Kiyomitsu Kawachi

Biophysical characteristics of HIMAC clinical irradiation system for heavy-ion radiation therapy

PURPOSE The irradiation system and biophysical characteristics of carbon beams are examined regarding radiation therapy. METHODS AND MATERIALS An irradiation system was developed for heavy-ion radiotherapy. Wobbler magnets and a scatterer were used for flattening the radiation field. A patient-positioning system using X ray and image intensifiers was also installed in the irradiation system. The depth-dose distributions of the carbon beams were modified to make a spread-out Bragg peak, which was designed based on the biophysical characteristics of monoenergetic beams. A dosimetry system for heavy-ion radiotherapy was established to deliver heavy-ion doses safely to the patients according to the treatment planning. A carbon beam of 80 keV/microm in the spread-out Bragg peak was found to be equivalent in biological responses to the neutron beam that is produced at cyclotron facility in National Institute Radiological Sciences (NIRS) by bombarding 30-MeV deuteron beam on beryllium target. The fractionation schedule of the NIRS neutron therapy was adapted for the first clinical trials using carbon beams. RESULTS Carbon beams, 290, 350, and 400 MeV/u, were used for a clinical trial from June of 1994. Over 300 patients have already been treated by this irradiation system by the end of 1997.

Heavy ion synchrotron for medical use —HIMAC project at NIRS-Japan—

Abstract A heavy ion synchrotron complex for medical use is being constructed at Chiba, Japan. General feature and present status of this project are described.

Spot scanning system for proton radiotherapy

In order to provide a uniform and desirable dose distribution over a large radiation field, spot beam scanning is one of the most useful methods. A new spot beam scanning system was constructed for a 70 MeV proton beam. The lateral dose distribution was uniform with +/- 2.5% for an 18 cm square field. It was possible to control the dose at each point in the radiation field by this spot scanning method. This system has been confirmed to be satisfactory for delivering a proton beam in the desired field shape and dose level.

Dosimetry and Measured Differential W Values of Air for Heavy Ions

Heavy-ion irradiation systems were designed and constructed at two cyclotron facilities in Japan for use in various fields of radiation physics and radiation biology. A 135 MeV/u carbon beam as well as 12 MeV/u carbon and helium-3 beams were first used in experiments. We have established a systematic method for heavy-ion dosimetry at both high and low incident energies involving measurements of fluences. We also obtained differential W values (w) of air for those beams by comparing the results of fluence measurement dosimetry with ionization chamber dosimetry. The differential W values of air were found to be 36.2 +/- 1.0, 34.5 +/- 1.0, and 33.7 +/- 0.9 eV for 6.7 MeV/u carbon ions, 10.3 MeV/u 3He ions, and 129.4 MeV/u carbon ions, respectively. The w value for high-energy heavy ions approaches the W value for high-energy electron or photon beams. In ionization chamber dosimetry for a heavy-ion beam, we found a track-size effect. A difference in the track sizes of heavy ions in the gas and solid phases affected the output current of the ion chamber in the case of high-energy heavy ions.

Three-dimensional beam scanning for proton therapy

Abstract An important goal of radiation therapy is to localize the dose in the target volume. The favorable properties of proton beams, such as a well-determined range and straight penetration through tissues, have been used to develop a three-dimensional beam scanning method. This system consists of a two-dimensional beam scanning system and an energy degrader of variable thickness which are both controlled by a beam monitor that is connected to a minicomputer. A typically conformed dose distribution with the three-dimensional beam scanning system was measured by a specially designed multiwire ionization chamber. The results have shown that the system works satisfactorily and considerably reduces the radiation dose outside the target volume.

Broad beam three‐dimensional irradiation for proton radiotherapy

A three-dimensional irradiation system using scatterers for lateral spreading is proposed. This system, which is applicable to proton beams, is easily achieved by ordinary techniques using a movable multileaf collimator, a variable thickness water column, and a computer for their control. Target volumes of convex shape can be irradiated in a three-dimensional way by this method.

Broad-beam three-dimensional irradiation system for heavy-ion radiotherapy at HIMAC

Abstract A three-dimensional irradiation system using a broad beam has been installed for heavy-ion cancer therapy at the Heavy Ion Medical Accelerator in Chiba (HIMAC) facility. Only the target region is irradiated at the 100% dose level; the dose level at other parts of irradiated tissues is less, using a range shifter, a multileaf collimator and a compensator. The devices are the same as those used in two-dimensional irradiation, except that the setting values of the devices can be dynamically changed during the treatment. The thickness of the absorber and the aperture of the multileaf collimator are dynamically controlled during irradiation, so that the Bragg peak is swept in the depth direction and the Bragg peak outside of the target volume is blocked by the multileaf collimator. The performance of this system was checked by irradiation of a phantom using a 290 MeV/nucleon carbon beam. The dose distribution realized by this three-dimensional irradiation agreed satisfactorily with the planned one.

Proton Therapy in Japan

There are two facilities for clinical trials with protons in Japan: the National Institute of Radiological Sciences (NIRS), Chiba, and the Particle Radiation Medical Science Center (PARMS), University of Tsukuba. At the National Institute of Radiological Sciences, patient treatment with the 70 MeV proton beam began in November 1979, and 29 patients were treated through December 1984. Of 11 patients who received protons only, 9 have had local control of the tumor. Two of the 9 patients, suffering from recurrent tumor after radical photon beam irradiation, developed complications after proton treatment. In the patients treated with photons or neutrons followed by proton boost, tumors were controlled in 12 of 18 patients (66.6%), and no complications were observed in this series. Malignant melanoma could not be controlled with the proton beam. A spot-beam-scanning system for protons has been effectively used in the clinical trials to minimize the dose to the normal tissues and to concentrate the dose in the target volume. At the Particle Radiation Medical Science Center, University of Tsukuba, treatment with a vertical 250 MeV proton beam was begun in April 1983, and 22 patients were treated through February 1984. Local control of the tumor was observed in 14 of 22 patients (63.6%), whereas there was no local control in the treatment of glioblastoma multiforme. There have been no severe complications in patients treated at PARMS. The results suggest that local control of tumors will be better with proton beams than with photon beams, whereas additional modalities are required to manage radioresistant tumors.

Performance of HIMAC

Abstract The NIRS heavy-ion two-synchrotron medical facility, HIMAC, was approved in the 1987 fiscal year and clinical trials were started in late June 1994 as previously arranged. The operation experiences show that the entire HIMAC facility can work well with high stability and excellent reproducibility. For example, the intensity of beam extracted slowly from the rings can be reduced as low as 500 particles per pulse because stable and reproducible acceleration can be achieved in the rings in spite of no beam feedback. This performance enables direct counting of the beam and its fragments in the preparatory experiments toward clinical treatments and provides a promising basis for acceleration and storage of radioactive beams toward simultaneous treatment and diagnosis in future.

Carbon beam dosimetry intercomparison at HIMAC

To verify international uniformity in carbon beam dosimetry, an intercomparison programme was carried out at the heavy ion medical accelerator (HIMAC). Dose measurements with ionization chambers were performed for both unmodulated and 6 cm modulated 290 MeV/nucleon carbon beams. Although two different dosimetry procedures were employed, the evaluated values of absorbed dose were in good agreement. This comparison established a common framework for ionization chamber dosimetry between two different carbon beam therapy facilities.