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

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no

stic

s

Courtesy of Prof Karen Kirkby, Precise Proton Research Group, University of Manchester

Thank you for listening

Q&A

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