Proton beam radiotherapy
GWI and TSL 1989 - 2015.
Erik Blomquist et al.
Dept:s of Oncology, Hospital Physics, Neurosurgery and Radiology
University Hospital
”Akademiska Sjukhuset”
Uppsala, Sweden
Protonbehandlingens förhistoria
Radiology 1946 (47) 487-91
Robert R Wilson
1914-2000
Depth Dose Distributions
120
173 MeV protons
Relative dose (%)
100
80
21 MV photons
60
40
20
16 MeV elektrons
0
0
5
10
15
Range (cm)
20
25
A short History of Proton Beam Therapy
1946 Wilson suggests high energy protons for radiotherapy
1954 First patient treated with protons at Berkeley
1957 First cancer in a patient treated with protons in
Uppsala
1961 First patient treated at the Harvard cyclotron
1989 Treatment restarted in Uppsala (Closes June 2015)
1990 First hospital-based proton beam facility at Loma Linda,
CA, USA
2015 Skandionkliniken in Uppsala starts treatmnt in August 2015
EB 2015
Background
• A long tradition in proton
therapy at The Svedberg
Laboratory (former Gustaf
Werner Institute in
Uppsala)
• First era 1957-1971(-73)
• Second era from 1989 and
onwards
5
Prof. Börje Larsson
1931-1998
6
1
2007-11-23 Jörgen Carlsson
First direct irradiation of a tumor
with a proton beam
”On November 23rd, 1957, this tumor was
irradiated with a dose of 1 900 rad of protons,
given over a period of 11 minutes. The
irradiated area was circular with a diameter of
3 cm, and the depth of penetration of the beam
was 2 cm. The whole vaginal tumor /4 cm x 5
cm/ was thus not irradiated.”
EB 2007
7
First direct irradiation of a tumor
with a proton beam
8
Proton beam treatments in Uppsala
The Svedberg
Laboratory
The Optical Bench
History –
proton beam energy at TSL
• 1989 – 1991
• 1991 – 1994
• 1994 – onwards
11
72 MeV
100 MeV
180 MeV
Patients positioned for treatment
Positioning
* Fidiucial markers in the bone of the skull
* Isocentric position
* Two orthogonal x-ray images
Dose planning and treatment with protons at
The Svedberg Laboratory
- A comparison with ”conventional photons”
* All fields must have:
- an individually made collimator
- a range modulator
- a range compensation filter
Collimators
Range modulators
RM0
RM18
RM71
Verification of position and setup
Frameless fiducial system
Examples of intracranial
targets (benign
meningeomas) treated at
TSL
Dose plans
Meningeoma
2-field proton plan
Meningeoma
2-field proton plan
Proton therapy of
prostate cancer
at TSL in Uppsala
