Installation of proton treatment equipment in existing radiotherapy room

Abstract

Proton therapy systems will be deployed in existing radiotherapy rooms to limit radiation exposure and meet radiation safety requirements. A patient support platform disposed in the treatment room is configured to support a patient, such as in a sitting position. The imager is configured to image a patient on the patient support platform. A proton beam generator including a synchrotron is provided in an area of the treatment room. A proton beam delivery device is configured to deliver a proton radiation agent to an isocenter of a target tissue during a treatment session, wherein the delivery device may be a scaffold-less pencil beam scanning device that operates without a collimator. The synchrotron may be disposed adjacent an inlet wall of the treatment chamber, and the proton radiant is directed to a rear wall of the treatment chamber. The synchrotron may pass through an aperture of a rear median wall of the treatment chamber, and the proton radiative is directed to an inlet median wall of the treatment chamber.

Description

Field of the Invention

[0001] The present invention relates generally to the field of radiotherapy, and more particularly to the installation of proton therapy equipment. Background of the Invention

[0003] Teletherapy is defined as a treatment method in which the radiation source is kept at a distance from the body to be treated. X-rays and electron beams have long been used in teletherapy to treat various cancers. Unfortunately, X-rays exhibit a linear energy transfer close to an exponential decay function, so the safe use of deeply buried vegetation is minimal. Since heavy particles can penetrate to a specific depth without significantly harming the tissues in between, the use of heavy particles, especially hadrons, and more especially protons, in teletherapy has become increasingly accepted. In particular, the linear energy transfer of hadrons presents an opposite depth distribution (where the marked Bragg peak is defined as the point where the hadron deposits most of its energy) and occurs at the end of the hadron path. For electrons, the Bragg peak is unobservable due to high scattering. For protons with energies below about 70MeV, scattering significantly suppresses the Bragg peak. Due to this effect, compared with X-rays and electron beams, the increased energy can be directed to the buried vegetation, which can especially harm the tissues in between. Although the term hadron includes a variety of particles, in fact, protons and various ions are most widely used in treatment. For clarity, this document will describe treatment performed with protons, but this is not meant to be limiting in any way.

[0004] Protons or ions can be focused to a target volume with a variable penetration depth. In this way, the dose distribution can be closely matched to the target volume with high precision. In particular, the proton beam can conform to the shape and depth of the target vegetation (such as a tumor), thereby avoiding irradiating healthy body tissues while providing a lower whole-body radiation dose. As a result, compared with conventional external beam therapy, proton therapy can gradually increase the dose, which may be particularly beneficial for certain treatments, such as eye tumors or skull base and paraspinal tumors. Proton therapy can also achieve high-precision treatment plans with reduced side effects, such as pediatric treatment or prostate cancer treatment. In order to ensure complete radiation of the target vegetation, multiple beams reaching the buried vegetation from several different directions are usually applied. The point where multiple beams intersect, whether sent sequentially or simultaneously, is called the "isocenter". In order to maximize biological effectiveness, the isocenter must be precisely juxtaposed with the target vegetation.

[0005] Radiation therapy is delivered to the target tissue in a clearly defined process. In the first phase, called the treatment planning phase, the target tissue is imaged and a treatment plan is defined that includes dose, patient positioning, and radiation angles. In addition, placement markers can be defined to ensure that subsequent radiation treatment sessions are correctly targeted. Then, in response to the developed treatment plan, radiation is performed in multiple sessions over a period of time, each session is called a segment. In each such segment, care must be taken to ensure that the patient is correctly positioned in response to the placement of markers to avoid damage to organs near the target tissue. Patient positioning in response to markers is performed based on visualization of the patient in response to the defined markers.

[0006] In particular, during each segment, the patient is positioned on a patient support platform (e.g., a bed) in a set pose. The set pose is the same as the patient pose during imaging during the treatment planning phase, except that the set pose is in the treatment room and the center of the vegetation mass is located at the isocenter of the radiation source. The set pose of the patient is optionally verified by imaging and / or positioning devices. Stabilization mechanisms can be applied to ensure that the patient's positioning relative to the isocenter is maintained during treatment, such as applying a mask or shield to immobilize the patient's face and / or other body parts.

[0007] Radiotherapy is usually performed when the patient is in a lying or prone position, wherein the patient's body is aligned with the ground substantially horizontally and supported by the platform surface below. For example, a lying patient may take a supine position with the back against the surface below and the face facing up, or take a prone position with the chest against the surface below and the face facing down. However, some treatments may be difficult to perform on a horizontally positioned patient, such as due to the position of the vegetation mass in the body, and may require or be facilitated by an upright or non-horizontal positioning. Therefore, the patient may sit in a reclining chair that can be repositioned and reoriented along multiple axes in three-dimensional space (e.g., along six degrees of freedom). An upright or sitting position may also provide greater patient comfort relative to a lying position, such as for patients with respiratory complications. In addition, an upright positioning may affect changes in the volume, position and / or movement of body organs (such as the lungs and heart) compared to a lying position, which may have a beneficial effect in certain clinical situations.

[0008] Despite the various benefits, the application of proton therapy in clinical settings remains rare. One major reason relates to the considerable physical size of the required equipment, which cannot be integrated into existing radiotherapy facilities. Specifically, the equipment used to generate and deliver proton-based radiation, such as particle accelerators, is quite large and difficult to integrate into conventional radiotherapy rooms, commonly known as linear accelerator (LINAC) rooms. In addition, safety considerations are a key factor in allowing the use of proton radiation for clinical treatment. Strict measures need to be taken to prevent harmful radiation exposure, which further hinders the installation of proton therapy equipment in conventional radiotherapy rooms. For example, proton accelerators usually need to be installed in separate shielded bunkers within the facility, especially cyclotrons that produce harmful neutrons during operation. Therefore, it is usually necessary to build a second new large treatment room to accommodate the proton therapy equipment. Summary of the invention

[0009] According to one aspect of the present invention, there is provided a proton radiotherapy system to be deployed in an existing radiotherapy room. The system includes a patient support platform, at least one imager, a proton beam generator, and a proton beam delivery device. The patient support platform is disposed in an area of ​​the treatment room and is configured to support a patient during a treatment session. The imager is configured to image the patient on the patient support platform. The proton beam generator includes a synchrotron, which is disposed in an area of ​​the treatment room and is configured to generate a proton radiation beam. The proton beam delivery device is coupled to the synchrotron and is disposed in an area of ​​the treatment room, and is configured to deliver at least one proton radioactive agent to the isocenter of a target tissue of the patient relative to an imaging coordinate system during proton therapy, so that the radiation exposure of the proton therapy is limited and meets radiation safety requirements. The system may further include a controller, wherein during a treatment planning phase, the controller is configured to: receive a treatment prescription for treating a patient, receive at least one image of the patient on a patient support platform, and a corresponding position and orientation of the patient in the image, and generate a proton treatment plan in response to the received image and the corresponding position and orientation and the received treatment prescription, and wherein during a treatment application phase, the controller is configured to instruct a proton beam delivery device to emit a proton agent according to a treatment plan field in the treatment plan, while selectively repositioning and redirecting a target tissue of the patient relative to an isocenter of the proton radiation beam. The treatment plan may include a series of agent parameters for at least one treatment course, and for each corresponding agent, each of the agent parameters includes: a dose, a position and orientation of the patient relative to an isocenter, and an angle of radiation. The proton beam delivery device may include a gantryless pencil beam scanning (PBS) device configured to deliver a proton agent without a collimator. The patient support platform may be a sitable platform, and wherein the patient is in a sitting position during the treatment course. The imager may be disposed outside the treatment room. The synchrotron may be disposed adjacent to an entrance wall of the treatment room, and the proton beam transport device may be configured to direct the proton radioactive agent to a patient support platform disposed adjacent to a rear wall of the treatment room. The synchrotron may be disposed in an enclosed compartment defined by the entrance wall of the treatment room, the outer side wall of the treatment room, and the inner side wall of the treatment room. The synchrotron may be disposed adjacent to the rear wall of the treatment room, and the proton beam transport device may be configured to direct the proton radioactive agent to a patient support platform disposed adjacent to the entrance wall of the treatment room. The synchrotron may be configured to extend through a plurality of holes of a first intermediate inner wall of the treatment room adjacent to the rear wall, and the patient support platform may be disposed at a rear end of a second intermediate inner wall of the treatment room adjacent to the entrance wall. The treatment room may include at least one intermediate wall or door comprising a thickness of at least 1 meter and a density of at least 2.35 g / cm 3of concrete material. The treatment room may include at least one additional shielding layer: an iron shield of approximately 20 cm thick on the inside of the intermediate wall; a boronized polyethylene shield of approximately 40 cm thick on the outside of the intermediate wall; and a boronized polyethylene shield of approximately 40 cm thick on the inside of an entrance door of the treatment room. The system may further include a platform adjustment mechanism configured to adjust the platform translationally and rotationally about three orthogonal axes to correspondingly change the positioning or orientation of the patient along six degrees of freedom. The distance between the imaging isocenter of the patient during the treatment planning phase and the imaging isocenter of the patient during the treatment application phase may be less than 2 meters. The distance between the distal end of the proton beam delivery device and the skin portion of the patient during the treatment application phase may be less than 1 meter.

[0010] According to another aspect of the present invention, a method for proton radiotherapy in an existing radiotherapy room is provided. The method includes the following steps: installing a patient support platform in an area of ​​the treatment room, the patient support platform being configured to support a patient; providing at least one imager configured to image the patient on the patient support platform; installing a proton beam generator including a synchrotron in an area of ​​the treatment room, the synchrotron being configured to generate a proton radiation beam; and installing a proton beam delivery device in an area of ​​the treatment room, the proton beam delivery device being configured to deliver at least one proton radioactive agent to the isocenter of a target tissue of the patient relative to an imaging coordinate system during proton therapy, so that the radiation exposure of the proton therapy is limited and meets radiation safety requirements. The method may further include the following steps: during a treatment planning phase, receiving a treatment prescription for treating a patient, receiving at least one image of a patient on a patient support platform, and a corresponding position and orientation of the patient in the image, and generating a proton treatment plan in response to the received image and the corresponding position and orientation and the received treatment prescription, and during a treatment application phase, instructing a proton beam delivery device to emit a proton agent while selectively repositioning and redirecting a target tissue of the patient relative to an isocenter of the proton radiation beam according to a treatment plan field in the treatment plan. The treatment plan may include a series of agent parameters for at least one treatment course, and for each corresponding agent, each of the agent parameters includes: a dose, a position and orientation of the patient relative to the isocenter, and an angle of radiation. The proton beam delivery device may include a gantryless pencil beam scanning (PBS) device configured to deliver a proton agent without a collimator. The patient support platform may be a sitable platform, and wherein the patient is in a sitting position during the treatment course. The imager may be disposed outside the treatment room. The synchrotron may be disposed adjacent to an entrance wall of the treatment room, and the proton beam transport device may be configured to direct the proton radioactive agent to a patient support platform disposed adjacent to a rear wall of the treatment room. The synchrotron may be disposed in an enclosed compartment defined by the entrance wall of the treatment room, the outer side wall of the treatment room, and the inner side wall of the treatment room. The synchrotron may be disposed adjacent to the rear wall of the treatment room, and the proton beam transport device may be configured to direct the proton radioactive agent to a patient support platform disposed adjacent to the entrance wall of the treatment room. The synchrotron may be configured to extend through a plurality of holes of a first intermediate inner wall of the treatment room adjacent to the rear wall, and the patient support platform may be disposed at a rear end of a second intermediate inner wall of the treatment room adjacent to the entrance wall. The treatment room may include at least one intermediate wall or door comprising a thickness of at least 1 meter and a density of at least 2.35 g / cm 3of concrete material. The treatment room may include at least one additional shielding layer: an iron shield of approximately 20 cm thick on the inside of the intermediate wall; a boronized polyethylene shield of approximately 40 cm thick on the outside of the intermediate wall; and a boronized polyethylene shield of approximately 40 cm thick on the inside of an entrance door of the treatment room. The system may further include a platform adjustment mechanism configured to adjust the platform translationally and rotationally about three orthogonal axes to correspondingly change the positioning or orientation of the patient along six degrees of freedom. The distance between the imaging isocenter of the patient during the treatment planning phase and the imaging isocenter of the patient during the treatment application phase may be less than 2 meters. The distance between the distal end of the proton beam delivery device and the skin portion of the patient during the treatment application phase may be less than 1 meter. BRIEF DESCRIPTION OF THE DRAWINGS

[0011] The present invention will be more fully understood and appreciated through the following detailed description in conjunction with the accompanying drawings, in which:

[0012] Figure 1 is a schematic diagram of a proton radiotherapy system constructed and operative in accordance with an embodiment of the present invention;

[0013] Figure 2 is a diagrammatic representation of an exemplary synchrotron configuration constructed and operated in accordance with an embodiment of the present invention;

[0014] Figure 3 is a floor plan of an exemplary LINAC treatment room for deploying a proton radiotherapy system operated in accordance with an embodiment of the present invention;

[0015] Figure 4 is a floor plan view of a first exemplary configuration for installing a proton radiotherapy system constructed and operated in accordance with an embodiment of the present invention in an existing LINAC treatment room in which the proton beam is directed to the back wall of the treatment room; and

[0016] Figure 5 is a floor plan view of a second exemplary configuration for installing a proton radiotherapy system constructed and operated in accordance with an embodiment of the present invention in an existing LINAC treatment room in which the proton beam is directed to an entrance wall of the treatment room. DETAILED DESCRIPTION

[0017] The present invention overcomes the shortcomings of the prior art by providing a proton therapy system and method that can be incorporated into existing radiotherapy (radiotherapy) treatment rooms. The disclosed embodiments allow existing health care facilities to incorporate proton therapy without requiring major modifications to the infrastructure while maintaining safety requirements in terms of radiation shielding and further enabling patients to receive treatment in a seated position.

[0018] Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which the present invention belongs. It should also be understood that terms, such as those defined in commonly used dictionaries, should be interpreted as having a meaning consistent with their meaning in the context of the specification and claims, and should not be interpreted in an idealized or overly formal sense unless explicitly defined herein. For the sake of brevity and / or clarity, well-known functions or configurations may not be described in detail.

[0019] It should be understood that although the terms first, second, etc. may be used herein to describe various elements, components, regions, layers and / or parts, these elements, components, regions, layers and / or parts should not be limited by these terms. Instead, these terms are only used to distinguish one element, component, region, layer and / or part from another element, component, region, layer and / or part.

[0020] It is understood that when an element is referred to as being "on", "attached" to, "operably coupled" to, "operably linked" to, "operably engaged" with, "connected" to, "coupled to", "contacting", "added to", etc., it can be directly on, attached to, connected to, operably coupled to, operably engaged with, coupled to, added to, and / or contacting the other element, and there may be intervening elements. In contrast, when an element is referred to as being "directly in contact with" or "directly added to" another element, there are no intervening elements and / or steps.

[0021] Whenever the term "about" or "approximately" is used, it refers to a measurable value, such as an amount, a duration of time, etc., and is meant to include variations from the specified value as such variations are suitable for performing the disclosed methods.

[0022] Certain features of the invention described in the context of separate embodiments for the sake of clarity may also be provided in combination in a single embodiment. Conversely, various features of the invention described in the context of a single embodiment for the sake of brevity may also be provided separately, or in any suitable sub-combination, or as appropriate in any other described embodiment of the invention. Certain features described in the context of various embodiments should not be considered essential features of those embodiments unless the embodiment is inoperative without those elements.

[0023] Whenever the terms "multiple" and "plurality" are used, it is meant to include, for example, "several" or "two or more". The terms "multiple" or "plurality" may be used throughout the specification to describe two or more components, devices, elements, units, parameters, etc. A term set used herein may include one or more items. Unless explicitly stated, the method embodiments described herein are not limited to a specific order or sequence. In addition, some of the described method embodiments or elements thereof may occur or be performed simultaneously, at the same point in time, or simultaneously.

[0024] Throughout the disclosure, references are made to "disclosed embodiments," "disclosed systems," and "disclosed methods," which refer to examples of the inventive ideas, concepts, and / or manifestations described herein. The fact that some disclosed embodiments are described as exhibiting a feature or characteristic does not imply that other disclosed embodiments necessarily share that feature or characteristic.

[0025] The present disclosure uses open licensing language, for example, indicating that some embodiments "may (may)" adopt, involve or include specific features. The use of the term "may (may)" and other open terms is intended to indicate that although not every embodiment may adopt a specific disclosed feature, at least one embodiment adopts a specific disclosed feature.

[0026] The term "operator" is used herein to refer to any individual or group of individuals who use or operate a method or system according to the disclosed embodiments, such as a medical practitioner involved in performing a proton therapy procedure (e.g., a radiation oncologist, radiation therapy nurse, medical radiation physicist, radiation therapist, dosimetrist, etc.).

[0027] The terms "subject" and "patient" are used interchangeably herein to refer to an individual on whom a method or system according to the disclosed embodiments is performed, such as a person undergoing a proton therapy procedure. The subject can be any organism, such as a human, a human being, or an animal, characterized by body tissue being subjected to radiation therapy.

[0028] The terms "proton therapy" and "proton treatment" are used interchangeably herein to broadly encompass all forms of particle therapy or hadron therapy that apply beams of charged ionizing particles, including but not limited to protons, neutrons, and other types of ions (all of which are considered to be encompassed by the term "proton" herein), for radiation therapeutic purposes.

[0029] The present invention will become apparent from the following detailed description with reference to the accompanying drawings, wherein like reference numerals refer to like elements. In order to better understand certain embodiments and to show how to implement these embodiments, reference will now be made purely by way of example to the accompanying drawings, wherein like numerals represent corresponding elements or parts.

[0030] Reference now Figure 1 , Figure 1 1 is a schematic diagram of a proton radiotherapy system (generally designated 110) constructed and operated in accordance with an embodiment of the present invention. The components of the system 110 are configured to be deployed in an existing conventional radiotherapy room 100 (also referred to as a linear accelerator (LINAC) treatment room). The treatment system 110 includes a proton beam generator 112, a proton beam delivery device 114, at least one imager 116, a controller 118, a patient support platform 122, and a platform adjuster 124. The controller 118 is communicatively coupled to the proton beam generator 112, the proton beam delivery device 114, the imager 116, and the platform adjuster 124. The LINAC treatment room 100 is a shielded room that contains at least the proton beam generator 112, the proton beam delivery device 114, and the patient support platform 122.

[0031] The patient support platform 122 is configured to support the patient 120 during a treatment or planning phase. In one embodiment, the patient support platform 122 comprises a chair so that the patient 120 can be in a sitting position and supported by the seat 121 and the backrest 123 (eg, Figure 1 The patient support platform 122 may also include or be converted into a bed, so that the patient 120 may be in a lying or prone position (ie, level with the ground) supported by the bed.

[0032] The patient support platform 122 can be adjusted using a platform adjuster 124 to change the position and / or orientation of the patient 120 accordingly along six degrees of freedom (6DOF). The platform adjuster 124 may include a rotation adjustment mechanism configured to adjust at least one rotation angle (e.g., pitch, yaw, roll rotation) of the platform 122 and / or a translation adjustment mechanism configured to translate and displace the platform 122 along at least one axis. For example, the platform adjuster 124 may include a first mechanism for adjusting the height of the platform 122 and a second mechanism for rotating the platform 122 around the pitch, yaw, and roll axes, respectively (e.g., to make the patient 120 supine, tilt sideways, or rotate, respectively). For example, the rotation adjustment mechanism can rotate the platform 122 around three orthogonal axes 125R, 127R, 129R, wherein the first axis 125R is parallel to the floor 102 of the treatment room 100, the second axis 127R is parallel to the floor 102 and perpendicular to the first axis 125R, and the third axis 129R is perpendicular to the floor 102. Rotation of the patient support platform 122 causes the patient 120 to rotate about three orthogonal axes 125P, 127P, 129P, wherein the first axis 125P is perpendicular to the longitudinal axis of the seat 121 and perpendicular to the longitudinal axis of the backrest 123, the second axis 127P is parallel to the longitudinal axis of the seat 121, and the third axis 129P is parallel to the longitudinal axis of the backrest 123. In one embodiment, the axes 125P, 127P, and 129P correspond to the axes 125R, 127R, and 129R, respectively.

[0033] The proton beam generator 112 includes components and techniques for generating a radiotherapy proton beam, such as a particle accelerator. According to one embodiment, the proton beam generator 112 includes a synchrotron. A synchrotron is a circular particle accelerator in which charged particles (e.g., protons) are accelerated by a series of magnets around a fixed closed loop path. The magnetic field that bends the particle beam around the ring increases over time because it is synchronized with the kinetic energy of the particles (hence the name "synchrotron"). In contrast to cyclotron-type particle accelerators, synchrotrons generally do not produce harmful neutron radiation during their operation and can therefore be safely placed in the treatment room 100. Although synchrotrons are generally larger in size than cyclotrons, newer synchrotron models are more compact, which may facilitate their transportation and delivery (e.g., via conventional elevators) and allow them to be installed in existing LINAC treatment rooms. Therefore, the size of the synchrotron can be selected to facilitate its deployment in the treatment room 100. For example, a synchrotron is characterized by an outer ring diameter of about 5 meters (m) and an accelerator weight of about 15 tons. Although synchrotrons may be limited to pulsed beam operation modes, synchrotrons may be able to provide any desired energy level (up to a maximum threshold) and may provide efficient beam usage compared to cyclotrons. Exemplary operating parameters for synchrotrons may include: a proton energy range of approximately 30-330 MeV; a therapeutic energy range of approximately 70-250 MeV; and a power of approximately 2.5 × 10 9 The extraction beam intensity of protons is about 90 millitesla (mT) during injection; the magnetic field strength is about 1.9 tesla (T); the average power consumption during treatment is about 30 kilowatts (kW). Figure 2 , Figure 2 is an illustration of an exemplary synchrotron configuration constructed and operated in accordance with an embodiment of the present invention. The synchrotron may also be deployed within a conventional LINAC treatment room having an intermediate wall, without completely removing the wall, by providing holes in the wall to accommodate the segments of the synchrotron ring, as will be described below with reference to Figure 5 Further discussion.

[0034] The proton beam delivery device 114 includes components and techniques for delivering a radioactive agent 115 to a patient 120 via a generated proton beam. According to one embodiment, the proton beam delivery device 114 includes a frameless pencil beam scanning delivery device. Pencil beam scanning (PBS) involves the use of an electronic and / or magnetically guided scanning mechanism to guide a proton beam along a target area to set a pattern and a focused beam shape, which is typically only a few millimeters wide (i.e., the width of a pencil). PBS allows control of beam position and depth so as to more accurately deliver the radioactive agent to a target tissue (e.g., a tumor) in three dimensions. Specifically, PBS can direct the proton beam in a customized pattern based on the location, shape, and size of the tumor to accurately treat the tumor while avoiding nearby healthy tissue. Compared to other proton delivery technologies (such as passive scattering proton therapy (PSPT)), PBS provides a smaller beam width and controlled scanning and allows delivery to provide an intensity-modulated dose to further minimize harmful exposure to healthy tissue and ensure high-quality treatment according to prescribed treatment plan goals and constraints. PBS also does not require the use of specialized components, such as apertures or compensators, for proton beam delivery, which can help reduce treatment times and delays, minimize costs, and increase flexibility. In addition, PBS delivery devices do not use collimators that can produce harmful neutron radiation.

[0035] The PBS device is characterized by beam extraction, magnet steering (along the x-axis and y-axis), and beam detection with a light emitting detector and an ion chamber array. The treatment field size can be at least 30x30cm (e.g., 40x40cm). The PBS device can include a removable Faraday cap for routine calibration. The PBS device can provide intensity modulated radiation therapy (IMRT) capabilities.

[0036] The proton beam delivery device 114 can also operate without the need for a rotating gantry for positioning and directing the beam, thereby significantly minimizing the required equipment and enhancing the flexibility of deploying the system 110 in an existing radiation treatment room 100. The gantry-less delivery mechanism allows the proton beam to be delivered to a wide variety of anatomical sites and body parts. In addition, the lack of a gantry allows for an upright or sitting position of the patient during treatment and delivery. The sitting position can reduce body movement to allow for more precise beam delivery and less organ movement, which results in more accurate treatment. In addition, the required setup time is shortened for patients in a sitting position.

[0037] The imager 116 is configured to image the patient 120, such as during and / or before a treatment session (i.e., during a treatment planning phase). For example, the imager 116 may be a medical imaging device used in a medical environment, including, but not limited to: a computed tomography (CT) imager, a four-dimensional computed tomography (4DCT), an X-ray computed tomography (X-ray CT) scanner, an optical coherence tomography (OCT) scanner, a magnetic resonance imaging (MRI) scanner, and an ultrasound imager. In general, the imager 116 may include any type of imaging sensor capable of capturing and storing an image representation of an object or scene. Therefore, the term "image" as used herein refers to any form of output from such an imager, including any optical or digital representation of a scene acquired at any wavelength or spectral region, and covers a single image frame and a sequence of image frames (i.e., a "video image"). An image rotation mechanism (not shown) may be configured to rotate the imager 116 about at least one axis to enable imaging from a selected direction or viewing angle. According to one embodiment, the imager 116 is located outside the treatment room 100.

[0038] The controller 118 is configured to selectively control the operation of the components of the system 110 and can dynamically adjust operating parameters of the operation. The controller 118 is further configured to receive instructions and data from the components of the system 110 and perform required data processing.

[0039] Information can be transferred between the components of the system 110 through any suitable data communication channel or network using any type of channel or network model and any data transmission protocol (e.g., wired, wireless, radio, WiFi, Bluetooth, etc.). The components and devices of the system 110 can be based on hardware, software, or a combination thereof. It should be understood that the functions associated with each device or component of the system 110 can be distributed among multiple devices or components, which can be located at a single location or at multiple locations. For example, the functionality associated with the controller 116 can be distributed among separate components, such as at least one control unit and at least one processing unit (e.g., it can be a server or part of a remote computer system accessible via a communication network, such as a cloud computing platform). The controller 116 can also be at least partially integrated with other components of the system 110 (e.g., incorporated into a dedicated local control unit).

[0040] System 110 may optionally include Figure 1Additional components not shown in the drawings may be used and / or associated with the disclosed subject matter. For example, system 110 may include a user interface (not shown) for allowing a user to provide instructions or control various parameters or settings associated with components of system 110, a display device (not shown) for visually displaying information related to the operation of system 110, and / or a memory or storage unit (not shown) for temporarily storing images or other data.

[0041] In operation, the patient 120 is supported by the platform 122. In one embodiment, the patient 120 is in a sitting position. During the first stage, referred to as the treatment planning stage, the imager 116 images the target tissue of the patient 120 to be treated, such as from multiple imaging angles. The controller 116 receives a treatment prescription for treating the patient 120, such as details related to the target tissue and the recommended dose (e.g., the recommended minimum and / or maximum dose) applied to the target tissue. The controller 116 determines a proton treatment plan based on the received treatment prescription and the received images. The treatment plan may include a series of radioactive agent parameters for at least one treatment course, which are defined by at least the following: dose, patient (relative to the isocenter) positioning and orientation, and the radiation angle of each radioactive agent. The controller 116 may construct a three-dimensional model of the target tissue based on the captured images to assist in determining the treatment plan. Placement markers may be positioned on or around the patient support platform 122 to ensure proper targeting of each radioactive agent and avoid harming organs or tissues near the target tissue. In the subsequent treatment stage, the operator applies proton radiation to the patient 120 according to the established treatment plan during at least one treatment course. Prior to treatment, the patient 120 is positioned relative to the placement markers, such as based on visualization of the patient 120 in response to the placement markers. Specifically, the patient 120 is placed on a platform 122 in the treatment room in a set posture, which corresponds to the patient's posture during imaging performed in the treatment planning phase, so that the target tissue is centered on the isocenter of the proton beam generator 112 and the proton beam delivery device 114 when the patient 120 is in the set posture. The set positioning of the patient 120 can be verified using auxiliary imaging and / or positioning devices. For example, multiple x-ray imaging devices can be integrated into the wall or floor of the treatment room and used to verify the correct positioning of the patient. Further imaging can also be performed, such as using an indoor CT modality configured for imaging the patient 120 in a sitting position. Note that in addition to verifying the correct positioning of the patient, auxiliary imaging can also be used to ensure that the characteristics of the target tissue have not changed significantly since the start of treatment. A stabilization mechanism can be applied to ensure that the patient's positioning relative to the isocenter is maintained during treatment, such as applying a mask or shield to fix the face and / or other body parts of the patient 120.

[0042] The system 110 is configured to be installed in an existing radiation therapy room or a LINAC treatment room. Figure 3 , Figure 3 1 is a floor plan of an exemplary LINAC treatment room (generally designated 150) for deploying a proton radiotherapy system operated in accordance with an embodiment of the present invention. Treatment room 150 may be an existing structure (e.g., previously used for other purposes), or may be purpose-built, such as within a radiation oncology facility, to house system 110 for performing proton therapy at the facility. Treatment room 150 is characterized by an inlet 151, an inlet wall 152, a rear wall 154, side walls 156, 157, and an intermediate wall 158. When system 110 is deployed in treatment room 150, the distance between the imaging isocenter and the treatment isocenter may be less than 2 meters and the distance between the distal end of the nozzle of proton beam delivery device 114 and the skin of patient 120 (to which the radiation dose is directed) may be less than 1 meter. At least some components of system 110 may be located outside of treatment room 150, such as imager 116.

[0043] The components of system 110 can be deployed in a variety of configurations within treatment room 100. For example, proton beam generator 112 and delivery device 114 can be located at the entrance of the treatment room (i.e., the end where the room entrance is located) and configured to direct proton radiation to patient 120 located at the back of the treatment room (i.e., the end opposite the room entrance). Figure 4 , Figure 41 is a plan view of a first exemplary configuration for installing a proton radiotherapy system constructed and operated according to an embodiment of the present invention in an existing LINAC treatment room (generally designated 160) in which the proton beam is directed to the back wall of the treatment room. The treatment room 160 is characterized by an entrance 161, an entrance wall 162, a back wall 164, an outer side wall 166, and an inner side wall 169. The entrance wall 162 and the back wall 164 extend along the transverse axis of the treatment room 160, and the side walls 166, 169 extend along the longitudinal axis of the treatment room 160, so that the outer side wall 166, the entrance wall 162, and the inner side wall 169 define an enclosed compartment or partitioned area adjacent to the entrance of the treatment room 160. The synchrotron proton beam generator 112 is located in the defined partitioned area adjacent to the entrance wall of the treatment room 160. The patient support platform 122 is located at the back wall 164 of the treatment room 160, i.e., at the far end opposite the entrance wall 162. The proton beam transport device 114 is located at an intermediate position of the treatment room 160 between the synchrotron 112 and the platform 122. Radiotherapy is directed to the patient 120 positioned on the platform 122 at the rear wall 164. Thus, the treatment room 160 is able to fully accommodate the system 110, while the separated compartment area (defined by the entrance wall 162 and the side walls 166, 169) acts as a shield to prevent radiation from penetrating outside the treatment area and outside the treatment room 160. In addition, the radiotherapy is directed to the rear of the treatment room 160 and away from the direction of potential bystanders (such as clinic staff) who may be located at or near the entrance.

[0044] In an alternative embodiment, the proton beam generator 112 and delivery device 114 may be located at the rear of the treatment room and configured to direct proton radiation to the patient 120 located at the entrance of the treatment room. Figure 5 , Figure 5 1 is a floor plan of a second exemplary configuration for installing a proton radiotherapy system constructed and operated according to an embodiment of the present invention in an existing LINAC treatment room (generally designated 170) in which the proton beam is directed to the back wall of the treatment room. The treatment room 170 is characterized by a door 171, an entrance wall 172, a back wall 174, outer side walls 176, 177, and intermediate inner walls 178, 179. The outer side walls 176, 177 extend along the longitudinal axis of the treatment room 170, and the intermediate inner walls 178, 179 extend along the transverse axis of the treatment room 170. The first intermediate inner wall 178 (at the Figure 5174) is disposed near the treatment room entrance adjacent to the entrance wall 172, and a second intermediate inner wall 179 is disposed adjacent to the rear wall 174. The synchrotron proton beam generator 112 is located around the second intermediate wall 179 adjacent to the rear wall 174 at the opposite end of the door 171. Specifically, the synchrotron 112 is configured such that a first synchrotron segment (i.e., one segment defining a closed loop) extends through a first hole in the intermediate wall 179, and a second synchrotron segment (i.e., another segment defining a closed loop) extends through a second hole in the intermediate wall 179. In this way, the synchrotron 112 can be accommodated in a treatment room 170 having at least one laterally aligned intermediate inner wall without completely removing or dismantling the intermediate inner wall, but rather by simply creating a hole of a suitable size in the intermediate wall (i.e., while leaving the rest of the intermediate wall intact). The patient support platform 122 is located at the rear side of the first intermediate wall 178 (i.e., the side away from the entrance wall 172 and the door 171). The proton beam delivery device 114 is located in the middle of the treatment room 170 between the synchrotron 112 and the platform 122. Radiotherapy is directed to the patient 120 positioned on the platform 122 at the intermediate wall 178. Therefore, the treatment room 170 is able to fully accommodate the system 110 without significantly changing the internal treatment room structure, while the intermediate wall 178 acts as a shield to prevent radiation from penetrating outside the treatment area and outside the treatment room 170. In fact, the radiation needs to pass through the two intermediate inner walls 178, 179 of the treatment room 170, which further limits the radiation penetration and potential exposure.

[0045] The disclosed proton radiotherapy system 110 can be deployed in an existing radiotherapy room 100 according to safety regulations while minimizing harmful secondary radiation exposure associated with neutron radiation. Neutrons dominate the prompt radiation field produced by protons. The neutron energy spectrum has two maxima: a first maximum of about 100 MeV (due to the interaction of high-energy incident protons with a single nucleon), and a second maximum of about 1-2 MeV (due to the evaporation of the nucleus after the energy of the incident nucleus is distributed among other nucleons). The shape of the energy spectrum is quite independent of the position within the shield, the incident energy, or the shielding material (for the same hydrogen content). The main processes of fast neutrons include elastic scattering (n, n) at lower energy and inelastic processes such as inelastic scattering (n, n') and (n, 2n) reactions. The cross section of the inelastic process increases with the increase of mass number. Inelastic processes reduce the neutron energy. After fast neutron shielding with high Z (high A) materials (such as iron, lead), hydrogen-containing shielding must be used for low-energy neutrons. Thus, the radiation exposure of the proton therapy of the disclosed embodiments is limited and meets the radiation safety requirements when deployed in a LINAC treatment room. Such safety requirements may be based on local regulations, such as a maximum allowed (cumulative) radiation dose of 2 millisieverts per year (msV / y) for the general public and 20 millisieverts per year for occupational exposure designated as "radiation workers". Radiation safety requirements may alternatively or additionally be based on international regulations, such as a maximum allowed (cumulative) radiation dose of 5 msV / y for the general public and 50 msV / y for occupational exposure designated as radiation workers.

[0046] Monte Carlo simulations were performed to compare different options for proton therapy system configuration to fit into an existing radiotherapy (LINAC) room with the necessary shielding parameters. The simulation setup consisted of a scanning proton beam and a CT gantry placed on the beamline. A 40x40x40 water phantom was positioned at the isocenter. A 40x40cm water phantom was performed at the isocenter using a pencil beam with a 0.3cm spot size (one sigma). 2 During the simulation, 4x10 7 Initial proton history. Effective dose distribution calculated using flux-dose conversion factor. Workload equivalent to 30 treatments per day at 2 Gy / L.

[0047] The first set of Monte Carlo simulations for the proton dose evaluation were performed for a 70MeV proton beam and a 240MeV proton beam. It is clear that the 250MeV operation mode has a much higher dose burden. The dose at the entrance is mainly formed by backscattered neutrons. It can be assumed that no additional shielding is needed at the entrance. However, it may be necessary to ensure that a door is provided at the entrance to the treatment room. The area with higher dose burden is located next to the back wall. The annual dose level outside the door and entrance wall is less than 2msV in the 250MeV operation mode.

[0048] A second set of Monte Carlo simulations for proton dose evaluation was performed for 70 MeV and 240 MeV proton beams. These simulations applied a 1 m concrete (2.35 g / cm 3 ) of the intermediate wall 168. Additional shielding appears to be required. Such additional shielding may include: 20 cm iron shielding on the inside of the intermediate wall 168, 40 cm boronized polyethylene shielding on the outside of the intermediate wall 168, and / or a 40 cm boronized polyethylene layer inside the entrance door of the treatment room 165. In the 250 MeV operating mode, the annual dose level outside the door and entrance wall of the room 165 is less than 2 msV.

[0049] A third set of Monte Carlo simulations for proton dose estimation was performed for 70 MeV proton beams and 240 MeV proton beams. It is apparent that neutrons are the dominant contributor to the secondary radiation field. Housing of the disclosed system 110 may require further protection against such neutron radiation.

[0050] Although certain embodiments of the disclosed subject matter have been described to enable those skilled in the art to practice the invention, the foregoing description is exemplary only. It should not be used to limit the scope of the disclosed subject matter, which should be determined by reference to the following claims.

Claims

1. A proton radiotherapy system configured to be deployed in an existing radiotherapy treatment room, the system comprising: a patient support platform disposed in an area of ​​the treatment room and configured to support a patient during a treatment session; at least one imager configured to image the patient on the patient support platform; a proton beam generator disposed in a region of the treatment room and comprising a synchrotron, the synchrotron configured to generate a proton radiation beam; A proton beam transport device is coupled to the synchrotron and disposed in a region of the treatment room, the proton beam transport device being configured to deliver at least one proton radioactive agent to the isocenter of a target tissue of the patient relative to an imaging coordinate system during proton therapy so that radiation exposure of the proton therapy is limited and meets radiation safety requirements.

2. The system of claim 1, further comprising a controller, wherein in a treatment planning phase, the controller is configured to: receive a treatment prescription for treating the patient, receive at least one image of the patient on the patient support platform and a corresponding position and orientation of the patient in the image, and generate a proton therapy plan in response to the received image and corresponding position and orientation and the received treatment prescription, and During the treatment application phase, the controller is configured to instruct the proton beam delivery device to emit proton radiation according to the treatment plan fields in the treatment plan, while selectively repositioning and redirecting the target tissue of the patient relative to the isocenter of the proton radiation beam.

3. The system of claim 2, wherein the treatment plan comprises a series of radiation agent parameters for at least one treatment course, each of the radiation agent parameters comprising, for each respective radiation agent: dose, positioning and orientation of the patient relative to the isocenter, and radiation angles.

4. The system of claim 1, wherein the proton beam delivery device comprises a gantry-less pencil beam scanning (PBS) device configured to deliver the proton agent without a collimator.

5. The system of claim 1, wherein the patient support platform is a sitable platform, and wherein the patient is in a sitting position during the treatment session.

6. The system of claim 1, wherein the imager is located outside of the treatment room.

7. The system of claim 1, wherein the synchrotron is disposed adjacent to an entrance wall of the treatment room, and wherein the proton beam delivery device is configured to direct the proton agent to the patient support platform disposed adjacent to a rear wall of the treatment room.

8. The system of claim 7, wherein the synchrotron is disposed within an enclosed enclosure defined by an entrance wall of the treatment room, an outer side wall of the treatment room, and an inner side wall of the treatment room.

9. The system of claim 1, wherein the synchrotron is disposed adjacent to a rear wall of the treatment room, and wherein the proton beam delivery device is configured to direct the proton agent to the patient support platform disposed adjacent to an entrance wall of the treatment room.

10. The system of claim 9, wherein the synchrotron is configured to extend through a plurality of holes of a first intermediate interior wall of the treatment room adjacent to the rear wall, and wherein the patient support platform is disposed at a rear end of a second intermediate interior wall of the treatment room adjacent to the entrance wall.

11. The system of claim 1, wherein the treatment room comprises at least one intermediate wall or door comprising a thickness of at least 1 meter and a density of at least 2.35 g / cm 3 of concrete material.

12. The system of claim 11, wherein the treatment room comprises at least one additional shielding layer selected from the group consisting of: An iron shield about 20 cm thick on the inner side of the intermediate wall; A boronized polyethylene shield about 40 cm thick on the outside of the intermediate wall; and Approximately 40 cm thick boronized polyethylene shielding on the inside of the entrance door to the treatment room.

13. The system of claim 1, further comprising a platform adjustment mechanism configured to adjust the platform translationally and rotationally about three orthogonal axes to accordingly change the position or orientation of the patient along six degrees of freedom.

14. The system of claim 2, wherein a distance between an imaging isocenter of the patient during the treatment planning phase and an imaging isocenter of the patient during the treatment application phase is less than 2 meters.

15. The system of claim 2, wherein a distance between a distal end of the proton beam delivery device and a skin portion of the patient is less than 1 meter during the treatment application phase.

16. A method for performing proton radiotherapy in an existing radiotherapy treatment room, the method comprising the following steps: mounting a patient support platform in a region of the treatment room, the patient support platform being configured to support a patient; providing at least one imager configured to image the patient on the patient support platform; a proton beam generator including a synchrotron mounted in a region of the treatment room, the synchrotron configured to generate a proton radiation beam; A proton beam transport device is installed in an area of ​​the treatment room, and the proton beam transport device is configured to deliver at least one proton radioactive agent to the isocenter of the target tissue of the patient relative to the imaging coordinate system during proton therapy so that the radiation exposure of the proton therapy is limited and meets radiation safety requirements.

17. The method of claim 16, further comprising the steps of: receiving, during a treatment planning phase, a treatment prescription for treating the patient, receiving at least one image of the patient on the patient support platform and a corresponding position and orientation of the patient in the image, and generating a proton therapy plan in response to the received image and corresponding position and orientation and the received treatment prescription, and During a treatment delivery phase, the proton beam delivery device is instructed to deliver a proton radiation agent while selectively repositioning and redirecting a target tissue of the patient relative to an isocenter of the proton radiation beam according to a treatment plan field in the treatment plan.

18. The method of claim 17, wherein the treatment plan comprises a series of radiation agent parameters for at least one treatment course, each of the radiation agent parameters comprising, for each respective radiation agent: dose, positioning and orientation of the patient relative to the isocenter, and radiation angles.

19. The method of claim 16, wherein the proton beam delivery device comprises a gantry-less pencil beam scanning (PBS) device configured to deliver the proton agent without a collimator.

20. The method of claim 16, wherein the patient support platform is a sitable platform, and wherein the patient is in a sitting position during the treatment session.

21. The method of claim 16, wherein the imager is located outside of the treatment room.

22. The method of claim 16, wherein the synchrotron is positioned adjacent to an entrance wall of the treatment room, and wherein the proton beam delivery device is configured to direct the proton agent to the patient support platform positioned adjacent to a rear wall of the treatment room.

23. The method of claim 22, wherein the synchrotron is disposed within an enclosed enclosure defined by an entrance wall of the treatment room, an outer side wall of the treatment room, and an inner side wall of the treatment room.

24. The method of claim 16, wherein the synchrotron is positioned adjacent to a rear wall of the treatment room, and wherein the proton beam delivery device is configured to direct the proton agent to the patient support platform positioned adjacent to an entrance wall of the treatment room.

25. The method of claim 24, wherein the synchrotron is configured to extend through a plurality of apertures of a first intermediate interior wall of the treatment room adjacent to the rear wall, and wherein the patient support platform is disposed at a rear end of a second intermediate interior wall of the treatment room adjacent to the entrance wall.

26. The method of claim 16, wherein the treatment room comprises at least one intermediate wall or door comprising a thickness of at least 1 meter and a density of at least 2.35 g / cm 3 of concrete material.

27. The method of claim 26, wherein the treatment room comprises at least one additional shielding layer selected from the group consisting of: An iron shield about 20 cm thick on the inner side of the intermediate wall; A boronized polyethylene shield about 40 cm thick on the outside of the intermediate wall; and Approximately 40 cm thick boronized polyethylene shielding on the inside of the entrance door to the treatment room.

28. The method of claim 16, wherein the platform is adjustable translationally and rotationally about three orthogonal axes using a platform adjustment mechanism to correspondingly change the position or orientation of the patient along six degrees of freedom.

29. The method of claim 17, wherein a distance between an imaging isocenter of the patient during the treatment planning phase and an imaging isocenter of the patient during the treatment application phase is less than 2 meters.

30. The method of claim 17, wherein a distance between a distal end of the proton beam delivery device and a skin portion of the patient is less than 1 meter during the treatment application phase.

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