Medical Radiology and radiation safety Medical Radiology and radiation safety Медицинская радиология и радиационная безопасность 1024-6177 2618-9615 28233 10.12737/article_5ca6027479faf5.57356528 Протонная терапия Proton therapy Протонная терапия Experience of Proton Radiotherapy at the Joint Institute for Nuclear Research, Dubna Опыт использования протонной лучевой терапии в объединенном институте ядерных исследований, г. Дубна Агапов А. В. Agapov A. V. Гаевский В. Н. Gaevsky V. N. Кижаев Е. В. Kizhaev E. V.

доктор медицинских наук;

doctor of medical sciences;

 Курганский Я. В. Kurgansky Ya. V. Лучин Е. И. Luchin E. I.

кандидат медицинских наук;

candidate of medical sciences;

 Мицын Г. В. Mitsyn G. V.

кандидат технических наук;

candidate of technical sciences;

 Молоканов А. Г. Molokanov A. G.

кандидат технических наук;

candidate of technical sciences;

 Цейтлина М. А. Tseytlina M. A.

кандидат медицинских наук;

candidate of medical sciences;

 Швидкий С. В. Shvidkiy S. V.

кандидат технических наук;

candidate of technical sciences;

 Шипулин К. Н. Shipulin K. N. Объединенный институт ядерных исследований Дубна Россия Joint Institute for Nuclear Research Dubna Russian Federation Объединенный институт ядерных исследований Дубна Россия Joint Institute for Nuclear Research Dubna Russian Federation Российская медицинская академия непрерывного профессионального образования Минздрава РФ Москва Россия Russian Medical Academy of Continuous Professional Education Moscow Russian Federation Объединенный институт ядерных исследований Дубна Россия Joint Institute for Nuclear Research Dubna Russian Federation Медико-санитарная часть № 9 ФМБА России Дубна Россия MSU-9 Dubna Russian Federation Объединенный институт ядерных исследований Дубна Россия Joint Institute for Nuclear Research Dubna Russian Federation Объединенный институт ядерных исследований Дубна Россия Joint Institute for Nuclear Research Dubna Russian Federation Объединенный институт ядерных исследований Дубна Россия Joint Institute for Nuclear Research Dubna Russian Federation Объединенный институт ядерных исследований Дубна Россия Joint Institute for Nuclear Research Dubna Russian Federation Объединенный институт ядерных исследований Дубна Россия Joint Institute for Nuclear Research Dubna Russian Federation Объединенный институт ядерных исследований Дубна Россия Joint Institute for Nuclear Research Dubna Russian Federation 64 2 61 69 https://zh-szf.ru/en/nauka/article/28233/view

В декабре 2017 г. исполнилось 50 лет со дня первого в России протонного облучения пациента, которое было проведено на пучке синхроциклотрона Лаборатории ядерных проблем им. В.П. Джелепова Объединенного института ядерных исследований (ОИЯИ), г. Дубна. В статье описывается краткая история создания первого терапевтического протонного пучка в Советском Союзе, хроника событий тех лет, этапы создания и развития многокабинного комплекса адронной терапии в ОИЯИ, разработанные методики и специализированное оборудование, современное состояние комплекса и перспективы его дальнейшего развития. Приводятся также результаты статистического анализа итогов лечения на протонном пучке пациентов с двумя классами нозологий: артерио-венозными мальформациями (АВМ) головного мозга, а также хордомами и хондросаркомами основания черепа.

First experiments on using proton beams for radiotherapy of malignant tumours at the 680 MeV proton synchrocyclotron of the V.P. Dzhelepov Laboratory of Nuclear Problems of the Joint Institute for Nuclear Research (DLNP JINR) have been initiated by Prof. V.P. Dzhelepov and were started in 1967. 28 patients with different types of superficially located malignancies, such as skin melanomas, metastases of cancer to peripheral nodes, larynx cancers and so on, were treated during the period of 1967–1971. Then the method of scanning rotation irradiation of deep-seated tumours was developed and started to use at DLNP JINR. 50 patients with esophagus cancer, larynx cancer and metastases of malignant tumors were treated with that technique. During the period of 1974–1984 the synchrocyclotron was modified to the Phasotron with the increase of output current. At the same time, a multi-room Medico-technical complex for hadron radiotherapy of cancer patients was constructed. It allows tumour treatment with wide and narrow horizontal beams of protons (70–660 MeV), negative pions (30–80 MeV), high-energy neutrons (mean energy 350 MeV), and with their combinations. The complex includes also the standard gamma-therapy unite Rokus-M with 60Co source for external irradiation. The unique equipment has been developed and constructed, including full-scale PET, X-ray CT for topometry of patients in sitting position, and proton CT. A new round of the development started in December 1999 when a specialized radiological department of patient capacity of 25 beds was opened in Dubna. Since 2000 regular sessions have been conducted in research of proton therapy efficiency in irradiation of patients with neoplasms located in the head, neck and other parts of the body. 1283 patients have received courses of radiotherapy at the Phasotron beams by the end of 2018. The technique of 3D conformal proton radiotherapy in which the maximum of the formed dose distribution conforms most accurately to the shape of the irradiated target has been realized and put into operation. In this way, the maximum sparing effect is achieved in normal tissues and organs surrounding the tumor. The statistical analysis of the proton treatment results of two classes of neoplasms treated with the JINR proton beam (arteriovenous malformation) of the brain and the skull base chordomas and chondrosarcomas) are presented. A new project of the development and construction of a modern superconducting cyclotron SC202 dedicated for proton radiotherapy was prepared recently by the staff of the DLNP JINR and Institute of Plasma Physics Chinese Academy of Sciences (Hefei, China). It is supposed that the accelerator will become the base of a new Proton Therapy Centre in Dubna. It will consist of two treatment rooms: the first one will be equipped with static wide horizontal proton beam and a therapeutic chair, and the second one is planned to provide with gantry for a pencil proton beam dynamic scanning and a positioner for supine patient position during irradiation.

 протонная терапия синхроциклотрон 3-хмерное конформное облучение болюсы апертурные коллиматоры опухоли головной мозг голова шеи ОИЯИ (Дубна) proton therapy synchrocyclotron 3-D conformal radiotherapy boluses aperture collimators brain head and neck tumours JINR Dubna

Dzhelepov VP, Komarov VI, Savchenko OV. Formation of a proton beam with an energy of 100-200 MeV. JINR Commun 16- 3491. 1967. (Russian). Dzhelepov VP, Komarov VI, Savchenko OV. Formation of a proton beam with an energy of 100-200 MeV. JINR Commun 16- 3491. 1967. (Russian). Salamov RF. Preparation and realization of the treatment using medical proton beam of the LNP JINR. Medical proton beam of the LNP JINR. Ed. Ruderman AI, Vaynberg MSh. JINR Commun P-5646. 1971:25-32. (Russian). Salamov RF. Preparation and realization of the treatment using medical proton beam of the LNP JINR. Medical proton beam of the LNP JINR. Ed. Ruderman AI, Vaynberg MSh. JINR Commun P-5646. 1971:25-32. (Russian). Dzhelepov VP, Goldin LL. The use of available and the possibility of creating new domestic accelerators of heavy charged particles for radiation therapy. JINR Commun 9-4560. 1969. (Russian). Dzhelepov VP, Goldin LL. The use of available and the possibility of creating new domestic accelerators of heavy charged particles for radiation therapy. JINR Commun 9-4560. 1969. (Russian). Konnov BA, Shustin VA, Melnikov LA, Tigliev GS, Badmaev KN, Bobrov YuF et al. First experience on the use of 1000-MeV proton beam in radiation therapy. Proceedings of the first International seminar on the uses of proton beams in radiation therapy Moscow. 1979;3:50-7. (Russian). Konnov BA, Shustin VA, Melnikov LA, Tigliev GS, Badmaev KN, Bobrov YuF et al. First experience on the use of 1000-MeV proton beam in radiation therapy. Proceedings of the first International seminar on the uses of proton beams in radiation therapy Moscow. 1979;3:50-7. (Russian). High-energy proton beams and radiation therapy of malignant tumors. Ed. Dzhelepov VP and Ruderman AI. JINR Commun 9035. 1975. (Russian). High-energy proton beams and radiation therapy of malignant tumors. Ed. Dzhelepov VP and Ruderman AI. JINR Commun 9035. 1975. (Russian). Dzhelepov VP, Savchenko OV, Astrakhan BV, Ruderman AI. Six-Compartment Clinicophysical Facility of JINR. Medical Radiology. 1987;32(8):81. (Russian). Dzhelepov VP, Savchenko OV, Astrakhan BV, Ruderman AI. Six-Compartment Clinicophysical Facility of JINR. Medical Radiology. 1987;32(8):81. (Russian). Abasov VM, Andreev GA, Astrakhan BV, Gavrilova TS, Klochkov II, Kutuzov SA et al. Technidues On-line with the Computer for Rotary Scanning Irradiation of Deeply Lying Tumours. JINR Commun 18-80-156. 1980. (Russian). Abasov VM, Andreev GA, Astrakhan BV, Gavrilova TS, Klochkov II, Kutuzov SA et al. Technidues On-line with the Computer for Rotary Scanning Irradiation of Deeply Lying Tumours. JINR Commun 18-80-156. 1980. (Russian). Boreyko VF, Grebenyuk VF, Zorin VP, Mytsin GV, Savchenko OV. A positron emission tomograph based on composite scintillators. Instr Exper Tech. 1998;5:131-136. (Russian). Boreyko VF, Grebenyuk VF, Zorin VP, Mytsin GV, Savchenko OV. A positron emission tomograph based on composite scintillators. Instr Exper Tech. 1998;5:131-136. (Russian). Abasov VM, Andreev GA, Astrakhan BV, Zorin VP, Klochkov II, Kutuzov SA et al. A simple version of X-ray computerized tomograph for receiving topometric information. JINR Commun 13-87-702. 1987. (Russian). Abasov VM, Andreev GA, Astrakhan BV, Zorin VP, Klochkov II, Kutuzov SA et al. A simple version of X-ray computerized tomograph for receiving topometric information. JINR Commun 13-87-702. 1987. (Russian). Alekseev GI, Zorin VP, Ivanov IA, Klenev GI, Mytsin GV, Molokanov AG et al. Proton tomograph for the proton therapy facility. JINR Commun 18-91-435. 1991. (Russian). Alekseev GI, Zorin VP, Ivanov IA, Klenev GI, Mytsin GV, Molokanov AG et al. Proton tomograph for the proton therapy facility. JINR Commun 18-91-435. 1991. (Russian). Savchenko OV. Status and prospects of new clinical methods of cancer diagnostics and treatment based on particle and ion beams available at JINR. JINR Commun 2-7195. 1996. (Russian). Savchenko OV. Status and prospects of new clinical methods of cancer diagnostics and treatment based on particle and ion beams available at JINR. JINR Commun 2-7195. 1996. (Russian). Agapov AV, Gaevsky VN, Gulidov IA, Iglin AV, Luchin EI, Mytsin GV et al. Technique of 3D conformal proton therapy. Part Nucl Lett 2005;2(6):80-86. (Russian). Agapov AV, Gaevsky VN, Gulidov IA, Iglin AV, Luchin EI, Mytsin GV et al. Technique of 3D conformal proton therapy. Part Nucl Lett 2005;2(6):80-86. (Russian). Budyashov YuG, Karpunin VO, Kolonuto PE, Mitsyn GV, Molokanov AG, Shvidky SV. A system for proton beam control during radiotherapy. Part Nucl Lett 2006;3(1):59-60. (Russian). Budyashov YuG, Karpunin VO, Kolonuto PE, Mitsyn GV, Molokanov AG, Shvidky SV. A system for proton beam control during radiotherapy. Part Nucl Lett 2006;3(1):59-60. (Russian). Bois AZ, Milker-Zabel S, Huber P, Schlegel W, Debus J. Linacbased radiosurgery or hypofractionated stereotactic radiotherapy in the treatment of large cerebral arteriovenous malformations. Int J Radiat Oncol Biol Phys. 2006;64:1049-1054. Bois AZ, Milker-Zabel S, Huber P, Schlegel W, Debus J. Linacbased radiosurgery or hypofractionated stereotactic radiotherapy in the treatment of large cerebral arteriovenous malformations. Int J Radiat Oncol Biol Phys. 2006;64:1049-1054. Menezes AH, Traynelis VC. Tumors of the craniovertebral junction. Neurological surgery. Philadelphia. WB Saunders. 1996:3041-3072. Menezes AH, Traynelis VC. Tumors of the craniovertebral junction. Neurological surgery. Philadelphia. WB Saunders. 1996:3041-3072. Gurskiy SV, Karamysheva GA, Karamyshev OV, Kostromin SA, Morozov NA, Samsonov EV et al. Research and development of a compact superconducting cyclotron SC200 for proton therapy. Proceedings of IPAC2016. 2016:1262-1264. Gurskiy SV, Karamysheva GA, Karamyshev OV, Kostromin SA, Morozov NA, Samsonov EV et al. Research and development of a compact superconducting cyclotron SC200 for proton therapy. Proceedings of IPAC2016. 2016:1262-1264.