Heidelberg ion beam therapy center

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The Heidelberg ion beam therapy center
On the left under the earth wall the synchrotron
One of the two horizontal jet treatment rooms in the HIT

The Heidelberg Ion Beam Therapy Center (HIT) is a German center for particle therapy of cancer patients with accelerated protons and carbon - ions . It was built from 2003 to 2009 in Heidelberg on the premises of the University Hospital and started operating for patients in early November 2009.

The HIT was the first therapy facility in Europe that also worked with heavy ions , and the first worldwide to have a gantry - a movable beam guidance system in which the beam exit can rotate 360 ​​° around the patient in order to open up better options for radiation. This gantry has a diameter of 13 meters, a length of 25 meters and weighs 670 t.

A second, similar facility, the Marburg Ion Beam Therapy Center (MIT), has been in operation since October 2015 and works in a coordinated manner with the HIT.

history

In contrast to the older German particle therapy institutions ( Hahn-Meitner-Institut Berlin , Gesellschaft für Schwerionenforschung Darmstadt ), the HIT was not designed for physical research, but for clinical radiation therapy . With around 1,300 patients per year, it is expected to increase the national capacity of this treatment method tenfold.

Half of the construction costs of 119 million euros were borne by the University of Heidelberg and the federal government. The planning was carried out by the Heidelberg University Clinic for Radiology, the German Cancer Research Center (DKFZ) , the Helmholtz Center Dresden-Rossendorf (HZDR) , the GSI Helmholtz Center for Heavy Ion Research and Siemens AG . Over 400 patients were treated at the GSI in Darmstadt during the test phase .

Radiation technology

The ions ( protons or carbon ions) are - after pre-acceleration in a linear accelerator - brought to about 75% of the speed of light in a synchrotron . Particle energies of 48 to 221  MeV for protons and 1.06 to 5.16  GeV for carbon are achieved. If - as is usual in ion therapy - the energy per atomic mass unit is given in MeV / u instead of the energy of the particle , the numerical values ​​for protons are the same, for carbon 88 to 430 MeV / u.

Not yet for therapy, but also helium (200 to 880 MeV, i.e. 50 to 220 MeV / u) and oxygen ions (1.6 to 6.9 GeV, i.e. 103 to 430 MeV / u ) are available for experiments and clinical studies ) available (as of 2014).

In addition to the heavy ion gantry, one of the special features of the HIT is that the radiation is administered by means of electromagnetic deflection and scanning of the target volume. In contrast to other irradiation techniques, no additional matter is brought into the beam path to expand the beam to the desired width, to expand the Bragg peak in depth to a so-called "spread-out Bragg peak" (SOBP) or to widen the SOBP distally (ie on the back of the tumor). Scanning, known as "spot scanning", protects the healthy tissue around the tumor, as the dose is administered more precisely and more precisely than with other methods. The dose to be administered at a grid point (spot) is calculated by therapy planning software. The dose proportions from the different irradiation angles work together in such a way that a homogeneous equivalent dose is achieved in the target volume , taking into account the biological effectiveness .

Operation and use

The medical management of the center was entrusted to the radiation therapist Jürgen Debus , the technical management to the physicist Thomas Haberer . The first indications for ion irradiation , which are being tested in Heidelberg, are various tumors ( chordomas and chondrosarcomas ) of the skull base that were previously insensitive to radiation , a certain type of salivary gland cancer and selected cases of unresectable prostate cancer . By the beginning of 2018, more than 5000 patients had already been irradiated and several clinical studies had started.

building

The HIT extends over an area of ​​5,027 square meters on three floors, two of which are underground. A single-storey glass building accommodates the offices of the medical (70 doctors, assistants, nursing staff) as well as the scientific (physicists) and technical staff (engineers, technicians). Next to the glass building is the so-called copper block, which extends over all three floors. It houses the massive heavy ion gantry. The remaining rooms of the irradiation area are located underground - under a layer of earth up to seven meters thick. The irradiation technology with ion source , linear accelerator and synchrotron is located there. Adjacent to this are the three irradiation rooms - the irradiation room of the gantry and two horizontal irradiation stations with a fixed beam. For radiation protection reasons, the entire irradiation area is surrounded by walls and ceilings made of reinforced concrete up to 2.50 meters thick. A connecting corridor connects the HIT with the head clinic of the university clinic, which also houses the clinic for radiation oncology and radiation therapy. The HIT forms the center of the Heidelberg Clinic Ring .

swell

  • Ingeborg Bördlein: Radiation Therapy and Oncology . In: Deutsches Ärzteblatt . tape 106 , no. 45 , November 6, 2009, p. A-2233 / B-1913 / C-1872 ( online ).

Web links

Individual evidence

  1. ^ Particle Therapy Co-Operative Group (PTCOG); https://www.ptcog.ch/index.php/patient-statistics .
  2. ↑ Information brochure The Heidelberg Ion Beam Therapy Center , February 2012.
  3. ↑ Heidelberg University Hospital: Brochure from the Heidelberg University Building Authority , 2009.

Coordinates: 49 ° 25 ′ 3 ″  N , 8 ° 39 ′ 50 ″  E