Particle Therapy – Norwegian plans

Dieter Roehrich University of (UiB)

Status in the Nordic countries • Proton facility in Uppala – Scandion (Sweden) • Proton facility in Århus Van de Graaff accelerator @ UiB, 1954 – DCPT (Denmark), under construction • Plans in Norway Accelerator physics – the Norwegian past

• Rolf Widerøe (1928): use alternating electric fields to accelerate charged particles

• First circular accelerator: Betatron

-> inspired Ernest Lawrence (Berkeley) to build a proton cyclotron (1931)

• First radio frequency linear accelerator (LINAC) Accelerator physics – the Norwegian past

• Rolf Widerøe, Odd Dahl: • Members of CERN’s Proton Synchrotron design team (1953-1959)

• Rolf Widerøe, Kjell Johnsen • Conceptual design of a George Collins (Brookhaven), Odd Dahl, Rolf Widerøe and Frank Goward (1952) collider: Widerøe (1943) • Construction of the Intersecting Storage Ring at CERN: Johnsen (1964-1971)

3 A CERN foundation meeting (1953) Public health care in Norway

• Organized via four Regional Health Trusts Health Trust Responsible for health care services for 10 % of the population

Central-Norway Health Trust Responsible for health care services for 13 % of the population

Western Norway Health Trust South-East Norway Health Trust Responsible for health care services for Responsible for health care services 21 % of the population For 56 % of the population

The population in Norway was around 5.2 million people per 01.01.2016. Planning for Particle Therapy in Norway - some key events

2010: The first report assessing the need for Proton Therapy in Norway Report: «Proton Therapy as a Treatment Modality for Norwegian Cancer Patients»

2012: Initialization of National Planning Group with a mandate to give advice to the Government on how to proceed with Particle Therapy in Norway

2013: Report: «Planning of a Norwegian Centre for Particle Therapy»

2014: Report: «Idea Phase Report for Regional Proton Centres»

2015: The Health Trusts prepare for Proton Therapy

2016: Report: «Conceptual Phase Report for the Establishment of Proton Facilities»

2017: Funding (75 million NOK) for pre-planning of facilities for Proton Therapy. The Health Trusts are charged with planning the startup of Proton Therapy in Norway by 2022 with two facilities, the first facility either in or in Bergen. Planning for Particle Therapy in Norway - some key events

September 2013; (03.09.2013) The minister of Health and Care Services announces further work with planning 3-4 Regional Proton Therapy facilities and recognizes the potential of Carbon Ion Therapy

September 2013; (27.09.2013) HOD instructs (yet again) the Health Trust to lead the planning work and, in close collaboration with the remaining Health Trusts, to proceed with planning for regional Proton Therapy facilities in all the 4 health regions in Norway (Tromsø, Trondheim, Bergen, Oslo), including the option of Carbon Ion Therapy in the future

Election – change of government (Ap, SV -> H, Frp) Planning for Particle Therapy in Norway - some key events

January 2017: (10.01.2017) Meeting between HOD and the 4 Regional Health Trusts, protocol:

«The Meeting requests the regional Health Trusts to:

Assess two Proton Therapy Facilities in Norway. The assessment shall include the establishment of one center by 2022, and a further phased expansion, depending on the need for treatment capacity and the development of treatment technology.

The localization of the centers will possibly be in Oslo and Bergen.

The Meeting requests a recommendation of alternatives in due time prior to October 15, 2017.» Status of Particle Therapy as of today

Bergen

• Consensus between Helse Vest, Helse Bergen, HUS, UiB; between Oncologists, Medical Physicists, Physicists to build a combined carbon/proton facility in Bergen

• Funding is basically secured, in particular due to a private d0nation for a carbon machine in Bergen (250 MNOK)

• Waiting for a ”go ahead” from the government – will not happen before the new government is in place after the election in September Status – Haukeland University Hospital in Bergen

90 m

Carbon ion beamlines

Ion Source A) Synchrotron Linear Accelerator D) Carbon ion diameter 25 m Treatment room

60 m Proton beamlines

D) Carbon ion Treatment room

C) Room for R&D B) Treatment room B) Treatment room and/or fixed beam with Rotating Gantry with Rotating Gantry Treatment room

Scenario 4: Proton and Carbon Ion therapy facility with: A) Proton and Carbon Ion Accelerator; Synchrotron (thus it is required to have a linear accelerator injector) B) 2 Proton treatment rooms with rotating gantry, C) 1 Research & Development room, with fixed beamline and D) 2 Carbon ion treatment rooms with rotating (superconducting) gantry. Status – Haukeland University Hospital in Bergen

What can we hope for in Bergen? • Combined proton and carbon facility • State-of-the-art technology • fast scanning/repainting system • active energy modulation • beam gating system • several treatment rooms • superconducting gantry for carbon ions • in-room, in-beam, in-situ, in-vivo imaging for treatment optimization and verification

University Hospital This is the end

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