Palaiseau FRANCE Feasability of protontherapy with lasers plasma
Palaiseau - FRANCE Feasability of protontherapy with lasers plasma accelerators : the SAPHIR project Victor Malka victor. malka@ensta. fr COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 1
In collaboration with : A. Flacco, F. Sylla, A. Guemnie-Tafo Laboratoire d’Optique Appliquée, ENSTA-Ecole Polytechnique, CNRS, 91761 Palaiseau, France E. Lefebvre, R. Nuter, M. Carrie CEA/DAM Ile-de-France, France Thanks to Prof. A. Smith, S. Bulanov, C. Ma, H. Daido COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 2
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 COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 3
Protons acceleration with lasers : Static electric fields COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 4
Protons are accelerated from both side : Courtesy of E. D’Humières COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 5
Proton number (/Me. V) Experimental results : Maxwellian spectra 10 10 109 108 107 106 0 2 4 6 8 10 Protons energy (Me. V) 10 Hz laser at LOA V. Malka et al. , Appl. Phys. Lett. 83, 15 (2003), Med. Phys. 31, 6 (2004) Robson et al. , Nature Physics 3 (2007) M. Borghesi : 20 Me. V, 1020 W/cm 2, 50 fs laser, D. Neely QM? COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 6
Experimental results : quasi mono energetic spectra proton counts [a. u. ] 1, 2 Simulation Experiment 1, 0 0, 8 0, 6 0, 4 0, 2 0, 0 0, 5 1, 0 1, 5 2, 0 proton energy [Me. V] 2, 5 Schwoerer, H. et al. , Nature, 439 (2006) COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 7
3 D Simulations : quasi mono energetic Spectra @ 170 Me. W with PW laser TARGET Gold pe / = 3 0. 5 mm 10 mm 5 mm protons 0. 03 mm pe / = 0. 53 code Schwoerer, H. et al. , Nature, 439 (2006) COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 8
3 D Simulations: Radiation Pressure Dominated regime with Linear Polarization I=1023 W/cm 2, Target thickness = 1 mm, Ne=5 1022 cm-3 Esirkepov, Bulanov, PRL 04 COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 9
2 D Simulations* : Radiation Pressure Dominated regime with Circular Polarization I=3 x 1020 W/cm 2, Ne=1. 5 1022 cm-3 Target thickness = 0. 2 mm 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 031301 S. Pukhov : 3 D Results are not so good COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 10
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 COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 11
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. COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 12
Comparison of the dose distribution Relative dose [%] 100 80 60 x ray g ray neutron 40 proton 20 tumor carbon ion 0 0 5 10 15 Depth in water [cm] COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 13
Protons provide superior dose distributions Protons Stop Photons don’t stop The « optimum » dose distribution delivers 100% 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. COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 14
Protons provide superior dose distributions COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 15
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 COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 16
Protontherapy Facilities in the World TREATING : PROTONS 26, CARBON IONS 3 COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 17
Protontherapy center : large & expensive & performant 18 COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639
Accelerators used in protonthrapy COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 19
Accelerators specifications protontherapy • • • Diameter : 3, 4 m Weigth 60 tons « self » radioprotection Courant max : 500 n. A (3. 1012 p. s-1) Output Energiy : 250 Me. V Extraction efficiency : 80 % Emittance : few p-mm. mrad 95 % reliability (garanty by the compagny) 6 compagnies in the world • Cost ~10 M€ COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 20
Accelerators specifications protonthrapy COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 21
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 COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 22
Need for improvement in cancer treatment Tumor Site Head/Neck Gastrointestinal Gynecologic Genitourinary Lung Breast Lymphoma Skin, Bone, Soft Tissue Brain Deaths/year 22, 000 135, 000 28, 000 55, 000 160, 000 41, 000 20, 000 15, 000 12, 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 COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 23
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. Medical impact Tumour localisation. Nb of patient per year. Total Major prescriptions Eyes tumours Neuro-oncology and Rachis 2. 000 / 2. 500 Childs and adolescent 300 / 500 Sarcomes retro-peritony 80 / 100 other possible prescriptions ORL Potential prescriptions 400 / 450 500 / 1. 000 Lungs (poumons) 3. 000 / 4. 000 other cancers 1. 000 / 1. 500 Some prostate cancers 2. 500 / 3. 000 Re-irradiations 4. 500 / 6. 500 3. 000 / 4. 000 500 / 1. 000 Estimation of the number of patients to be treated per year in France • 2. 800 / 3. 550 10. 300 / 14. 050 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). COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 24
The raisons of a non satisfied medical need -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 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 COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 25
The SAPHIR/PROPULSE Project Economic Challenges Reduce the cost Reduce the infrastructure size Reduce the radioprotection cost &size Optimize the energy distribution Project Partners: G. RIBOULET, Amplitude Tech. , PDG H. KAFROUNI, Dosisoft, PDG P. BOVAL, Propulse SAS, PDG Y. DEMAY, ENSTA, Directeur P. BEY, Inst. Curie, Dir. de l’Hôpital Curie G. LENOIR, IGR, Dir. de la Recherche D. NORMAND, CEA, Dir. SPAM-IRAMIS R. FERRAND, CPO-Curie, Resp. Tech. Scientific Challenges for an alternative technique Energy max (150 -200 Me. V ) 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 Phase 1 : 6 ME Phase 2 : 14 ME Phase 3 : Prototype COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 26
Potential advantages of laser plasma accelerators Radioprotection is strongly Wall thicknesses of 3 m reduced X Laser beam transport Proton beam transport No need of radioprotection + radioprotection 70 m Gantry : 10 m, >120 tons, 10 MEuros Beam delivering at the end Cyclotron or synchrotron Laser chain, weight : 1 ton (activation) Power : 10 k. W 100 to 400 tons, power> 500 k. W Cost : 10 ME Adjustable beam parameters 27 COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639
Russia: courtesy of Prof. S. Bulanov PRESENT-DAY SYSTEM SUGGESTION Протонный ускоритель 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 precisely manufactured and capable of being rotated as a whole (~100 tons ! ). GANTRY IS NOT REQUIRED DOUBLE-LAYER TARGET S. Bulanov, V. Khoroshkov, PPHR 5/2002 COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 28
Development of Laser-Accelerated Proton Accelerators for Cancer Therapy USA Courtesy of Prof C-M Ma, Department of Radiation Oncology, Philadelphia, USA COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 29
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 COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 30
The concurrent : Dielectric Wall Accelerators An electric field propagates down the bore of the accelerator pushing the proton « packet » in front of it 250 Me. V protons in 2 meters The goal is to have a full scale prototype operational in 4 -5 years COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 31
Dielectric Wall Accelerators : artistic view COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 32
Industrial markert for accelerators: Total accelerators sales increase more than 10%/year Application Total systems System Sales/yr (2007) approx. sold/yr ($M) System price ($M) Cancer Therapy 9100 500 1800 2. 0 - 5. 0 Ion Implantation 9500 1400 1. 5 - 2. 5 Electron cutting and welding 4500 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 33 COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639
Laser based protontherapy projects around the world • • Projet Fox Chase Center (USA) LIBRA (UK consortium) Dresden (Germany) : On. COOPtics MPQ (Germany) JAERI (Japon): « Medical laser Valley » : PMRC Russia Italy (Bologna, Prof. G. Turchetti) Etc…? COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 34
Conclusions Proton beam are produced by by plasma accelerators : : • • Proton • Stability has been improved by improving the laser contrast • They produce quasi monoenergetic beam • Peak energy still moderated (no evolution in 6 years) : 12 Me. V with 10 Hz laser, 70 Me. V with PW large scale laser : 20 Me. V with 50 fs • 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? V. Malka et al. , Nature Physics 2008 COULOMB 09, ICFA workshop, Senigallia, Italia , June 8 -12 (2009) http: //loa. ensta. fr/ UMR 7639 35
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