1. Hadrontherapy in France and the ARCHADE programme
WS NuPECC, GANIL, October 9, 2015
Hadrontherapy in France and the ARCHADE programme
Daniel GUERREAU, Cyclhad (Chairman)
Daniel CUSSOL, LPC Caen
CYCLHAD

2. THE ARCHADE PROGRAMME
The Archade programme is aiming at
- The creation in Caen of a treatment
and research center in Hadrontherapy
( protons and carbon ions) using innovative technologies
The emergence of an industrial sector for the
manufacture, marketing and using of medical accelerators for hadrontherapy treatments

3. Why ARCHADE IN CAEN?
Competences
Hospitals
Research centers
What is ARCHADE?
Different facets
Organization
Status
Research program around ARCHADE

4. Archade: a pluridisciplinary project in Caen
GANIL
LPC
CIMAP
LARIA
Multiple competences within 1km distance:
 Medical doctors and scientists from various fields concerned by hadrontherapy (physicists, biologists, radiobiologists…)
Collaborations
France-Hadron
Research Institutes
Curie Institute (Paris-Orsay)
NIRS (Japan)
…..
Industrial Partners
Archade: a pluridisciplinary project in Caen

5. ORGANIZATION: 3 entities
MANAGEMENT BODY
SAS CYCLHAD
SAS NORMANDY
HADRONTHERAPY
ARCHADE
ASSOCIATION
Research Institutes
Laboratories
CONSTRUCTION OF THE HADRONTHERAPY
CENTER
Building construction
Equipments (accelerators) for cancer treatment and R&D
IN PARALLEL, DEVELOPMENT AND
CONSTRUCTION OF C400 N° 1
to be purchased by CYCLHAD
(followed later by the development of an industrial
sector)
RESEARCH DEVELOPMENT
Developement of experimental equipments

6. ACCELERATORS, Treatment rooms, experimental areas**
ACCELERATORS, Treatment rooms, experimental areas

7. PHASE 1 Proteus®ONE (IBA) SC Synchrocyclotron
Compact IMPT solution
*Subject to review by Competent Authorities (FDA, European Notified Bodies, et al.) before being put on the market.
COMPACT
Robust compact gantry
& accelerator design
INTEGRATED
Software, Dosimetry &
Training
TREATMENT ROOM
Most precise treatments
PBS allowing IMPT
S2C2 230 MeV p

8. PHASE 1 SCHEDULE October 2014 Creation of CYCLHAD Society
December 2014 Contract signatures ( civil engineering, Proteus One)
September Construction permits
December Start of building construction
July First patient treatments with the Proteus One
Operated by the Cancer Institute François Baclesse
Financing of phase 1: 76.5 M€
Total cost of the project 129 M€

9. PHASE 2: C400, a new generation SC medical cyclotron
A 2nd generation equipment:
Preliminary design study realized by IBA
Validation by international expert committees (last in 2013 in Caen run by Archade)
Lower cost purchase (compared to synchrotron)
More compact and low operational cost

10. ONGOING CONSTITUTION OF NORMANDY HADRONTHERAPY (Nha)
the operational centre for the development
and implementation of the prototype
External
collaborations
Prospective investors for the consortium

11. PHASE 2: CONSTRUCTION OF C400
Estimated schedule
2016 (semester 1) Creation of Normandy Hadrontherapy Consortium
Finalization of Detailed Design Study, Execution order file
2018 Construction starts
2021 C400 into operation
purchased by Cyclhad

12. RESEARCH PROGRAMME: THE ACTORS
National Institutes CEA, CNRS, INSERM
National programs
France-Hadron
Gathers french laboratories around hadrontherapy studies (physics, biologogy, medicine)
Nodes : CPO, CAL Nice, GANIL, ARCHADE, PERICLES, ETOILE
IN2P3-Joint Research Group « MI2B »
Gathers french nuclear physics laboratories around hadrontherapy studies
« Poles » : Imaging, Radio-Biology, Therapy, Radio-Nucleides.
Local Actors
LPC Caen
CIMAP
LARIA
ISTCT/CYCERON
ToxeMAC-ABTE
CHU Caen
Centre François Baclesse
Local Institutions
ENSICAEN
CHU Caen
Centre François Baclesse
Normandy University
GANIL
Nucleopolis

13. THE ARCHADE SCIENTIFIC PROGRAMME
WP1 : Clinical research
leader : J.L. Habrand
WP2 : Physics-Chemistry
leaders : D. Cussol & J.C. Poully
WP3 : Hadronbiology
leaders : C. Laurent & Y. Saintigny
WP4 : R&D for treatment improvement
leaders : S. Valable & J.M. Fontbonne

14. Induced structural effects Induced chemical effects
IRRADIATION WITH CARBON IONS
WP2
WP3
WP4
Brain tumours
Secondary particles detectors
(post-check)
Beam Monitors
(pre-check)
In line controls
Clinical imaging
Cranium
Skin
Gazeous monitors
Solid monitors
Brain
Tumour
Secondary fragments production
Induced structural effects
Induced chemical effects
Toxicity on healthy tissues
Efficiency on tumoral tissues

15. CLINICAL RESEARCH Clinical testing for different pathologies
Radio-resistant non-operable tumours (head and neck)
Pediatric cancers
Optimizing treatment protocols :
Best particles
Best dose delivery sequence
Long term side effects :
Functionnal disorders
Radio-induced pathologies
12C, p, 4He
p, 4He, 6Li, 10B, 12C, 14N, 16O, 18F, 20Ne
12C, p, 4He
Need for instrumentation for monitoring the delivered dose and control the irradiation process

16. Need for instrumentation for measuring and monitoring these quantities
HADRON-BIOLOGY
Toxicity on healty tissues :
Skin
Brain (astrocytes)
Cranium
Cartilages (chondrocytes)
Bystander effects
Efficiency on tumoral tissues :
Brain tumours (glioblastomas)
Cartilage tumour (chondrosarcoma)
Influence of physico-chemical quantities :
Dose
Dose rate
LET
Secondary electrons energy distribution
Additional drugs (chemicals, nano-particles)
Irradiation on cells and small animals
12C, p, 4He, 6Li, 10B, 14N, 16O, 18F, 20Ne
12C, 14N, 16O, 18F, 20Ne
Need for instrumentation for measuring and monitoring these quantities

17. Need for basic nuclear physics data
PHYSICS, CHEMISTRY & INSTRUMENTATION
Basic data :
Secondary particles production cross sections (FRACAS)
b+ emitters production cross sections
Damages on the DNA bases
Production of chemical toxic species
Dose monitors :
Gazeous (IC2/3)
Diamonds
Dose monitors for radio-biology experiments (Dosion III)
In-line control of the dose deposition :
«Prompt» g
In line PET
Interaction Vertex Imaging
Clinical Imaging :
p-CT, C-CT
Tissues chemical composition imaging
Tumour identification
Image Guided Irradiation, moving organs
Need for basic nuclear physics data

18. Thank you for your attention !

19. SECONDARY PARTICLES EFFECTS
GEANT4 simulations
Pathogenic mutations
Functional damages
12C
Tumoral control
12C
Pathogenic mutations
Functional damages
p, , B 19 19

20. BEAM MONITORS PBS beam control LPC CAEN – IBA Collaboration
X(64) I1
gap ~10mm I2
Y(64)
Charlotte Courtois PhD october 2011
C. Courtois, et al., Nuclear Instruments & Methods in Physics Research A (2013),
Patent IBA 28/12/2009
Inventors : J.M.Fontbonne & J.Perronnel
LPC CAEN – IBA Collaboration
2009 : experiments in ESSEN
« Westdeutsches Protontherapiezentrum Essen »

21. FRACAS (LPC Caen, IPHC Strasbourg)
Yvan Merrer
REC-Hadron A
Z, v
Samuel Salvador
q, j
France-Hadron

22. CONTROL IMAGINGS

23. CALENDAR ~ 300 to 500 h/year ~ 1 900 h/year France-Hadron ARCHADE
Proto Beam Line (Nice)
Beam monitors, Controls, Imageries
Experiments at GANIL, Orsay, Nice
Moving
set-ups
Rec-Hadron (XRays)
Radio-biology experiments
Hadronbiology experiments
Preparing the
radio-chemistry experiments
Radio-chemistry experiments
Design and building of FRACAS
Nuclear physics experiments (FRACAS)
2015
2016
2017
2018
2019
2020
2021
2022
2023

24. Segmentation et taille du marché accessible
Analyse Marché pour la constitution du BP US
16 centres opérationnels en proton thérapie
8 projets en planification
Japon
Proton thérapie:
6 centres opérationnels
3 en planification
Ions Carbone:
3 centres opérationnels
5 en projets
Europe
Prix du traitement
Proton thérapie:
15 centres opérationnels
Dont 2 en France
Ions Carbone:
2 centres opérationnels (700 patients / ans pour ~600 séances) et
1 Project ARCHADE
Commentaires
50 centres opérationnels en proton thérapie, 6 centres en ions de Carbone et 27 projets en planification : Japon est le leader mondial,
Fin 2013, on a identifié 6 centres d’ions de Carbone et 6 autres en planification,
70000 patients traités par Hadron thérapie (Proton + ions Carbone),
15 pathologies possibles à date pour la thérapie par ions carbone.
NHa