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ONCOLOGY


releasing energy and harming tissue. This is called the exit dose.


Because PBT uses a high energy beam of protons rather than high energy x-rays to deliver radiotherapy, it is considered a non-invasive form of treatment. Patients don’t experience pain during treatment and the procedure has very few side effects compared to that of traditional radiotherapy. The proton-based Particle Therapy system that Hitachi developed jointly with Hokkaido University Hospital is advancing PBT by bringing tumour-tracking and spot- scanning radiotherapy to the treatment. This


combination makes it possible to deliver a concentrated beam that reduces treatment- induced stress to the body, allowing patients the opportunity to undergo treatment on an outpatient basis while continuing to work and carry out their daily lives. There are two main features of this system. The first is that it can deal with parts of the body that are in continuous motion. Depending on where they are located, cancers can move around not only due to respiration, heartbeat, or intestinal activity, but also as a result of emotional reactions such as tension or anxiety. While the best


practice for dealing with this movement used to be to broaden the target region, it is now possible to use a technique called “tumour tracking” that monitors the movement of the target site during radiotherapy and is able to track these movements.


The second feature of this PBT system is its ability to deal with a variety of treatment shapes and sizes. The shapes of cancerous organs or other body parts vary in size and location. Spot scanning radiotherapy was developed to deal with this. Using a tightly focused proton beam and scanning it across the treatment site enables the beam to be better concentrated on the target location.


Looking ahead


Just as researchers recognised all those years ago in the 1950s, the full potential of isolating protons for the treatment of medical conditions, researchers and healthcare professionals today should continue to support the progression in the understanding of particle accelerations, proton beams, and their applied use in radiation treatment. Even with the rapid growth of proton treatment centres, until recently, PBT has been relatively inaccessible for most patients. Due to the efforts of hospitals and manufacturers, however, the therapy method can now be received at state-of-the-art treatment centres across the world, from Japan to Spain.


The stats speak volumes of the Hitachi expands advanced proton


therapy technology across Europe The development of Hitachi’s advanced Proton Beam Therapy Treatment began in 2010. This was after a grant known as the “FIRST Programme” (Funding programme for world-leading Innovative Research and development in Science and Technology) was awarded to a project between Hitachi and Hokkaido University to jointly develop an advanced technology to treat moving targets with proton beam therapy. By 2014, the tumour tracking system and the advanced irradiation technology of Spot Scanning were integrated into Hitachi’s system for the first time. By combining this technology with Spot Scanning technology, it is possible to irradiate tumours accurately, including those attached to large organs in motion.


Hitachi’s healthcare division met a major milestone in 2020 by installing its entire Proton Beam Therapy System


in Europe for the first time. The move coincided with the technology’s growing uptake over the continent, with the past decade seeing proton facilities open in France, Germany, Italy and UK. The proton therapy system was installed at the Cancer Centre of Universidad de Navarra in Madrid, Spain, which treats more than 8,600 new cancer patients a year, and the Clinica’s first intrahospital facility. The installation brings state-of-the-art technology including spot scanning technology to Spain. The therapeutic proton beam at Universidad de Navarra precisely conforms to the shape of the target tumour and also has a 360-degree rotating gantry treatment room with cone beam CT3 and Real-time image Gated Proton Therapy (RGPT)4 capability. Furthermore, the system has the option to add an additional gantry treatment room in the future.


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importance of continuing the growth of PBT. PBT has now been used to treat more than 160,000 people worldwide, and by 2030 it is estimated that between 300,000 and 600,000 patients will have received PBT. In the United States, alone, proton therapy more than doubled between from 2012 to 2016 and the number of patients receiving the treatment increased by 70% during this period.2


As innovations in the technology continue to improve, and the system becomes more compact and inexpensive, the therapy method will be installed in more locations in different countries across the world.


One size doesn’t fit all


Medicine has always been personal to some extent – a doctor looks for the best way to help the patient sitting in front of them. But as we look ahead to the future of personalised medicine, thanks to advances in technology it is becoming possible to take this to the next level and tailor treatments for each patient.


The fight against cancer is benefiting from this approach. We are seeing new technologies helping medical professionals’ approach individual cases and offer precise treatments such as PBT, which is a huge leap forward. It leads to better outcomes for the patient and better cost effectiveness for


JANUARY 2021


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