanjh M. Development of a novel fibre optic beam profile and dose monitor for very high energy electron radiotherapy at ultrahigh dose rates. Phys Med Biol 2024; 69:085006. [PMID: 38478998 DOI: 10.1088/1361-6560/ad33a0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/13/2024] [Indexed: 04/04/2024]
Abstract
Objective. Very high energy electrons (VHEE) in the range of 50-250 MeV are of interest for treating deep-seated tumours with FLASH radiotherapy (RT). This approach offers favourable dose distributions and the ability to deliver ultra-high dose rates (UHDR) efficiently. To make VHEE-based FLASH treatment clinically viable, a novel beam monitoring technology is explored as an alternative to transmission ionisation monitor chambers, which have non-linear responses at UHDR. This study introduces the fibre optic flash monitor (FOFM), which consists of an array of silica optical fibre-based Cherenkov sensors with a photodetector for signal readout.Approach. Experiments were conducted at the CLEAR facility at CERN using 200 MeV and 160 MeV electrons to assess the FOFM's response linearity to UHDR (characterised with radiochromic films) required for FLASH radiotherapy. Beam profile measurements made on the FOFM were compared to those using radiochromic film and scintillating yttrium aluminium garnet (YAG) screens.Main results. A range of photodetectors were evaluated, with a complementary-metal-oxide-semiconductor (CMOS) camera being the most suitable choice for this monitor. The FOFM demonstrated excellent response linearity from 0.9 Gy/pulse to 57.4 Gy/pulse (R2= 0.999). Furthermore, it did not exhibit any significant dependence on the energy between 160 MeV and 200 MeV nor the instantaneous dose rate. Gaussian fits applied to vertical beam profile measurements indicated that the FOFM could accurately provide pulse-by-pulse beam size measurements, agreeing within the error range of radiochromic film and YAG screen measurements, respectively.Significance. The FOFM proves to be a promising solution for real-time beam profile and dose monitoring for UHDR VHEE beams, with a linear response in the UHDR regime. Additionally it can perform pulse-by-pulse beam size measurements, a feature currently lacking in transmission ionisation monitor chambers, which may become crucial for implementing FLASH radiotherapy and its associated quality assurance requirements.
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Affiliation(s)
- Joseph J Bateman
- John Adams Institute for Accelerator Science, Department of Physics, University of Oxford, Oxford, OX1 3RH, United Kingdom
| | - Emma Buchanan
- European Organization for Nuclear Research (CERN), Meyrin, 1211, Geneva, Switzerland
| | - Roberto Corsini
- European Organization for Nuclear Research (CERN), Meyrin, 1211, Geneva, Switzerland
| | - Wilfrid Farabolini
- European Organization for Nuclear Research (CERN), Meyrin, 1211, Geneva, Switzerland
| | - Pierre Korysko
- John Adams Institute for Accelerator Science, Department of Physics, University of Oxford, Oxford, OX1 3RH, United Kingdom
- European Organization for Nuclear Research (CERN), Meyrin, 1211, Geneva, Switzerland
| | - Robert Garbrecht Larsen
- European Organization for Nuclear Research (CERN), Meyrin, 1211, Geneva, Switzerland
- Particle Therapy Research Centre (PARTREC), Department of Radiation Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Alexander Malyzhenkov
- European Organization for Nuclear Research (CERN), Meyrin, 1211, Geneva, Switzerland
| | - Iñaki Ortega Ruiz
- European Organization for Nuclear Research (CERN), Meyrin, 1211, Geneva, Switzerland
| | - Vilde Rieker
- European Organization for Nuclear Research (CERN), Meyrin, 1211, Geneva, Switzerland
- Department of Physics, University of Oslo, NO-0316 Blindern, Oslo, Norway
| | - Alexander Gerbershagen
- Particle Therapy Research Centre (PARTREC), Department of Radiation Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Manjit Dosanjh
- John Adams Institute for Accelerator Science, Department of Physics, University of Oxford, Oxford, OX1 3RH, United Kingdom
- European Organization for Nuclear Research (CERN), Meyrin, 1211, Geneva, Switzerland
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Clements N, Esplen N, Bateman J, Robertson C, Dosanjh M, Korysko P, Farabolini W, Corsini R, Bazalova-Carter M. Mini-GRID radiotherapy on the CLEAR very-high-energy electron beamline: collimator optimization, film dosimetry, and Monte Carlo simulations. Phys Med Biol 2024; 69:055003. [PMID: 38295408 DOI: 10.1088/1361-6560/ad247d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 01/31/2024] [Indexed: 02/02/2024]
Abstract
Objective.Spatially-fractionated radiotherapy (SFRT) delivered with a very-high-energy electron (VHEE) beam and a mini-GRID collimator was investigated to achieve synergistic normal tissue-sparing through spatial fractionation and the FLASH effect.Approach.A tungsten mini-GRID collimator for delivering VHEE SFRT was optimized using Monte Carlo (MC) simulations. Peak-to-valley dose ratios (PVDRs), depths of convergence (DoCs, PVDR ≤ 1.1), and peak and valley doses in a water phantom from a simulated 150 MeV VHEE source were evaluated. Collimator thickness, hole width, and septal width were varied to determine an optimal value for each parameter that maximized PVDR and DoC. The optimized collimator (20 mm thick rectangular prism with a 15 mm × 15 mm face with a 7 × 7 array of 0.5 mm holes separated by 1.1 mm septa) was 3D-printed and used for VHEE irradiations with the CERN linear electron accelerator for research beam. Open beam and mini-GRID irradiations were performed at 140, 175, and 200 MeV and dose was recorded with radiochromic films in a water tank. PVDR, central-axis (CAX) and valley dose rates and DoCs were evaluated.Main results.Films demonstrated peak and valley dose rates on the order of 100 s of MGy/s, which could promote FLASH-sparing effects. Across the three energies, PVDRs of 2-4 at 13 mm depth and DoCs between 39 and 47 mm were achieved. Open beam and mini-GRID MC simulations were run to replicate the film results at 200 MeV. For the mini-GRID irradiations, the film CAX dose was on average 15% higher, the film valley dose was 28% higher, and the film PVDR was 15% lower than calculated by MC.Significance.Ultimately, the PVDRs and DoCs were determined to be too low for a significant potential for SFRT tissue-sparing effects to be present, particularly at depth. Further beam delivery optimization and investigations of new means of spatial fractionation are warranted.
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Affiliation(s)
- Nathan Clements
- Department of Physics and Astronomy, University of Victoria, Victoria, BC, Canada
| | - Nolan Esplen
- Department of Physics and Astronomy, University of Victoria, Victoria, BC, Canada
| | - Joseph Bateman
- Department of Physics, University of Oxford, Oxford, United Kingdom
| | | | - Manjit Dosanjh
- Department of Physics, University of Oxford, Oxford, United Kingdom
- CERN, Geneva, Switzerland
| | - Pierre Korysko
- Department of Physics, University of Oxford, Oxford, United Kingdom
- CERN, Geneva, Switzerland
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Ige T, Lewis P, Shelley C, Pistenmaa D, Coleman CN, Aggarwal A, Dosanjh M, Zergoug I, Eduardo HM, Bvochora-Nsingo M, Fulu K, Ralefala T, Grover S, Maison-Mayeh AM, Ndi SR, Attalla E, Deiab N, Belay EY, Acquah GF, Amankwaa-Frempong E, Foy H, Ngigi E, Badi F, Elburi I, Harivony T, Kone A, Maiga S, Tolba A, Mootoosamy S, El-Boutayeb S, Momade A, Midzi W, Grobler M, Aruah SC, Kra J, Diagne M, Trauernicht C, Elbashir F, Ali NAE, Makwani H, Yusufu S, Farhat L, Mounir B, Awusi K, Azangwe G. Understanding the challenges of delivering radiotherapy in low- and middle-income countries in Africa. J Cancer Policy 2023; 35:100372. [PMID: 36512899 DOI: 10.1016/j.jcpo.2022.100372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 11/25/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Access to high quality radiotherapy (RT) continues to be a major issue across Africa with Africa having just 34% of its optimal capacity. METHODS We co-developed a survey with clinical, academic and policy stakeholders designed to provide a structured assessment of the barriers and enablers to RT capacity building in Africa. The survey covered nine key themes including funding, procurement, education and training. The survey was sent to RT professionals in 28 countries and the responses underwent qualitative and quantitative assessment. RESULTS We received completed questionnaires from 26 African countries. Funding was considered a major issue, specifically the lack of a ring fenced funds from the Ministry of Health for radiotherapy and the consistency of revenue streams which relates to a lack of prioritisation for RT. In addition to a significant shortfall in RT workforce disciplines, there is a general lack of formal education and training programmes. 13/26 countries reported having some IAEA support for RT for education and training. Solutions identified to improve access to RT include a) increasing public awareness of its essential role in cancer treatment; b) encouraging governments to simplify procurement and provide adequate funding for equipment; c) increasing training opportunities for all radiotherapy disciplines and d) incentivizing staff retention. CONCLUSION This survey provides unique information on challenges to delivering and expanding radiotherapy services in Africa. The reasons are heterogonous across countries but one key recommendation would be for national Cancer Control plans to directly consider radiotherapy and specifically issues of funding, equipment procurement, servicing and training. POLICY SUMMARY The study demonstrates the importance of mixed methods research to inform policy and overcome barriers to radiotherapy capacity and capability in LMICs.
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Affiliation(s)
- Taofeeq Ige
- National Hospital Abuja, Abuja, Nigeria; University of Abuja, Abuja, Nigeria
| | | | - Charlotte Shelley
- The Royal Surrey County Hospital NHS Foundation trust, Guildford, UK
| | - David Pistenmaa
- ICEC, International Cancer Expert Corps, Washington, DC, USA
| | | | | | - Manjit Dosanjh
- ICEC, International Cancer Expert Corps, Washington, DC, USA; CERN, ATS-DO, Geneva, Switzerland; Department of Physics, University of Oxford, UK.
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Wroe LM, Ige TA, Asogwa OC, Aruah SC, Grover S, Makufa R, Fitz-Gibbon M, Coleman N, Dosanjh M, Van den Heuvel F, Sheehy SL. Corrigendum to "Comparative Analysis of Radiotherapy Linear Accelerator Downtime and Failure Modes in the UK, Nigeria and Botswana" [Clinical Oncology 32 (2020) e111-e118]. Clin Oncol (R Coll Radiol) 2023; 35:e347. [PMID: 36813695 DOI: 10.1016/j.clon.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- L M Wroe
- Department of Physics, University of Oxford, Oxford, UK
| | - T A Ige
- National Hospital Abuja, Abuja, Nigeria
| | | | - S C Aruah
- National Hospital Abuja, Abuja, Nigeria
| | - S Grover
- Department of Radiation Oncology, University of Pennsylvania, Botswana-UPENN Partnership, Philadelphia, Pennsylvania, USA
| | - R Makufa
- Life Gaborone Private Hospital, Gaborone, Botswana
| | - M Fitz-Gibbon
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - N Coleman
- International Cancer Expert Corps, Washington, DC, USA
| | - M Dosanjh
- Department of Physics, University of Oxford, Oxford, UK; CERN, Geneva, Switzerland
| | - F Van den Heuvel
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Department of Oncology, University of Oxford, Oxford, UK
| | - S L Sheehy
- Department of Physics, University of Oxford, Oxford, UK
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Heuchel L, Hahn C, Pawelke J, Sørensen BS, Dosanjh M, Lühr A. Clinical use and future requirements of relative biological effectiveness: survey among all european proton therapy centres. Radiother Oncol 2022; 172:134-139. [PMID: 35605747 DOI: 10.1016/j.radonc.2022.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/29/2022] [Accepted: 05/15/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND PURPOSE The relative biological effectiveness (RBE) varies along the treatment field. However, in clinical practice, a constant RBE of 1.1 is assumed, which can result in undesirable side effects. This study provides an accurate overview of current clinical practice for considering proton RBE in Europe. MATERIALS AND METHODS A survey was devised and sent to all proton therapy centres in Europe that treat patients. The online questionnaire consisted of 39 questions addressing various aspects of RBE consideration in clinical practice, including treatment planning, patient follow-up and future demands. RESULTS All 25 proton therapy centres responded. All centres prescribed a constant RBE of 1.1, but also applied measures (except for one eye treatment centre) to counteract variable RBE effects such as avoiding beams stopping inside or in front of an organ at risk and putting restrictions on the minimum number and opening angle of incident beams for certain treatment sites. For the future, most centres (16) asked for more retrospective or prospective outcome studies investigating the potential effect of the effect of a variable RBE. To perform such studies, 18 centres asked for LET and RBE calculation and visualisation tools developed by treatment planning system vendors. CONCLUSION All European proton centres are aware of RBE variability but comply with current guidelines of prescribing a constant RBE. However, they actively mitigate uncertainty and risk of side effects resulting from increased RBE by applying measures and restrictions during treatment planning. To change RBE-related clinical guidelines in the future more clinical data on RBE are explicitly demanded.
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Affiliation(s)
- Lena Heuchel
- Department of Physics, TU Dortmund University, Germany
| | - Christian Hahn
- Department of Physics, TU Dortmund University, Germany; OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Germany; Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
| | - Jörg Pawelke
- OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Germany; Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology - OncoRay, Germany
| | - Brita Singers Sørensen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Denmark; Danish Center for Particle Therapy, DCPT, Aarhus University Hospital, Denmark
| | - Manjit Dosanjh
- Department of Physics, University of Oxford, UK; CERN, Geneva, Switzerland
| | - Armin Lühr
- Department of Physics, TU Dortmund University, Germany.
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Dosanjh M. Collaboration, the force that makes the impossible possible. Adv Radiat Oncol 2022; 7:100966. [PMID: 35942426 PMCID: PMC9356205 DOI: 10.1016/j.adro.2022.100966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/06/2022] [Indexed: 12/02/2022] Open
Abstract
Over the last three decades, the landscape of cancer treatment with radiotherapy has never stopped improving. ENLIGHT – the European Network for Light Ion Hadron Therapy – has been an active participant in the huge changes that have taken place, in particular in Europe. At the end of the 90s when I arrived at CERN, it appeared clear that an improvement in communication, sharing and exchange, while keeping a common goal, was needed to bring together international experts from accelerator physics, imaging, medical physics, radiobiology and clinical medicine. ENLIGHT network was most aptly launched at CERN, since CERN is renowned as a place for global collaboration. The network has come a long way since the kick-off meeting at CERN in 2002 when only about 70 specialists from different disciplines took part and continues to grow and flourish with now over 1000 participants, accounting for over 100 institutions, from around 40 countries around the globe.
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Affiliation(s)
- Manjit Dosanjh
- CERN, Geneva, Switzerland
- Department of Physics, University of Oxford, Oxford, United Kingdom
- Corresponding author Manjit Dosanjh, PhD
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Dosanjh M, Ristova M, Gershan V, Georgieva P, Balin Kovacevic M, Bregu L, Coralic I, Djurovic T, Dosieva D, Foka Y, Fröbe A, Hatziioannou K, Hourdakis CJ, Kabashi Y, Kalev D, Kurtishi I, Litov L, Mezelxhiu B, Nestoroska Madjunarova S, Nikolova G, Skrk D, Smajlbegovic V, Smichkoska S, Stojkovski I, Strojan P, Tecic Z, Tešanović D, Todorovic V, Valerianova Z. Availability of technology for managing cancer patients in the Southeast European (SEE) region. Clin Transl Radiat Oncol 2022; 34:57-66. [PMID: 35345867 PMCID: PMC8956881 DOI: 10.1016/j.ctro.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 03/13/2022] [Indexed: 12/24/2022] Open
Abstract
Gap of public on-the-ground cancer data was addressed through questionnaires to professionals in the SEE region. There is a lack of diagnostic imaging and radiotherapy modalities in the SEE region in comparison to Western Europe. The Mortality to incidence ratio correlates inversely with the economic development and the availability of radiotherapy equipment. The cancer incidence in SEE countries was correlate directly with the life expectancy and the availability of diagnostic equipment. The need for reliable national and regional cancer registries in SEE countries for data collection and analysis has been emphasized.
Background The Southeast European (SEE) region of 10 countries and about 43 million people differs from Western Europe in that most SEE countries lack active cancer registries and have fewer diagnostic imaging devices and radiotherapy (RT) units. The main objective of this research is to initiate a common platform for gathering SEE regional cancer data from the ground up to help these countries develop common cancer management strategies. Methods To obtain detailed on-the-ground information, we developed separate questionnaires for two SEE groups: a) ONCO - oncologists regarding cancer treatment modalities and the availability of diagnostic imaging and radiotherapy equipment; and b) REG - national radiation protection and safety regulatory bodies regarding diagnostic imaging and radiotherapy equipment in SEE facilities. Results Based on responses from 13/17 ONCO participants (at least one from each country) and from 9/10 REG participants (all countries but Albania), cancer incidence rates are higher in those SEE countries that have greater access to diagnostic imaging equipment while cancer mortality-to-incidence (MIR) ratios are higher in countries that lack radiotherapy equipment. Conclusion By combining unique SEE region information with data available from major global databases, we demonstrated that the availability of diagnostic imaging and radiotherapy equipment in the SEE countries is related to their economic development. While immediate diagnostic imaging and radiation therapy capacity building is necessary, it is also essential to develop both national and SEE-regional cancer registries in order to understand the heterogeneity of each country’s needs and to establish regional collaborative strategies for combating cancer.
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Affiliation(s)
- Manjit Dosanjh
- CERN, Geneva, Switzerland
- International Cancer Expert Corps, Washington, DC, USA
| | - Mimoza Ristova
- CERN, Geneva, Switzerland
- Faculty of Natural Sciences and Mathematics, Ss Cyril and Methodius University in Skopje, North Macedonia
- SEEIIST Association, Geneva, Switzerland
| | - Vesna Gershan
- Faculty of Natural Sciences and Mathematics, Ss Cyril and Methodius University in Skopje, North Macedonia
| | - Petya Georgieva
- CERN, Geneva, Switzerland
- SEEIIST Association, Geneva, Switzerland
| | | | | | - Irma Coralic
- State Regulatory Agency for Radiation and Nuclear Safety, Bosnia and Herzegovina
| | - Tamara Djurovic
- Ministry of Ecology, Spatial Planning and Urbanism, Montenegro
| | | | - Yiota Foka
- CERN, Geneva, Switzerland
- GSI, Darmstadt, Germany
| | - Ana Fröbe
- University Hospital Clinic, Sestre Milisrdnice, Zagreb, Croatia
| | | | | | - Yllka Kabashi
- Institute of Oncology, University Clinical Center of Kosovo
| | - Dimitar Kalev
- SHATOD "Dr. Marko Markov", Varna Ltd, Varna, Bulgaria
| | - Ilir Kurtishi
- Institute of Oncology, University Clinical Center of Kosovo
| | - Leandar Litov
- CERN, Geneva, Switzerland
- Sofia University St. Kliment Ohridski, Sofia, Bulgaria
| | - Beqir Mezelxhiu
- Kosovo Agency for Radiation Protection and Nuclear Safety, Kosovo
| | | | | | - Damijan Skrk
- Slovenian Radiation Protection Administration and Faculty of Mathematics and Physics, Slovenia
| | | | - Snezana Smichkoska
- University Clinic of Radiotherapy and Oncology, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia
| | - Igor Stojkovski
- University Clinic of Radiotherapy and Oncology, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia
| | - Primož Strojan
- Dept. of Radiotherapy, Institute of Oncology Ljubljana, Slovenia
| | - Zdravka Tecic
- Ministry of the Interior, Civil Protection Directorate, Sector for Radiological and Nuclear Safety, Croatia
| | - Dušanka Tešanović
- Oncology Institute of Vojvodina, Sremska Kamenica, Serbia
- Medical Faculty, Novi Sad University, Serbia
| | - Vladimir Todorovic
- SEEIIST Association, Geneva, Switzerland
- Clinical Center of Montenegro (KCCG), Podgorica, Montenegro
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Dosanjh M, Cirilli M, Durante M, Facoetti A, Fossati P, Graeff C, Haberer T, Livraga M, Necchi M, Plesko M, Rossi L, Rossi S, Sammut N, Schoetz U, Vretenar M. FLASH in the Clinic Track (Oral Presentations) HITRIPLUS PROJECT: BUILDING A PAN-EUROPEAN HEAVY ION THERAPY RESEARCH COMMUNITY AND PROVIDING RESEARCH FACILITIES ACCESS. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01552-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Ristova MM, Gershan V, Schopper H, Amaldi U, Dosanjh M. Patients With Cancer in the Countries of South-East Europe (the Balkans) Region and Prospective of the Particle Therapy Center: South-East European International Institute for Sustainable Technologies (SEEIIST). Adv Radiat Oncol 2021; 6:100772. [PMID: 34805620 PMCID: PMC8581504 DOI: 10.1016/j.adro.2021.100772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/19/2021] [Accepted: 07/28/2021] [Indexed: 01/02/2023] Open
Abstract
PURPOSE A recent initiative was launched for establishing the South-East European International Institute for Sustainable Technologies (SEEIIST), which will provide a cutting-edge Hadron radiation therapy treatment and research institute for treating cancer patients with Hadron therapy (HT). To justify the initiative for building the SEEIIST facility, a study was conducted to estimate the number of patients with cancer from the SEE region that would be eligible for HT. METHODS AND MATERIALS Two different methods for projecting the future annual cancer incidence have been applied: (1) using the International Agency on Research on Cancer@World Health Organization's (WHO) Globocan model which uses country's demographic factors, and (2) averaging the crude incidence data of 3 SEE countries with available national cancer registries, using a linear regression model of combined incidence per 100,000, and applying it to the entire SEE region. Cancer epidemiology data were collected and studied by using the countries' cancer datasheets from WHO. The top 10 cancers were presented for the SEE region. Studies of other countries were used to develop a primordial model for estimating the number of SEE patients who could be treated most successfully with HT upon SEEIIST commissioning in 2030. RESULTS A model was developed to estimate the number of eligible patients for HT from SEE. It is estimated that 2900 to 3200 patients per year would be eligible for HT in the new SEEIIST facility in 2030. CONCLUSIONS After commissioning, SEEIIST will initially treat approximately 400 patients per year, progressing toward 1000. Creation of SEEIIST dedicated patient selection criteria will be both necessary and highly challenging.
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Affiliation(s)
- Mimoza M. Ristova
- Faculty of Natural Sciences and Mathematics, Physics Department, University Ss Cyril and Methodius in Skopje, North Macedonia
- SEEIIST Association, Geneva, Switzerland
- CERN, Geneva, Switzerland
| | - Vesna Gershan
- Faculty of Natural Sciences and Mathematics, Physics Department, University Ss Cyril and Methodius in Skopje, North Macedonia
| | - Herwig Schopper
- SEEIIST Association, Geneva, Switzerland
- CERN, Geneva, Switzerland
| | | | - Manjit Dosanjh
- CERN, Geneva, Switzerland
- Department of Physics, University of Oxford, Oxford, United Kingdom
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Rossi S, Cirilli M, Dosanjh M, Durante M, Facoetti A, Fossati P, Graeff C, Haberer T, Livraga M, Necchi M, Plesko M, Rossi L, Sammut N, Schoetz U, Vretenar M. PO-1529 HITRIplus project: building a pan-European heavy ion therapy research community. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07980-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Heuchel L, Hahn C, Pawelke J, Singers B, ørensen S, Dosanjh M, Lühr A. OC-0417 Is a variable proton RBE considered in clinical practice? - ESTRO survey among 25 proton centres. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06904-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Aruah SC, Asogwa OC, Ubah FI, Maurice NN, Oyesegun R, Ige TA, Coleman CN, Dosanjh M, Pistenmaa D. Overcoming Challenges in Providing Radiation Therapy to Patients With Cancer in Nigeria and Experience in the National Hospital Abuja, Nigeria. JCO Glob Oncol 2021; 6:1232-1236. [PMID: 32755480 PMCID: PMC7456314 DOI: 10.1200/jgo.19.00177] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Ige TA, Jenkins A, Burt G, Angal-Kalinin D, McIntosh P, Coleman CN, Pistenmaa DA, O'Brien D, Dosanjh M. Surveying the Challenges to Improve Linear Accelerator-based Radiation Therapy in Africa: a Unique Collaborative Platform of All 28 African Countries Offering Such Treatment. Clin Oncol (R Coll Radiol) 2021; 33:e521-e529. [PMID: 34116903 DOI: 10.1016/j.clon.2021.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/22/2021] [Accepted: 05/19/2021] [Indexed: 12/24/2022]
Abstract
Radiation therapy is a critical component for curative and palliative treatment of cancer and is used in more than half of all patients with cancer. Yet there is a global shortage of access to this treatment, especially in Sub-Saharan Africa, where there is a shortage of technical staff as well as equipment. Linear accelerators (LINACs) offer state-of-the-art treatment, but this technology is expensive to acquire, operate and service, especially for low- and middle-income countries (LMICs), and often their harsh environment negatively affects the performance of LINACs, causing downtime. A global initiative was launched in 2016 to address the technology and system barriers to providing radiation therapy in LMICs through the development of a novel LINAC-based radiation therapy system designed for their challenging environments. As the LINAC prototype design phase progressed, it was recognised that additional information was needed from LMICs on the performance of LINAC components, on variables that may influence machine performance and their association, if any, with equipment downtime. Thus, a survey was developed to collect these data from all countries in Africa that have LINAC-based radiation therapy facilities. In order to understand the extent to which these performance factors are the same or different in high-income countries, facilities in Canada, Switzerland, the UK and the USA were invited to participate in the survey, as was Jordan, a middle-income country. Throughout this process, LMIC representatives have provided input on technology challenges in their respective countries. This report presents the method used to conduct this multilevel study of the macro- and microenvironments, the organisation of departments, the technology, the training and the service models that will provide input into the design of a LINAC prototype for a LINAC-based radiation therapy system that will improve access to radiation therapy and thus improve cancer treatment outcomes. It is important to note that new technology should be introduced in a contextual manner so as not to disrupt existing health systems inadvertently, especially with regards to existing staffing, infrastructure and socioeconomic issues. A detailed analysis of data is underway and will be presented in a follow-up report. Selected preliminary results of the study are the observation that LINAC-based facilities in LMICs experience downtime associated with failures in multileaf collimators and vacuum pumps, as well as power instability. Also, that there is a strong association of gross national product per capita with the number of LINACs per population.
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Affiliation(s)
- T A Ige
- National Hospital Abuja, Abuja, Nigeria; University of Abuja, Abuja, Nigeria
| | | | - G Burt
- University of Lancaster, Lancaster, UK
| | | | - P McIntosh
- STFC Daresbury Laboratory, Warrington, UK
| | - C N Coleman
- International Cancer Expert Corps, Washington, DC, USA
| | - D A Pistenmaa
- International Cancer Expert Corps, Washington, DC, USA
| | - D O'Brien
- International Cancer Expert Corps, Washington, DC, USA
| | - M Dosanjh
- University of Oxford, Oxford, UK; International Cancer Expert Corps, Washington, DC, USA; CERN, Geneva, Switzerland.
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Coleman CN, Wong JE, Wendling E, Gospodarowicz M, O'Brien D, Ige TA, Aruah SC, Pistenmaa DA, Amaldi U, Balogun OO, Brereton HD, Formenti S, Schroeder K, Chao N, Grover S, Hahn SM, Metz J, Roth L, Dosanjh M. Capturing Acquired Wisdom, Enabling Healthful Aging, and Building Multinational Partnerships Through Senior Global Health Mentorship. Glob Health Sci Pract 2020; 8:626-637. [PMID: 33361231 PMCID: PMC7784062 DOI: 10.9745/ghsp-d-20-00108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 08/24/2020] [Indexed: 11/18/2022]
Abstract
The undeniable benefit of mentorship by experience senior mentors can meaningfully
increase the breadth of their experience and contributions to society as well as address
the dire inequality in global health. This model captures wisdom lost to retirement,
enables opportunities for purposeful lifespan, underpins sustainable health care systems,
and has the potential for building multinational partnerships.
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Affiliation(s)
| | - John E Wong
- National University Health System, Singapore
| | | | | | - Donna O'Brien
- International Cancer Expert Corps, Washington, DC, USA
| | | | | | - David A Pistenmaa
- International Cancer Expert Corps, Washington, DC, USA.,Radiation Research Program, National Cancer Institute, Washington, DC, USA
| | | | - Onyi-Onyinye Balogun
- International Cancer Expert Corps, Washington, DC, USA.,Department of Radiation Oncology, Weill-Cornell Medical Center, New York City, NY, USA
| | - Harmar D Brereton
- International Cancer Expert Corps, Washington, DC, USA.,Department of Radiation Oncology, Weill-Cornell Medical Center, New York City, NY, USA
| | - Silvia Formenti
- International Cancer Expert Corps, Washington, DC, USA.,Department of Radiation Oncology, Weill-Cornell Medical Center, New York City, NY, USA
| | - Kristen Schroeder
- International Cancer Expert Corps, Washington, DC, USA.,Duke University School of Medicine, Durham, NC, USA.,Bugando Cancer Center, Mwanza, Tanzania
| | - Nelson Chao
- International Cancer Expert Corps, Washington, DC, USA.,Duke University School of Medicine, Durham, NC, USA.,Bugando Cancer Center, Mwanza, Tanzania
| | - Surbhi Grover
- International Cancer Expert Corps, Washington, DC, USA.,University of Pennsylvania, Philadelphia, PA, USA.,University of Botswana & Princess Marina Hospital, Gaborone, Botswana
| | | | - James Metz
- University of Pennsylvania, Philadelphia, PA, USA
| | - Lawrence Roth
- International Cancer Expert Corps, Washington, DC, USA
| | - Manjit Dosanjh
- International Cancer Expert Corps, Washington, DC, USA.,European Organization for Nuclear Research (CERN), Geneva, Switzerland
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Coleman CN, Mansoura MK, Marinissen MJ, Grover S, Dosanjh M, Brereton HD, Roth L, Wendling E, Pistenmaa DA, O'Brien DM. Achieving flexible competence: bridging the investment dichotomy between infectious diseases and cancer. BMJ Glob Health 2020; 5:e003252. [PMID: 33303514 PMCID: PMC7733114 DOI: 10.1136/bmjgh-2020-003252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/07/2020] [Accepted: 10/09/2020] [Indexed: 01/08/2023] Open
Abstract
Today's global health challenges in underserved communities include the growing burden of cancer and other non-communicable diseases (NCDs); infectious diseases (IDs) with epidemic and pandemic potential such as COVID-19; and health effects from catastrophic 'all hazards' disasters including natural, industrial or terrorist incidents. Healthcare disparities in low-income and middle-income countries and in some rural areas in developed countries make it a challenge to mitigate these health, socioeconomic and political consequences on our globalised society. As with IDs, cancer requires rapid intervention and its effective medical management and prevention encompasses the other major NCDs. Furthermore, the technology and clinical capability for cancer care enables management of NCDs and IDs. Global health initiatives that call for action to address IDs and cancer often focus on each problem separately, or consider cancer care only a downstream investment to primary care, missing opportunities to leverage investments that could support broader capacity-building. From our experience in health disparities, disaster preparedness, government policy and healthcare systems we have initiated an approach we call flex-competence which emphasises a systems approach from the outset of program building that integrates investment among IDs, cancer, NCDs and disaster preparedness to improve overall healthcare for the local community. This approach builds on trusted partnerships, multi-level strategies and a healthcare infrastructure providing surge capacities to more rapidly respond to and manage a wide range of changing public health threats.
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Affiliation(s)
- C Norman Coleman
- International Cancer Expert Corps (Approved outside activity from NCI), Washington, DC, USA
| | | | | | - Surbhi Grover
- International Cancer Expert Corps, Washington, DC, USA
- Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Manjit Dosanjh
- International Cancer Expert Corps, Washington, DC, USA
- University of Oxford, Oxford, UK
| | | | - Lawrence Roth
- International Cancer Expert Corps, Washington, DC, USA
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Dosanjh M, Aggarwal A, Pistenmaa D, Amankwaa-Frempong E, Angal-Kalinin D, Boogert S, Brown D, Carlone M, Collier P, Court L, Di Meglio A, Van Dyk J, Grover S, Jaffray D, Jamieson C, Khader J, Konoplev I, Makwani H, McIntosh P, Militsyn B, Palta J, Sheehy S, Aruah S, Syratchev I, Zubizarreta E, Coleman C. Developing Innovative, Robust and Affordable Medical Linear Accelerators for Challenging Environments. Clin Oncol (R Coll Radiol) 2019; 31:352-355. [DOI: 10.1016/j.clon.2019.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/08/2018] [Accepted: 01/15/2019] [Indexed: 12/21/2022]
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17
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Coleman CN, Prasanna PGS, Bernhard EJ, Buchsbaum JC, Ahmed MM, Capala J, Obcemea C, Deye JA, Pistenmma DA, Vikram B, Bernier J, Dosanjh M. Accurate, Precision Radiation Medicine: A Meta-Strategy for Impacting Cancer Care, Global Health, and Nuclear Policy and Mitigating Radiation Injury From Necessary Medical Use, Space Exploration, and Potential Terrorism. Int J Radiat Oncol Biol Phys 2019; 101:250-253. [PMID: 29726348 DOI: 10.1016/j.ijrobp.2018.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/26/2018] [Accepted: 02/01/2018] [Indexed: 11/16/2022]
Affiliation(s)
- C Norman Coleman
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
| | - Pataje G S Prasanna
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Eric J Bernhard
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Jeffrey C Buchsbaum
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Mansoor M Ahmed
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Jacek Capala
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Ceferino Obcemea
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Jim A Deye
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - David A Pistenmma
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Bhadrasain Vikram
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Jacques Bernier
- Department of Radio-Oncology, Genolier Clinic, Genolier, Switzerland; Centre d'Oncologie des Eaux-Vives, Geneva, Switzerland; International Conference on Translational Research in Radio-Oncology-Physics for Health in Europe, Genolier, Switzerland
| | - Manjit Dosanjh
- International Conference on Translational Research in Radio-Oncology-Physics for Health in Europe, Genolier, Switzerland; Conseil Européen pour la Recherche Nucléaire (European Council for Nuclear Research), Geneva, Switzerland
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Pistenmaa DA, Dosanjh M, Amaldi U, Jaffray D, Zubizarreta E, Holt K, Lievens Y, Pipman Y, Coleman CN. Changing the global radiation therapy paradigm. Radiother Oncol 2018; 128:393-399. [DOI: 10.1016/j.radonc.2018.05.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/23/2018] [Accepted: 05/23/2018] [Indexed: 02/08/2023]
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Dosanjh M, Jones B, Pawelke J, Pruschy M, Sørensen BS. Overview of research and therapy facilities for radiobiological experimental work in particle therapy. Report from the European Particle Therapy Network radiobiology group. Radiother Oncol 2018; 128:14-18. [DOI: 10.1016/j.radonc.2018.03.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 03/13/2018] [Accepted: 03/13/2018] [Indexed: 11/30/2022]
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20
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Dosanjh M, Amaldi U, Mayer R, Poetter R. ENLIGHT: European network for Light ion hadron therapy. Radiother Oncol 2018; 128:76-82. [DOI: 10.1016/j.radonc.2018.03.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 03/11/2018] [Indexed: 12/20/2022]
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Pötter R, Balosso J, Baumann M, Bert C, Davies J, Enghardt W, Fossati P, Harris S, Jones B, Krämer M, Mayer R, Mock U, Pullia M, Schreiner T, Dosanjh M, Debus J, Orecchia R, Georg D. Union of light ion therapy centers in Europe (ULICE EC FP7) – Objectives and achievements of joint research activities. Radiother Oncol 2018; 128:83-100. [DOI: 10.1016/j.radonc.2018.04.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 04/21/2018] [Indexed: 12/25/2022]
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Biguri A, Dosanjh M, Hancock S, Soleimani M. A general method for motion compensation in x-ray computed tomography. ACTA ACUST UNITED AC 2017; 62:6532-6549. [DOI: 10.1088/1361-6560/aa7675] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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23
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Coleman CN, Pistenmaa D, Jaffray D, Gospodarowicz M, Vikram B, Myers S, Vretenar M, Amaldi U, Dosanjh M. Effective Global Cancer Care Requires Radiation Therapy: Defining a Path From No Radiotherapy to Radiotherapy of High Quality Globally. J Glob Oncol 2017. [DOI: 10.1200/jgo.2017.009241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract 46 Background: The increasing global burden of cancer in health disparity regions is now well recognized. To appropriately address the need, the full spectrum of cancer care is required, including cancer control plans, cancer registries, prevention, diagnosis, treatment, multidisciplinary care, and follow-up. Radiation therapy is required for curative treatment, particularly for solid tumors, and for palliation. The Global Task Force for Radiation for Cancer Control, created by the Union for International Cancer Control, demonstrated that radiotherapy is economically beneficial and affordable (Lancet Oncol. 2015 16:1153-86). Recognizing that many low- and middle-income countries have inadequate or no radiation therapy and that there is a need globally for at least 5,000 radiation therapy machines, a well-designed implementation plan is necessary. This includes attention to the potential danger from misuse or mishandling of cobalt-60 and the potential for remote networking to ensure high-quality treatment. Methods: Experts with a broad range of interests and representatives from public and private sectors met at an International Cancer Expert Corps–sponsored workshop on the CERN campus on November 7 and 8, 2016, to consider future options, including innovative technology, a software and systems approach to dealing with the complexity of radiation therapy, and the need for ongoing education and training. Discussions included replacement of cobalt-60 units over time for security and safety reasons. Results: The International Cancer Expert Corps–CERN workshop produced criteria for what could be a newly designed linear accelerator. Three task groups were established to address technology/software solutions, education and training, and economic issues. Conclusion: The workshop report is forthcoming and the task groups will work to define short- and long-term solutions to this major global shortfall. This workshop represents a potential watershed moment for augmenting global cancer care by bringing together expertise and potential investment at the scope needed to address the gap in radiation treatment capacity. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST C. Norman Coleman No relationship to disclose David Pistenmaa No relationship to disclose David Jaffray Consulting or Advisory Role: IBA Mary Gospodarowicz No relationship to disclose Bhadrasain Vikram No relationship to disclose Steve Myers No relationship to disclose Maurizio Vrentenar No relationship to disclose Ugo Amaldi No relationship to disclose Manjit Dosanjh No relationship to disclose
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Affiliation(s)
- C. Norman Coleman
- C. Norman Coleman and David Pistenmaa, International Cancer Expert Corps, Washington, DC; Bhadrasain Vikram, National Cancer Institute, Bethesda, MD; David Jaffray and Mary Gospodarowicz, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Steve Myers, ADAM; Maurizio Vretenar and Manjit Dosanjh, CERN; and Ugo Amaldi, TERA Foundation, Geneva, Switzerland
| | - David Pistenmaa
- C. Norman Coleman and David Pistenmaa, International Cancer Expert Corps, Washington, DC; Bhadrasain Vikram, National Cancer Institute, Bethesda, MD; David Jaffray and Mary Gospodarowicz, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Steve Myers, ADAM; Maurizio Vretenar and Manjit Dosanjh, CERN; and Ugo Amaldi, TERA Foundation, Geneva, Switzerland
| | - David Jaffray
- C. Norman Coleman and David Pistenmaa, International Cancer Expert Corps, Washington, DC; Bhadrasain Vikram, National Cancer Institute, Bethesda, MD; David Jaffray and Mary Gospodarowicz, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Steve Myers, ADAM; Maurizio Vretenar and Manjit Dosanjh, CERN; and Ugo Amaldi, TERA Foundation, Geneva, Switzerland
| | - Mary Gospodarowicz
- C. Norman Coleman and David Pistenmaa, International Cancer Expert Corps, Washington, DC; Bhadrasain Vikram, National Cancer Institute, Bethesda, MD; David Jaffray and Mary Gospodarowicz, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Steve Myers, ADAM; Maurizio Vretenar and Manjit Dosanjh, CERN; and Ugo Amaldi, TERA Foundation, Geneva, Switzerland
| | - Bhadrasain Vikram
- C. Norman Coleman and David Pistenmaa, International Cancer Expert Corps, Washington, DC; Bhadrasain Vikram, National Cancer Institute, Bethesda, MD; David Jaffray and Mary Gospodarowicz, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Steve Myers, ADAM; Maurizio Vretenar and Manjit Dosanjh, CERN; and Ugo Amaldi, TERA Foundation, Geneva, Switzerland
| | - Steve Myers
- C. Norman Coleman and David Pistenmaa, International Cancer Expert Corps, Washington, DC; Bhadrasain Vikram, National Cancer Institute, Bethesda, MD; David Jaffray and Mary Gospodarowicz, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Steve Myers, ADAM; Maurizio Vretenar and Manjit Dosanjh, CERN; and Ugo Amaldi, TERA Foundation, Geneva, Switzerland
| | - Maurizio Vretenar
- C. Norman Coleman and David Pistenmaa, International Cancer Expert Corps, Washington, DC; Bhadrasain Vikram, National Cancer Institute, Bethesda, MD; David Jaffray and Mary Gospodarowicz, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Steve Myers, ADAM; Maurizio Vretenar and Manjit Dosanjh, CERN; and Ugo Amaldi, TERA Foundation, Geneva, Switzerland
| | - Ugo Amaldi
- C. Norman Coleman and David Pistenmaa, International Cancer Expert Corps, Washington, DC; Bhadrasain Vikram, National Cancer Institute, Bethesda, MD; David Jaffray and Mary Gospodarowicz, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Steve Myers, ADAM; Maurizio Vretenar and Manjit Dosanjh, CERN; and Ugo Amaldi, TERA Foundation, Geneva, Switzerland
| | - Manjit Dosanjh
- C. Norman Coleman and David Pistenmaa, International Cancer Expert Corps, Washington, DC; Bhadrasain Vikram, National Cancer Institute, Bethesda, MD; David Jaffray and Mary Gospodarowicz, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Steve Myers, ADAM; Maurizio Vretenar and Manjit Dosanjh, CERN; and Ugo Amaldi, TERA Foundation, Geneva, Switzerland
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Kanellopoulos V, Kirkby NF, Jena R, Dosanjh M, Kirkby KJ. An analytical model of tumour response to radiotherapy to investigate biological parameters of chordoma treated by X-rays, protons and carbon ions. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Lima TVM, Dosanjh M, Ferrari A, Molineli S, Ciocca M, Mairani A. Monte Carlo Calculations Supporting Patient Plan Verification in Proton Therapy. Front Oncol 2016; 6:62. [PMID: 27047796 PMCID: PMC4796019 DOI: 10.3389/fonc.2016.00062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 03/04/2016] [Indexed: 11/17/2022] Open
Abstract
Patient’s treatment plan verification covers substantial amount of the quality assurance (QA) resources; this is especially true for Intensity-Modulated Proton Therapy (IMPT). The use of Monte Carlo (MC) simulations in supporting QA has been widely discussed, and several methods have been proposed. In this paper, we studied an alternative approach from the one being currently applied clinically at Centro Nazionale di Adroterapia Oncologica (CNAO). We reanalyzed the previously published data (Molinelli et al. (1)), where 9 patient plans were investigated in which the warning QA threshold of 3% mean dose deviation was crossed. The possibility that these differences between measurement and calculated dose were related to dose modeling (Treatment Planning Systems (TPS) vs. MC), limitations on dose delivery system, or detectors mispositioning was originally explored, but other factors, such as the geometric description of the detectors, were not ruled out. For the purpose of this work, we compared ionization chambers’ measurements with different MC simulation results. It was also studied that some physical effects were introduced by this new approach, for example, inter-detector interference and the delta ray thresholds. The simulations accounting for a detailed geometry typically are superior (statistical difference – p-value around 0.01) to most of the MC simulations used at CNAO (only inferior to the shift approach used). No real improvement was observed in reducing the current delta ray threshold used (100 keV), and no significant interference between ion chambers in the phantom were detected (p-value 0.81). In conclusion, it was observed that the detailed geometrical description improves the agreement between measurement and MC calculations in some cases. But in other cases, position uncertainty represents the dominant uncertainty. The inter-chamber disturbance was not detected for the therapeutic protons energies, and the results from the current delta threshold are acceptable for MC simulations in IMPT.
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Affiliation(s)
- Thiago V M Lima
- European Organization for Nuclear Research (CERN), Geneva, Switzerland; Division of Surgery and Interventional Science, University College London, London, UK; Fachstelle Strahlenschutz, Kantonsspital Aarau AG, Aarau, Switzerland
| | - Manjit Dosanjh
- European Organization for Nuclear Research (CERN) , Geneva , Switzerland
| | - Alfredo Ferrari
- European Organization for Nuclear Research (CERN) , Geneva , Switzerland
| | - Silvia Molineli
- Department of Medical Physics, Fondazione CNAO , Pavia , Italy
| | - Mario Ciocca
- Department of Medical Physics, Fondazione CNAO , Pavia , Italy
| | - Andrea Mairani
- Department of Medical Physics, Fondazione CNAO , Pavia , Italy
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Abstract
State-of-the-art techniques derived from particle accelerators, detectors, and physics computing are routinely used in clinical practice and medical research centers: from imaging technologies to dedicated accelerators for cancer therapy and nuclear medicine, simulations, and data analytics. Principles of particle physics themselves are the foundation of a cutting edge radiotherapy technique for cancer treatment: hadron therapy. This article is an overview of the involvement of CERN, the European Organization for Nuclear Research, in medical applications, with specific focus on hadron therapy. It also presents the history, achievements, and future scientific goals of the European Network for Light Ion Hadron Therapy, whose co-ordination office is at CERN.
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Lima T, Marchetto F, Ferrari A, Mairani A, Ricketts K, Royle G, Dosanjh M. ENTERVISION biological dosimetric phantom. Proof of concept and results. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)30225-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Biguri A, Dosanjh M, Hancock S, Soleimani M. GPU based iterative CBCT for prospective motion compensated algorithm for radiation therapy. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)30023-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cerutti F, Dosanjh M, Ferrari A, Mendonca T, Ortega P, Parodi K, Sala P, Augusto R, Stora T. A systematic Monte Carlo study on the dosimetric and imaging properties of C-11 and O-15 beams. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)30011-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Dosanjh M, Cirilli M, Navin S. Introduction to the EC's Marie Curie Initial Training Network Project: The European Training Network in Digital Medical Imaging for Radiotherapy (ENTERVISION). Front Oncol 2015; 5:265. [PMID: 26697403 PMCID: PMC4668289 DOI: 10.3389/fonc.2015.00265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 11/12/2015] [Indexed: 12/30/2022] Open
Abstract
Between 2011 and 2015, the ENTERVISION Marie Curie Initial Training Network has been training 15 young researchers from a variety of backgrounds on topics ranging from in-beam Positron Emission Tomography or Single Particle Tomography techniques, to adaptive treatment planning, optical imaging, Monte Carlo simulations and biological phantom design. This article covers the main research activities, as well as the training scheme implemented by the participating institutes, which included academia, research, and industry.
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Orecchia R, Potter R, Debus J, Dosanjh M. SP-0304: The contribution of the ULICE project to the development of hadron therapy in Europe. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40302-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Viana Miranda Lima T, Dosanjh M, Ferrari A, Mairani A, Marchetto F, Ricketts K, Royle G. 210: ENTERVISION WP4. Biological Dosimetric Phantom. Proof of Concept Preliminary results. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)34231-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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35
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Garonna A, Abler D, Carli C, Stafford-Hayworth J, Kuchler D, Dosanjh M, Myers S, Collier P. 75: A Biomedical Research Facility at CERN based on the Low Energy Ion Ring. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)34096-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Orecchia R, Pötter R, Debüs J, Dosanjh M. SP-0330: ULICE: Clinical cooperation in hadrontherapy born from the ULICE results. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30435-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Böhlen TT, Bauer J, Dosanjh M, Ferrari A, Haberer T, Parodi K, Patera V, Mairani A. A Monte Carlo-based treatment-planning tool for ion beam therapy. J Radiat Res 2013; 54 Suppl 1:i77-81. [PMID: 23824131 PMCID: PMC3700514 DOI: 10.1093/jrr/rrt050] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Ion beam therapy, as an emerging radiation therapy modality, requires continuous efforts to develop and improve tools for patient treatment planning (TP) and research applications. Dose and fluence computation algorithms using the Monte Carlo (MC) technique have served for decades as reference tools for accurate dose computations for radiotherapy. In this work, a novel MC-based treatment-planning (MCTP) tool for ion beam therapy using the pencil beam scanning technique is presented. It allows single-field and simultaneous multiple-fields optimization for realistic patient treatment conditions and for dosimetric quality assurance for irradiation conditions at state-of-the-art ion beam therapy facilities. It employs iterative procedures that allow for the optimization of absorbed dose and relative biological effectiveness (RBE)-weighted dose using radiobiological input tables generated by external RBE models. Using a re-implementation of the local effect model (LEM), the MCTP tool is able to perform TP studies using ions with atomic numbers Z ≤ 8. Example treatment plans created with the MCTP tool are presented for carbon ions in comparison with a certified analytical treatment-planning system. Furthermore, the usage of the tool to compute and optimize mixed-ion treatment plans, i.e. plans including pencil beams of ions with different atomic numbers, is demonstrated. The tool is aimed for future use in research applications and to support treatment planning at ion beam facilities.
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Affiliation(s)
- T T Böhlen
- European Organization for Nuclear Research CERN, CH-1211, Geneva 23, Switzerland.
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Dosanjh M, Magrin G. Introduction to the EC's Marie Curie Initial Training Network (MC-ITN) project: Particle Training Network for European Radiotherapy (PARTNER). J Radiat Res 2013; 54 Suppl 1:i1-5. [PMID: 23824113 PMCID: PMC3700503 DOI: 10.1093/jrr/rrt013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 01/30/2013] [Indexed: 06/02/2023]
Abstract
PARTNER (Particle Training Network for European Radiotherapy) is a project funded by the European Commission's Marie Curie-ITN funding scheme through the ENLIGHT Platform for 5.6 million Euro. PARTNER has brought together academic institutes, research centres and leading European companies, focusing in particular on a specialized radiotherapy (RT) called hadron therapy (HT), interchangeably referred to as particle therapy (PT). The ultimate goal of HT is to deliver more effective treatment to cancer patients leading to major improvement in the health of citizens. In Europe, several hundred million Euro have been invested, since the beginning of this century, in PT. In this decade, the use of HT is rapidly growing across Europe, and there is an urgent need for qualified researchers from a range of disciplines to work on its translational research. In response to this need, the European community of HT, and in particular 10 leading academic institutes, research centres, companies and small and medium-sized enterprises, joined together to form the PARTNER consortium. All partners have international reputations in the diverse but complementary fields associated with PT: clinical, radiobiological and technological. Thus the network incorporates a unique set of competencies, expertise, infrastructures and training possibilities. This paper describes the status and needs of PT research in Europe, the importance of and challenges associated with the creation of a training network, the objectives, the initial results, and the expected long-term benefits of the PARTNER initiative.
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Affiliation(s)
| | - Giulio Magrin
- MedAustron, Marie Curie-St. 5, A-2700 Wiener Neustadt, Austria
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Abler D, Garonna A, Carli C, Dosanjh M, Peach K. Feasibility study for a biomedical experimental facility based on LEIR at CERN. J Radiat Res 2013; 54 Suppl 1:i162-7. [PMID: 23824122 PMCID: PMC3700518 DOI: 10.1093/jrr/rrt056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 04/03/2013] [Accepted: 04/09/2013] [Indexed: 06/02/2023]
Abstract
In light of the recent European developments in ion beam therapy, there is a strong interest from the biomedical research community to have more access to clinically relevant beams. Beamtime for pre-clinical studies is currently very limited and a new dedicated facility would allow extensive research into the radiobiological mechanisms of ion beam radiation and the development of more refined techniques of dosimetry and imaging. This basic research would support the current clinical efforts of the new treatment centres in Europe (for example HIT, CNAO and MedAustron). This paper presents first investigations on the feasibility of an experimental biomedical facility based on the CERN Low Energy Ion Ring LEIR accelerator. Such a new facility could provide beams of light ions (from protons to neon ions) in a collaborative and cost-effective way, since it would rely partly on CERN's competences and infrastructure. The main technical challenges linked to the implementation of a slow extraction scheme for LEIR and to the design of the experimental beamlines are described and first solutions presented. These include introducing new extraction septa into one of the straight sections of the synchrotron, changing the power supply configuration of the magnets, and designing a new horizontal beamline suitable for clinical beam energies, and a low-energy vertical beamline for particular radiobiological experiments.
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Affiliation(s)
- Daniel Abler
- CERN, CH1211 Geneva 23, Switzerland
- Department of Physics, University of Oxford, Oxford, OX1 3RH, United Kingdom
| | | | | | | | - Ken Peach
- Department of Physics, University of Oxford, Oxford, OX1 3RH, United Kingdom
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Abler D, Kanellopoulos V, Davies J, Dosanjh M, Jena R, Kirkby N, Peach K. Data-driven Markov models and their application in the evaluation of adverse events in radiotherapy. J Radiat Res 2013; 54 Suppl 1:i49-i55. [PMID: 23824126 PMCID: PMC3700509 DOI: 10.1093/jrr/rrt040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 03/08/2013] [Accepted: 03/21/2013] [Indexed: 06/02/2023]
Abstract
Decision-making processes in medicine rely increasingly on modelling and simulation techniques; they are especially useful when combining evidence from multiple sources. Markov models are frequently used to synthesize the available evidence for such simulation studies, by describing disease and treatment progress, as well as associated factors such as the treatment's effects on a patient's life and the costs to society. When the same decision problem is investigated by multiple stakeholders, differing modelling assumptions are often applied, making synthesis and interpretation of the results difficult. This paper proposes a standardized approach towards the creation of Markov models. It introduces the notion of 'general Markov models', providing a common definition of the Markov models that underlie many similar decision problems, and develops a language for their specification. We demonstrate the application of this language by developing a general Markov model for adverse event analysis in radiotherapy and argue that the proposed method can automate the creation of Markov models from existing data. The approach has the potential to support the radiotherapy community in conducting systematic analyses involving predictive modelling of existing and upcoming radiotherapy data. We expect it to facilitate the application of modelling techniques in medical decision problems beyond the field of radiotherapy, and to improve the comparability of their results.
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Roman FL, Abler D, Kanellopoulos V, Amoros G, Davies J, Dosanjh M, Jena R, Kirkby N, Peach K, Salt J. Hadron therapy information sharing prototype. J Radiat Res 2013; 54 Suppl 1:i56-i60. [PMID: 23824127 PMCID: PMC3700506 DOI: 10.1093/jrr/rrt037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Revised: 03/15/2013] [Accepted: 03/21/2013] [Indexed: 06/02/2023]
Abstract
The European PARTNER project developed a prototypical system for sharing hadron therapy data. This system allows doctors and patients to record and report treatment-related events during and after hadron therapy. It presents doctors and statisticians with an integrated view of adverse events across institutions, using open-source components for data federation, semantics, and analysis. There is a particular emphasis upon semantic consistency, achieved through intelligent, annotated form designs. The system as presented is ready for use in a clinical setting, and amenable to further customization. The essential contribution of the work reported here lies in the novel data integration and reporting methods, as well as the approach to software sustainability achieved through the use of community-supported open-source components.
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Abstract
A well-attended meeting, called "Brainstorming discussion for a possible biomedical facility at CERN", was held by the European Organization for Nuclear Research (CERN) at the European Laboratory for Particle Physics on 25 June 2012. This was concerned with adapting an existing, but little used, 78-m circumference CERN synchrotron to deliver a wide range of ion species, preferably from protons to at least neon ions, with beam specifications that match existing clinical facilities. The potential extensive research portfolio discussed included beam ballistics in humanoid phantoms, advanced dosimetry, remote imaging techniques and technical developments in beam delivery, including gantry design. In addition, a modern laboratory for biomedical characterisation of these beams would allow important radiobiological studies, such as relative biological effectiveness, in a dedicated facility with standardisation of experimental conditions and biological end points. A control photon and electron beam would be required nearby for relative biological effectiveness comparisons. Research beam time availability would far exceed that at other facilities throughout the world. This would allow more rapid progress in several biomedical areas, such as in charged hadron therapy of cancer, radioisotope production and radioprotection. The ethos of CERN, in terms of open access, peer-reviewed projects and governance has been so successful for High Energy Physics that application of the same to biomedicine would attract high-quality research, with possible contributions from Europe and beyond, along with potential new funding streams.
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Affiliation(s)
- M Dosanjh
- European Organization for Nuclear Research (CERN), Geneva, Switzerland
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Orecchia R, Poetter R, Dosanjh M, Debus J. SP-0124: ULICE- particle therapy behind ULICE. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)32430-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Böhlen TT, Brons S, Dosanjh M, Ferrari A, Fossati P, Haberer T, Patera V, Mairani A. Investigating the robustness of ion beam therapy treatment plans to uncertainties in biological treatment parameters. Phys Med Biol 2012; 57:7983-8004. [DOI: 10.1088/0031-9155/57/23/7983] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
The European Network for Light Ion Hadron Therapy (ENLIGHT) was established in 2002 to coordinate European efforts on hadron therapy (radiotherapy performed with protons and light ions instead of high-energy photons). The ENLIGHT network is formed by the European Hadron Therapy Community, with more than 300 participants from 20 different countries. A major success of ENLIGHT has been uniting traditionally separate communities so that clinicians, physicists, biologists, and engineers with experience and interest in particle therapy work together. ENLIGHT has been a successful initiative in forming a common European platform and bringing together people from diverse disciplines. ENLIGHT demonstrates the advantages of regular and organized exchanges of data, information, and best practices, as well as determining and following strategies for future needs in research and technological development in the hadron therapy field.
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Affiliation(s)
- Manjit Dosanjh
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland.
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Holzscheiter MH, Bassler N, Dosanjh M, Sørensen BS, Overgaard J. A community call for a dedicated radiobiological research facility to support particle beam cancer therapy. Radiother Oncol 2012; 105:1-3. [DOI: 10.1016/j.radonc.2012.08.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 08/14/2012] [Indexed: 10/27/2022]
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Kessel KA, Bougatf N, Bohn C, Habermehl D, Oetzel D, Bendl R, Engelmann U, Orecchia R, Fossati P, Pötter R, Dosanjh M, Debus J, Combs SE. Connection of European particle therapy centers and generation of a common particle database system within the European ULICE-framework. Radiat Oncol 2012; 7:115. [PMID: 22828013 PMCID: PMC3464964 DOI: 10.1186/1748-717x-7-115] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2012] [Accepted: 07/24/2012] [Indexed: 11/16/2022] Open
Abstract
Background To establish a common database on particle therapy for the evaluation of clinical studies integrating a large variety of voluminous datasets, different documentation styles, and various information systems, especially in the field of radiation oncology. Methods We developed a web-based documentation system for transnational and multicenter clinical studies in particle therapy. 560 patients have been treated from November 2009 to September 2011. Protons, carbon ions or a combination of both, as well as a combination with photons were applied. To date, 12 studies have been initiated and more are in preparation. Results It is possible to immediately access all patient information and exchange, store, process, and visualize text data, any DICOM images and multimedia data. Accessing the system and submitting clinical data is possible for internal and external users. Integrated into the hospital environment, data is imported both manually and automatically. Security and privacy protection as well as data validation and verification are ensured. Studies can be designed to fit individual needs. Conclusions The described database provides a basis for documentation of large patient groups with specific and specialized questions to be answered. Having recently begun electronic documentation, it has become apparent that the benefits lie in the user-friendly and timely workflow for documentation. The ultimate goal is a simplification of research work, better study analyses quality and eventually, the improvement of treatment concepts by evaluating the effectiveness of particle therapy.
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Affiliation(s)
- Kerstin A Kessel
- Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
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Debus J, Dosanjh M, Orecchia R, Pötter R, Bono C. SP-0616 ULICE – UNION OF LIGHT ION CENTRES IN EUROPE. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70949-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Combs SE, Kieser M, Habermehl D, Weitz J, Jäger D, Fossati P, Orrechia R, Engenhart-Cabillic R, Pötter R, Dosanjh M, Jäkel O, Büchler MW, Debus J. Phase I/II trial evaluating carbon ion radiotherapy for the treatment of recurrent rectal cancer: the PANDORA-01 trial. BMC Cancer 2012; 12:137. [PMID: 22472035 PMCID: PMC3342902 DOI: 10.1186/1471-2407-12-137] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Accepted: 04/03/2012] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Treatment standard for patients with rectal cancer depends on the initial staging and includes surgical resection, radiotherapy as well as chemotherapy. For stage II and III tumors, radiochemotherapy should be performed in addition to surgery, preferentially as preoperative radiochemotherapy or as short-course hypofractionated radiation. Advances in surgical approaches, especially the establishment of the total mesorectal excision (TME) in combination with sophisticated radiation and chemotherapy have reduced local recurrence rates to only few percent. However, due to the high incidence of rectal cancer, still a high absolute number of patients present with recurrent rectal carcinomas, and effective treatment is therefore needed.Carbon ions offer physical and biological advantages. Due to their inverted dose profile and the high local dose deposition within the Bragg peak precise dose application and sparing of normal tissue is possible. Moreover, in comparison to photons, carbon ions offer an increase relative biological effectiveness (RBE), which can be calculated between 2 and 5 depending on the cell line as well as the endpoint analyzed.Japanese data on the treatment of patients with recurrent rectal cancer previously not treated with radiation therapy have shown local control rates of carbon ion treatment superior to those of surgery. Therefore, this treatment concept should also be evaluated for recurrences after radiotherapy, when dose application using conventional photons is limited. Moreover, these patients are likely to benefit from the enhanced biological efficacy of carbon ions. METHODS AND DESIGN In the current Phase I/II-PANDORA-01-Study the recommended dose of carbon ion radiotherapy for recurrent rectal cancer will be determined in the Phase I part, and feasibilty and progression-free survival will be assessed in the Phase II part of the study.Within the Phase I part, increasing doses from 12 × 3 Gy E to 18 × 3 Gy E will be applied.The primary endpoint in the Phase I part is toxicity, the primary endpoint in the Phase II part is progression-free survival. DISCUSSION With conventional photon irradiation treatment of recurrent rectal cancer is limited, and the clinical effect is only moderate. With carbon ions, an improved outcome can be expected due to the physical and biological characteristics of the carbon ion beam. However, the optimal dose applicable in this clincial situation as re-irradiation still has to be determined. This, as well as efficacy, is to be evaluated in the present Phase I/II trial. TRIAL REGISTRATION NCT01528683.
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Affiliation(s)
- Stephanie E Combs
- Deparment of Radiation Oncology, University Hospital of Heidelberg, Heidelberg, Germany.
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Böhlen T, Brons S, Dosanjh M, Fossati P, Mairani A, Patera V. 304 INVESTIGATING THE ROBUSTNESS OF ION RT TREATMENT PLANS TO UNCERTAINTIES IN BIOLOGICAL TREATMENT PARAMETERS. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70266-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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