Proton therapy project at PSI

Particle radiation which might present steeper dose distribution has received much attention as the third particle facility at the Paul Scherrer Institute (PSI), Switzerland. Proton conformation with sharp fall-off is considered to be the radiation beam suitable for confining high doses to a target volume without complications and for verifying which factor out of high RBE or physical dose distribution is more essential for local control in malignant tumors. This paper discusses the current status of the spot scanning method, which allows three dimensional conformation radiotherapy, and preliminary results. Preliminary dose distribution with proton conformation technique was acquired by modifying a computer program for treatment planning in pion treatment. In a patient with prostate carcinoma receiving both proton and pion radiation therapy, proton conformation was found to confine high doses to the target area and spare both the bladder and rectum well; and pion therapy was found to deliver non-homogeneous radiation to these organs. Although there are some obstacles in the proton project at PSI, experimental investigations are encouraging. The dynamic spot scanning method with combination of the kicker magnet, wobbler magnet, range shifter, patient transporter, and position sensitive monitor provides highly confined dose distribution, making it possible to increase total doses and thus to improve local control rate. Proton confirmation is considered to be useful for verifying possible biological effectiveness of negative pion treatment of PSI as well. (N.K.)