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A variable energy proton accelerator was commissioned at Fermi National Accelerator Laboratory for use in cancer treatment at the Loma Linda University Medical Center. The advantages of precise dose localization by proton therapy, while sparing nearby healthy tissue, are well documented [R. R. Wilson, Radiology 47, 487 (1946); M. Wagner, Med. Phys. 9, 749 (1982); M. Goitein and F. Chen, Med. Phys. 10, 831 (1983)]. One of the components of the proton therapy facility is a beam delivery system capable of delivering precise dose distributions to the target volume in the patient. To this end, a prototype beam delivery system was tested during the accelerator's commissioning period. The beam delivery system consisted of a beam spreading device to produce a large, uniform field, a range modulator to generate a spread out Bragg peak (SOBP), and various beam detectors to measure intensity, beam centering, and dose distributions. The beam delivery system provided a uniform proton dose distribution in a cylindrical volume of 20-cm-diam area and 9-cm depth. The dose variations throughout the target volume were found to be less than +/- 5%. Modifications in the range modulator should reduce this considerably. The central axis dose rate in the region of the SOBP was found to be 0.4 cGy/spill with an incident beam intensity of 6.7 x 10(9) protons/spill. With an accelerator repetition rate of 30 spills/min and expected intensity of 2.5 x 10(10) protons/spill for patient treatment, this system can provide 50 cGy/min for a 20-cm-diam field and 9-cm range modulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Proton beam therapy is now widely recognized as the most precise form of radiation treatment available for certain types of diseases. As such, there is an ever-increasing demand for efficient hospital-based systems capable of providing proton therapy on a routine basis. A hospital-based proton-beam treatment center consists of many systems that must be integrated to form a single simple-to-operate and maintain medical device. The system must be capable of accelerating the proton beam to the needed energies safely and effectively, transporting the beam successfully to the appropriate treatment room, and shaping the proton beam to the desired target volume within the patient. This paper overviews the major systems needed to meet these objectives as part of a complete proton-beam treatment system. This paper focuses on the areas of beam acceleration, beam transport, and beam delivery methods, including an introduction to both passive and active beam delivery methods. Additionally, it introduces and provides examples of the required simplicity and types of automation needed to achieve a high-capacity proton-beam treatment system, with specific examples based on use at the system at Loma Linda University Medical Center.

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Multiple groups have hypothesised that the use of scanning beams in proton therapy will reduce the neutron component of secondary radiation in comparison with conventional methods with a corresponding reduction in risks of radiation-induced cancers. Loma Linda University Medical Center (LLUMC) has had FDA marketing clearance for scanning beams since 1988 and an experimental scanning beam has been available at the LLUMC proton facility since 2001. The facility has a dedicated research room with a scanning beam and fast switching that allows its use during patient treatments. Dosimetric measurements and microdosimetric distributions for a scanned beam are presented and compared with beams produced with the conventional methods presently used in proton therapy.