Proton Therapy Dr Ed Smith Clinical Director, Proton Therapy Prof Neil Burnet Chair in Academic Proton Clinical Oncology © Copyright Greater Manchester Cancer. All rights reserved.
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Proton Therapy
Dr Ed Smith
Clinical Director, Proton Therapy
Prof Neil Burnet
Chair in Academic Proton Clinical Oncology
© Copyright Greater Manchester Cancer. All rights reserved.
What is proton beam therapy?
A type of radiation therapy where protons (hydrogen ions) are used,
rather than X-rays (photons) and other ionising radiations, to kill cancer
The Proton
• Discovered 1917-1919
• Sir Ernest Rutherford
• Victoria University, Manchester
Clinical benefits of proton therapy (Compared to standard photon-based radiation therapy)
No exit dose past the target volume being treated • Dose to normal tissue as low as possible
• Don’t irradiate what you don’t have to
• Reduce damage to normal tissues
• A major motivation in most paediatric and teenage cancers
• Treat radio-resistant tumours near critical structures
• A motivation in treating some adult cancers
All 3 clinical gantries are treating patients
0
10
20
30
40
50
60
70
80
90
1 5 9 13 17 21 25 29 33 37 41 45 49 53 57 61 65 69 73 77 81 85 89 93
Patients
Week
Patients receiving treatment, per day
Max Capacity Ramp-up
Actuals
04/1
0/2
019
As of 04/10/19
127th patient has started treatment 108 patients have completed treatment
As of 08/11/19
Paediatric
(n=60)
Adult
(n=29)
TYA
(n=19)
Age
As of 08/11/19
CNS incl. BoS (n=57)
H&N (n=26)
Spine (n=25)
Body (n=15)
CSI (n=4)
Site
Proton Clinical Outcomes Unit (PCOU)
Dedicated to the capture, analysis
and publishing of UK proton clinical outcome data
Monitoring outcomes • All Christie treated patients (up to 750 patients pa)
• All ‘overseas treated’ proton patients (>1600 patients to date)
Staffing • Data input/extraction, specialist nurse, fellow support
• Statistician, data scientist
UCLH • Will adopt the minimum dataset and surveillance policy
• Share/pool data
Proton Beam Therapy
• Clinical treatment and research are intertwined
• That is how to achieve faster progress
• Ensure safety
• All our research efforts are focussed on improving results for the patients
• Understanding what happens in short and long term is crucial
One of our patients
successfully treated with radiotherapy
some years ago
Proton Beam Therapy
• Characterised by uncertainties • We know how to handle the uncertainties to make the treatment safe and
effective • Knowing more about them would allow us to be more effective
• Uncertainties apply to • Molecules • Cells • Tissues / tumour • Patients • Population
Proton Beam Therapy
• We will start the first randomised trial comparing Proton Beam Therapy to X-ray treatment (IMRT)
• TORPEDO • Developed and led by Dr David Thomson
• For patients with mouth/throat cancer
Tumour Normal tissues
Basic research
Pre-clinical research
Translational research
Clinical trials
Clinical trials
Application of basic and preclinical research to address real clinical issues
Application of basic research to address proton research questions
Underlying basic research; physics, biology, chemistry
Cli
nic
al tr
ials
Proton
Therapy
Research
Radiobiology
Clinical
oncology and
translational
research
Da
ta a
na
lys
is,
big
da
ta, d
ata
the
rag
no
stic
s
Courtesy of Prof Karen Kirkby, Precise Proton Research Group, University of Manchester
Thank you for listening
Q&A
© Copyright Greater Manchester Cancer. All rights reserved.
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