Proton radiotherapy for eye cancer

The proton radiotherapy is one of the method of the eye-ball cancer treatment. In this type of therapy a suitably formed proton beam is applied to irradiate the tumour. It is distinctive for proton radiotherapy that a suitable radiation dose is delivered precisely to the treated tumour while minimizing the radiation dose deposited to healthy tissues thus reducing side effects of the treatment. Proton radiotherapy allows effective destruction of tumours –with its favourable location- while saving critical organs such as optic nerve, yellow spot (macula) or lens. Therefore, it is very likely for the patient to preserve their sight in the treated eye.

For the purposes of radiotherapy the proton beam must be properly prepared. The proton beam from the cyclotron is delivered to the therapy room through the ion-guides. The proton beam is formed and monitored in the therapy room on the "optical bench". Suitably formed and prepared beam allows to provide a precise dose to the target volume (tumour) in the patient.

The first proton eye radiotherapy facility operating in Poland was built at the Institute of Nuclear Physics Polish Academy of Sciences (IFJ PAN) in Krakow. This facility was designed and constructed in-house at the IFJ PAN by the team of physicists, engineers and computer scientists from the IFJ PAN and from cooperative institutions. For the purpose of eye-ball radiation therapy the 60 MeV proton beam from the AIC-144 cyclotron is used. The parameters of the proton beam, created in this cyclotron, allow irradiation of tumours located in any place inside the patient's eyeball.

The facility on cyclotron AIC-144 was fully activated in 2009 and on February 2011 proton irradiation of the first two patients with ocular melanoma began at IFJ PAN. This clinical endeavor was conducted by the collaborating team of physicians, physicists and engineers from the Department of Ophthalmology and Ocular Oncology (Collegium Medicum of the Jagiellonian University-CMUJ), the Institute of Nuclear Physics PAN and the Centre of Oncology in Krakow. By the end of 2015 128 patients from Department of Ophthalmology and Ocular Oncology (Collegium Medicum of the Jagiellonian University-CMUJ) benefited from proton radiotherapy.

Since 2016 proton therapy of ocular cancers is performed in the facility with isochronic cyclotron Proteus C-230. The eye line facility was designed and build by specialist from IFJ PAN and co-operating institutions. The eye treatment room is equipped with modern technology ( e.g. robotic treatment chair) and the proton beam of 70 MeV is used for the treatment. The eye line facility is compliant with the essential requirements and provisions of law, standards of quality and safety for medical devices. This is confirmed by a certificate of conformity issued by the notified body for the Proton Therapy System installed in the Bronowice Cyclotron Centre IFJ PAN in Krakow and marking system with the CE.

In the field of proton radiotherapy IFJ PAN collaborates with European centers, including Germany (Charité - Universitätsmedizin HZB, Berlin), the UK (Clatterbridge Center for Oncology), Russia (Joint Institute for Nuclear Research, Dubna) and Italy (CATANA, Catania), which have many years of experience in conducting proton radiotherapy.