1 feasability of protontherapy with lasers plasma accelerators : the saphir project victor malka...

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Feasability of protontherapy with lasers plasma accelerators : the SAPHIR project

Victor Malka

[email protected]

COULOMB 09, ICFA workshop, Senigallia, Italia , June 8-12 (2009)

http://loa.ensta.fr/ UMR 7639

Palaiseau - FRANCE

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E. Lefebvre, R. Nuter, M. Carrie CEA/DAM Ile-de-France, France

A. Flacco, F. Sylla, A. Guemnie-TafoLaboratoire d’Optique Appliquée, ENSTA-Ecole Polytechnique, CNRS, 91761 Palaiseau, France

In collaboration with :



Thanks to Prof. A. Smith, S. Bulanov, C. Ma, H. Daido

3COULOMB 09, ICFA workshop, Senigallia, Italia , June 8-12 (2009)


Summary

Part 1 : Short review of laser produced proton beam

Part 2 : On the use of proton beam for oncology Part 3 : The SAPHIR project

Part 4 :Conclusion and perspectives

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Protons acceleration with lasers :Static electric fields



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Protons are accelerated from both side :



Courtesy of E. D’Humières

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Experimental results : Maxwellian spectra

Robson et al., Nature Physics 3 (2007)V. Malka et al., Appl. Phys. Lett. 83, 15 (2003), Med. Phys. 31, 6 (2004)

106

107

108

109

1010

0 2 4 6 8 10Protons energy (MeV)

Pro

ton

nu

mb

er

(/M

eV

)

10 Hz laser at LOA



M. Borghesi :20 MeV, 1020 W/cm2, 50 fs laser, D. Neely QM?

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Experimental results :quasi mono energetic spectra

0,0 0,5 1,0 1,5 2,0 2,5

0,0

0,2

0,4

0,6

0,8

1,0

1,2 Simulation Experiment

pro

ton

co

un

ts [

a.u

.]

proton energy [MeV]

Schwoerer, H. et al., Nature, 439 (2006)



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3D Simulations : quasi mono energetic Spectra @ 170 MeW with PW laser

Schwoerer, H. et al., Nature, 439 (2006)

code

0.5m

0.03m

Gold

protons

5m10m

TARGET

pe / = 3

pe / = 0.53



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3D Simulations: Radiation PressureDominated regime with Linear Polarization

I=1023W/cm2, Target thickness = 1m, Ne=5 1022cm-3



Esirkepov, Bulanov, PRL 04

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2 D Simulations* : Radiation PressureDominated regime with Circular Polarization

Macchi A et al 2005 Phys. Rev. Lett. 94 165003 Robinson A P L et al 2008 New J. Phys. 10 013021 *Klimo O et al 2008 Phys. Rev. ST-AB 11 031301COULOMB 09, ICFA workshop, Senigallia, Italia , June 8-12 (2009)


I=3x1020W/cm2, Ne=1.5 1022cm-3

Target thickness = 0.2 mS. Pukhov : 3DResults are not so good



Summary




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Causes of Local Cancer Failure

The primary cause for local failure is our inability to deliver a letal dose of radiation to the tumour cells.The reasons for this include :

-We cannot determine the exact location and extend tumor cells and their route to spread-Inadequate treatment.-Proximity of dose limiting normal tissues and organs(brains stem, optics, lung, gut, etc.)-Less that optimum dose distribution of the radiation beam used for treatment.



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Comparison of the dose distribution

100

0 5 10 15Depth in water [cm]

Rela

tive d

ose [

%]

ray

x ray

neutron

proton

carbon iontumor

80

60

40

20

0



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Protons provide superior dose distributions

Protons Stop

Photons don’t stop

The « optimum » dose distribution delivers100% dose to the tumour target and not to critical normal tissues.

Proton beams deliver dose distribution that are more optimum than those from photon beams

This should result in improved clinical outcomes when proton beams are used.



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Protons provide superior dose distributions



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Protontherapy Facilities in the World

26 facilities worldwide treating patients

• 6 in Japan (4 hospital-based) : Chiban, NCC East-Kashiva, HIBMC-Hyogo, PMRC-Tsukuba, WERC-Wakasa, Shizuoka,Cancer Center

• 6 in the United States (4 hospital-based) : LLUMC, MGH, MDACC, Univ. of Florida, Univ. of Indiana, UC Davis

• 10 in Europe/Russia

• 4 additional facilites (UK, China, Korea, South Africa)

• > 55,000 patients have been treated with proton beams

• 22 additional Institutions worldwide are developing new facilities



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Protontherapy Facilities in the World

TREATING : PROTONS 26, CARBON IONS 3COULOMB 09, ICFA workshop, Senigallia, Italia , June 8-12 (2009)


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Protontherapy center : large & expensive & performant



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Accelerators used in protonthrapy



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Accelerators specifications protontherapy

• Diameter : 3,4 m• Weigth 60 tons• « self » radioprotection • Courant max : 500 nA (3. 1012

p.s-1)• Output Energiy : 250 MeV• Extraction efficiency : 80 % • Emittance : few p-mm.mrad• 95 % reliability (garanty by the

compagny) • 6 compagnies in the world

• Cost ~10 M€



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Accelerators specifications protonthrapy





Summary




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Tumor Site

Head/NeckGastrointestinalGynecologicGenitourinaryLungBreastLymphomaSkin, Bone, Soft TissueBrain

Deaths/year

22,000135,000

28,00055,000

160,00041,00020,00015,00012,000

Deaths due to local failure of treatment

13,200 (60%)54,000 (40%)14,000 (50%)27,500 (50%)40,000 (25%)

4,920 (12%)2,400 (12%)5,000 (33%)

10,800 (90%)

Total 488,000 171,820 (35%)

350,000 new cancer patients per year in the US

Need for improvement in cancer treatment



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Indications for protontherapy in France• Very selective prescription because of the cost and of the weight of the

infrastrucutre. Determined by the need of having an high balistic precision.

• recent publication: protontherapy should be beneficial for 15% of patients wich requires

radiotherapy treatment (i.e. 27.000 patients per year in France)

• Capacity of protontherapy in France : 600 patients per year (800 en 2011).

Medical impact Tumour localisationNb of patient per yearTotalEyes tumours 400 / 450

Neuro-oncology and Rachis 2.000 / 2.500

Childs and adolescent 300 / 500

Sarcomes retro-peritony 80 / 100

ORL 500 / 1.000

Lungs (poumons) 3.000 / 4.000

other cancers 1.000 / 1.500

Some prostate cancers 2.500 / 3.000

Re-irradiations 500 / 1.000

10.300 / 14.050

Potential prescriptions

3.000 / 4.000

Estimation of the number of patients to be treated per year in France

Major prescriptions

2.800 / 3.550other possible prescriptions

4.500 / 6.500



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The raisons of a non satisfied medical need

2 2

6

10

2

21

7

1960-1970 1971-1980 1981-1990 1991-2000 2001-2010

protons

ions carbone

5 centres protons et2 centres carbone(en projet : 1 centre protons)

7 centres protons (dont 1 au Canada)( en projet : 2 centres protons)

1 centre protons

1 centre protons( en projet : 1 centre protons)

en projet : 1 centre protons

12 centres protons et 1 centre carbone( en projet : 5 centres protons, 1 centre carbone et 4 centres associant protons et carbone)

5 centres protons et2 centres carbone(en projet : 1 centre protons)

7 centres protons (dont 1 au Canada)( en projet : 2 centres protons)

1 centre protons

1 centre protons( en projet : 1 centre protons)

en projet : 1 centre protons

12 centres protons et 1 centre carbone( en projet : 5 centres protons, 1 centre carbone et 4 centres associant protons et carbone)

Market in progress but still limited by the cost and the size of the installation Estimation of the needed protontherapy center in the world (based on the hypothesis that 15% of patients are treated by proton beam) :

In Europe : 300 In USA : 150

-2 protontherapy center in France (Orsay et Nice)

-30 centres in « modern » countries

-Limitation due :–Cost of the installation : 80 à 140 M€–Size of the installation : 1000 to 2000 m²



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Economic Challenges

Reduce the cost Reduce the infrastructure size Reduce the radioprotection cost

&size Optimize the energy distribution

Scientific Challenges for an alternative technique

Energy max (150-200 MeV ) Modulate and control the energy

spectrum Stable and repoducible Compact

Goal of the project :

To develop a demonstrator (pre prototype)Machine cost less than 10-20 M€Total size : <1000 m²

The SAPHIR/PROPULSE Project

Project Partners:

G. RIBOULET, Amplitude Tech., PDGH. KAFROUNI, Dosisoft, PDGP. BOVAL, Propulse SAS, PDGY. DEMAY, ENSTA, DirecteurP. BEY, Inst. Curie, Dir. de l’Hôpital CurieG. LENOIR, IGR, Dir. de la RechercheD. NORMAND, CEA, Dir. SPAM-IRAMISR. FERRAND, CPO-Curie, Resp. Tech.



Phase 1 : 6MEPhase 2 : 14 MEPhase 3 : Prototype

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70 m

Potential advantages of laser plasmaaccelerators

X Cyclotron or synchrotron (activation) 100 to 400 tons, power> 500 kW

Laser chain, weight : 1 tonPower : 10 kWCost : 10 ME

Radioprotection is strongly reduced

Wall thicknesses of 3 m Proton beam transport + radioprotection

Adjustable beam parameters

Gantry :10m, >120 tons, 10 MEurosBeam delivering at the end

Laser beam transportNo need of radioprotection



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PRESENT-DAY SYSTEMPRESENT-DAY SYSTEMSUGGESTIONSUGGESTION

General scheme of the GANTRY:1. bending magnets;2. quadrupole lenses;3. couch (positioner);4. dose delivery and monitoring system;5. procedure room;6. concrete shielding.Magneto-optic system must be preciselymanufactured and capable of beingrotated as a whole (~100 tons ! ).

General scheme of the GANTRY:1. bending magnets;2. quadrupole lenses;3. couch (positioner);4. dose delivery and monitoring system;5. procedure room;6. concrete shielding.Magneto-optic system must be preciselymanufactured and capable of beingrotated as a whole (~100 tons ! ).

GANTRY IS NOT REQUIREDGANTRY IS NOT REQUIRED

Протонный ускорительПротонный ускоритель

S. Bulanov,V.Khoroshkov, PPHR 5/2002S. Bulanov,V.Khoroshkov, PPHR 5/2002

DOUBLE-LAYER TARGETDOUBLE-LAYER TARGET

Russia: courtesy of Prof. S. Bulanov



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Development of Laser-Accelerated Proton Accelerators for Cancer Therapy USA

Courtesy of Prof C-M Ma, Department of Radiation Oncology, Philadelphia, USA





Summary


Part 2 : On the use of proton beam for oncology

Part 3 : The SAPHIR project


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The concurrent : Dielectric Wall Accelerators

An electric field propagates down the bore of the accelerator pushing the proton « packet » in front of it

250 MeV protons in 2 metersThe goal is to have a full scale prototype operational in 4-5 years



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Dielectric Wall Accelerators : artistic view



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ApplicationTotal systems (2007) approx.

System sold/yr

Sales/yr ($M)

System price ($M)

Cancer Therapy 9100 500 1800 2.0 - 5.0

Ion Implantation 9500 500 1400 1.5 - 2.5

Electron cutting and welding 4500 100 150 0.5 - 2.5

Electron beam and X-ray irradiators 2000 75 130 0.2 - 8.0

Radioisotope production (incl. PET) 550 50 70 1.0 - 30

Non-destructive testing (incl. security) 650 100 70 0.3 - 2.0

Ion beam analysis (incl. AMS) 200 25 30 0.4 - 1.5

Neutron generators (incl. sealed tubes) 1000 50 30 0.1 - 3.0

Total 27500 1400 3680

Industrial markert for accelerators: Total accelerators sales increase more than 10%/year



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Laser based protontherapy projectsaround the world

• Projet Fox Chase Center (USA)

• LIBRA (UK consortium)

• Dresden (Germany) : OnCOOPtics

• MPQ (Germany)

• JAERI (Japon): « Medical laser Valley »: PMRC

• Russia

• Italy (Bologna, Prof. G. Turchetti)

• Etc…?



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Conclusions

• Proton beam are produced by plasma accelerators :• Stability has been improved by improving the laser contrast

• They produce quasi monoenergetic beam

• Peak energy still moderated (no evolution in 6 years) : 12MeV with 10 Hz laser, 70 MeV with PW large scale laser

• Number of proton per second can be a problem ?

• Target fabrication and alignement at high repetition rate ?

• Biological response with high current dose?

V. Malka et al., Nature Physics 2008COULOMB 09, ICFA workshop, Senigallia, Italia , June 8-12 (2009)


• Proton beam are produced by plasma accelerators :• Stability has been improved by improving the laser contrast

• They produce quasi monoenergetic beam

• Peak energy still moderated (no evolution in 6 years) : 12MeV with 10 Hz laser, 70 MeV with PW large scale laser : 20 MeV with 50fs

• Number of proton per second can be a problem ?

• Target fabrication and alignement at high repetition rate ? In progress (LIBRA)

• Biological response with high current dose?

1 feasability of protontherapy with lasers plasma accelerators : the saphir project victor malka...

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