Radiation beam therapy evolution: From X-rays to hadrons
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E 60th ANNIVERSARY OF THE INSTITUTE OF THEORETICAL AND EXPERIMENTAL PHYSICS (ITEP, MOSCOW) ELEMENTARY PARTICLES AND FIELDS
Radiation Beam Therapy Evolution: From X-rays to Hadrons V. S. Khoroshkov* Institute of Theoretical and Experimental Physics, Bol’shaya Cheremushkinskaya ul. 25, Moscow, 117218 Russia Received July 13, 2005; in final form, September 22, 2005
Abstract—The history of external radiation beam therapy (radiotherapy)—in particular, proton therapy (PT)—is briefly outlined. Two possible strategies in increasing the efficacy of radiotherapy are considered. The radiotherapy methods and techniques are briefly described. The possibilities of PT in providing effective treatment and the main achievements are demonstrated. The state of the art in the PT development involving the active creation of large clinical PT centers since 1990 is analyzed. PACS numbers : 01.65.+g, 25.90.+k DOI: 10.1134/S1063778806100073
INTRODUCTION Creation of the Proton Therapy Center at the Institute of Theoretical and Experimental Physics (ITEP) was started in 1965. Besides undoubted basic importance and social significance of the development of research in this direction, there was one more reason that frightened us and stimulated us to be in a hurry: Academician I.Ya. Pomeranchuk, an outstanding Russian scientist, world recognized specialist in theoretical physics, and a favorite person in the ITEP got severely ill. Everybody—and Pomeranchuk the first—understood that gamma rays, which were widely used for radiotherapy at that time, were not the only and by no means the best radiation type for the radiotherapy of cancer. But Pomeranchuk was the first who asked: “Why are all cancer patients and I treated with gamma rays, whereas we are successfully generating and using in experimental physics the beams of high-energy protons offering obvious therapeutic advantages?” The idea of developing the new direction in radiotherapy was immediately supported by Academicians A.I. Alikhanov (head of ITEP) and V.P. Dzhelepov (head of the Laboratory of Nuclear Problems of the Joint Institute of Nuclear Research (JINR) in Dubna), as well as by L.B. Okun’ and L.L. Gol’din. However, implementation of this idea turned out to be highly laborious and it could not be realized as fast as it was hoped in the beginning. It was necessary to develop and construct a vast number of special devices, including the system of beam extraction from accelerator, high-precision dose meters, *
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therapeutic setups and beam transport channels, etc. One example is offered by the creation of an extremely complicated construction—the ITEP Proton Therapy Center building with a high-performance biological protection system—that was accommodated between the existing buildings and was accomplished within a record short period of nine months. Unfortunately, it was late: Academician Pomeranchuk died in 1966. We were late, but we remember that proton radiotherapy in Russia began with his “why,” and with the instantaneous response “why not, indeed” from all his fr
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