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HADRONTHERAPY INDICATIONS

Hadrontherapy is an advanced form of radiotherapy. Radiation  therapy alone, or combined with surgery and/or chemotherapy, improves  local control in different tumors.  In addition, the non-invasive nature  of radiation therapy represents a suitable alternative to surgery for  those tumors located in anatomical locations complicated by vital organs  or in sites where tumor removal would be too debilitating for the  patient. Today, about 50% of patients with cancer are undergoing  radiation therapy. Hadrontherapy is not a substitute for conventional  radiotherapy, but arises as an ideal technique for those cancers where  conventional radiotherapy does not provide significant advantages in  particular for “radio-resistant” tumors and for those located close to  organs at risk. “Radio-resistant” tumors are those  which, because of their biological behavior, are less likely to be cured  by conventional radiotherapy. Tumors located in the vicinity of  organs deemed “critical” or “at risk”,  often cannot be irradiated by doses high enough to be effective,  because it could harm healthy organs. The possibility of cure depends  not only on factors related to the tumor itself, such as its  radio-sensitivity and anatomic location, but also on factors related to  the radiation treatment, such as the total dose delivered and the  precision of the technique employed in irradiating the site  of the  disease. These “limits” can be overcome by hadrons (specifically protons  and carbon ions) due to their different physical nature compared to  X-rays used in conventional radiotherapy. The intrinsic physical  properties of these particles allow us to conform the dose “around the  tumor” with greater accuracy, while saving the surrounding healthy  tissue. With carbon ions in particular, one has the advantage of  inducing more damage to the tumor “overcoming” its intrinsic  radio-resistance.

The clinical use of these particles, especially that of carbon ions,  has been limited up to now due to the limited availability of this  therapy worldwide. However, initial clinical experiences have  demonstrated their therapeutic advantage in many cases and the  longer-term results continue to be encouraging .

Clinical trials have increased in recent years, and are aimed at  expanding the indications to include other anatomical sites. Here, it  should be noted that studies have shown that the results obtained with  hadrontherapy are as good as or better than those obtained with  conventional radiotherapy .

However, to estimate the real clinical benefits of hadrontherapy a  representative number of treated patients should be carefully followed  up for a long period of time.  Those indications in which the advantage  has been demonstrated are known as “consolidated indications”.  There are other cases where there have been promising results, but on  too few patients for a limited number of years for definite conclusions  to be reached. Thus, while there is a substantial amount of theoretical  evidence to support the efficacy of hadrontherapy in these cases, there  is a need for more empirical data from larger studies over a longer  period of time to confirm this evidence. These are potential  indications.In any case, only after assessment of individual cases by  medical specialists can one establish the best therapeutic approach and,  eventually, confirm the need for hadrontherapy treatment.

Currently, scientific literature has documented the following  consistent results for some cancers that have been treated for a long  time with protons and carbon ions.

Chordoma and chondrosarcomahave traditionally been  considered an indication for proton therapy. Their characteristic  anatomical location of onset, the base of the skull and spine, the  difficulties of treatment with surgery or radiotherapy and the local  growing trend rather than distant metastases provide the scientific  rationale for believing that an increase of local control can result in  increased survival and thus justify the use of sophisticated techniques  of radiotherapy. The results so far obtained and published in the  literature show that radiation therapy with protons could constitute the  standard treatment after surgery for these tumors. Results obtained so  far indicate that radiotherapy with carbon ions is equally safe and  could produce superior results over those obtained with protons. The  rationale for the use of hadrontherapy in the treatment of  atypical meningioma, malignant or recurrent meningioma is  mainly based on its high spatial selectivity. The frequent place of  occurrence of meningioma is at the base of the skull, in close proximity  to structures like the optic tract and the brainstem (vital organ)  makes it improbable, in most cases, for successful surgery. The presence  of any residual tumor after surgery amply justifies the use of this  technique.

Radiotherapy with protons for the treatment ofuveal melanomais  now an established alternative to radical surgical treatment requiring  enucleating the eye. Introduced in 1975, the proton therapy has gained  wide acceptance in the scientific community because it has been shown  that disease-free survival and overall survival results obtained with  protons are similar to those obtained by enucleation. Local control with  organ preservation is the most important goal of treatment with  protons.

Sarcomas of the bone tissue in difficult locations  such as the spine, pelvis and the skull  where the presence of the  spinal cord, internal organs and brain, respectively, fully justify the  use of proton therapy and carbon ion therapy given the well-known radio  resistance of this type of cancer. In the same way, carbon ions are the  ideal tool for the treatment of retroperitoneal soft tissue sarcoma,  inoperable or not radically operated, or recurrences. Salivary glands tumors are  radio-resistant and the treatment of choice is surgery, usually  combined with radiotherapy in cases of incomplete resection, advanced or  high grade tumors. Although this therapeutic approach has improved the  results in terms of local control compared with surgery alone, this is  still not optimal. The radio resistance of these tumors has led to the  use of neutrons due to their superior radiobiological properties  suitable to overcome their radio-resistance. Unfortunately, in spite of  the therapeutic success in terms of disease control, data from studies  using neutrons, showed significant toxicity. Carbon ions, thanks to  their intrinsic radiobiological properties that reduce tumor  radio-resistance without significant side effects, have shown better  results.

Radiotherapy with protons has aroused great interest for its possible use in pediatric therapy.  In recent decades, thanks to the improved effectiveness of new  treatment protocols, there is a significant increase in survival rates,  which at the same time, allow for assessment of the extent of late side  effects related to radiation treatment. Endocrine and neurosensory  deficits, growth retardation, malformations and other side effects that  occur close to or later after the end of the therapy have been well  studied. Numerous pre-clinical dosimetry studies have revealed  appreciable reduction of irradiation to healthy tissues from treatment  plans carried out with protons compared to those made by X-ray Another  important finding observed with the use of protons is the drastic  decrease of the integral dose, i.e. the total amount of energy  administered to the patient during irradiation, leading to increased  risk of second cancer (carcinogenic effect). These “savings” of  radiation are of substantial importance in children whose tissues, still  immature, are much more susceptible to the harmful effects of  radiation.

The head and neck cancersare the subject of  considerable interest. The potential benefit of hadrontherapy in the  treatment of these tumors derives from where they occur. They often  arise at or close to the base of the skull, surrounded by healthy vital  organs such as: the spinal cord, brainstem, temporal lobes of the brain,  auditory and optical pathways and pituitary gland. The location close  to these important organs makes it impossible for the administration of  the high radiation doses necessary to eradicate the disease.  Pre-clinical and clinical studies suggest a potential benefit of  treating those tumors characterized by low radio sensitivity and  critical location with hadrontherapy. Paranasal sinuses and adenoid cystic carcinoma, some selected tumors of the nasopharynx and bone and soft tissue sarcomas are  being studied. In the case of sarcomas of the head and neck, the use of  hadrontherapy is justified for those situations in which photons  therapy is unable to obtain adequate dose distributions. The use of  carbon ions is also reserved for cases with macroscopic disease in this  location.


What cancers we can cure?

Advanced Therapies that allow you to treat the most difficult cancers exist. Here is a list of curable cancers:

  • Chordoma and chondrosarcoma
  • Atypical meningioma
  • Malignant or recurrent meningioma
  • Uveal melanoma
  • Sarcomas of the bone tissue
  • Salivary glands tumors
  • Pediatric therapy
  • The head and neck cancers
  • Paranasal sinuses
  • Adenoid cystic carcinoma
  • Some selected tumors of the
  • nasopharynx
  • Bone and soft tissue sarcomas

CANCER TYPES

Cancer is the name given to a collection of related diseases. In all types of cancer, some of the body’s cells begin to divide without stopping and spread into surrounding tissues.

Cancer can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and divide to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place.

When cancer develops, however, this orderly process breaks down. As cells become more and more abnormal, old or damaged cells survive when they should die, and new cells form when they are not needed. These extra cells can divide without stopping and may form growths called tumors.

There are more than 100 types of cancer. Types of cancer are usually named for the organs or tissues where the cancers form.

On this page you can read and get information about each one by clicking on its name.


A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

A

  • Acute Lymphoblastic Leukemia (ALL)
  • Acute Myeloid Leukemia (AML)
  • Adolescents, Cancer in
  • Adrenocortical Carcinoma, Adult
    • Childhood Adrenocortical Carcinoma - see Unusual Cancers of Childhood
    • AIDS-Related Cancers
      • Kaposi Sarcoma (Soft Tissue Sarcoma)
      • AIDS-Related Lymphoma (Lymphoma)
      • Primary CNS Lymphoma (Lymphoma)
      • Anal Cancer
      • Appendix Cancer - see Gastrointestinal Carcinoid Tumors
      • Astrocytomas, Childhood (Brain Cancer)
      • Atypical Teratoid/Rhabdoid Tumor, Childhood, Central Nervous System (Brain Cancer)
      • B

        • Basal Cell Carcinoma of the Skin - see Skin Cancer
        • Bile Duct Cancer
        • Bladder Cancer
          • Childhood Bladder Cancer - see Unusual Cancers of Childhood
          • Bone Cancer (includes Ewing Sarcoma and Osteosarcoma and Malignant Fibrous Histiocytoma)
          • Brain Tumors
          • Breast Cancer
            • Childhood Breast Cancer - see Unusual Cancers of Childhood
            • Bronchial Tumors, Childhood - see Unusual Cancers of Childhood
            • Burkitt Lymphoma - see Non-Hodgkin Lymphoma
            • C

              • Carcinoid Tumor (Gastrointestinal)
                • Childhood Carcinoid Tumors - see Unusual Cancers of Childhood
                • Carcinoma of Unknown Primary
                  • Childhood Carcinoma of Unknown Primary - see Unusual Cancers of Childhood
                  • Cardiac (Heart) Tumors, Childhood - see Unusual Cancers of Childhood
                  • Central Nervous System
                    • Atypical Teratoid/Rhabdoid Tumor, Childhood (Brain Cancer)
                    • Embryonal Tumors, Childhood (Brain Cancer)
                    • Germ Cell Tumor, Childhood (Brain Cancer)
                    • Primary CNS Lymphoma
                    • Cervical Cancer
                      • Childhood Cervical Cancer - see Unusual Cancers of Childhood
                      • Childhood Cancers
                      • Cancers of Childhood, Unusual
                      • Cholangiocarcinoma - see Bile Duct Cancer
                      • Chordoma, Childhood - see Unusual Cancers of Childhood
                      • Chronic Lymphocytic Leukemia (CLL)
                      • Chronic Myelogenous Leukemia (CML)
                      • Chronic Myeloproliferative Neoplasms
                      • Colorectal Cancer
                        • Childhood Colorectal Cancer - see Unusual Cancers of Childhood
                        • Craniopharyngioma, Childhood (Brain Cancer)
                        • Cutaneous T-Cell Lymphoma - see Lymphoma (Mycosis Fungoides and Sézary Syndrome)
                        • D

                          • Ductal Carcinoma In Situ (DCIS) - see Breast Cancer
                          • E

                            • Embryonal Tumors, Central Nervous System, Childhood (Brain Cancer)
                            • Endometrial Cancer (Uterine Cancer)
                            • Ependymoma, Childhood (Brain Cancer)
                            • Esophageal Cancer
                              • Childhood Esophageal Cancer - see Unusual Cancers of Childhood
                              • Esthesioneuroblastoma - see Unusual Cancers of Childhood
                              • Ewing Sarcoma (Bone Cancer)
                              • Extracranial Germ Cell Tumor, Childhood
                              • Extragonadal Germ Cell Tumor
                              • Eye Cancer
                                • Intraocular Melanoma
                                • Retinoblastoma
                                • F

                                  • Fallopian Tube Cancer
                                  • Fibrous Histiocytoma of Bone, Malignant, and Osteosarcoma
                                  • G

                                    • Gallbladder Cancer
                                    • Gastric (Stomach) Cancer
                                      • Childhood Gastric (Stomach) Cancer - see Unusual Cancers of Childhood
                                      • Gastrointestinal Carcinoid Tumor
                                      • Gastrointestinal Stromal Tumors (GIST) (Soft Tissue Sarcoma)
                                        • Childhood Gastrointestinal Stromal Tumors - see Unusual Cancers of Childhood
                                        • Germ Cell Tumors
                                          • Childhood Central Nervous System Germ Cell Tumors (Brain Cancer)
                                          • Childhood Extracranial Germ Cell Tumors
                                          • Extragonadal Germ Cell Tumors
                                          • Ovarian Germ Cell Tumors
                                          • Testicular Cancer
                                          • Gestational Trophoblastic Disease
                                          • H

                                            • Hairy Cell Leukemia
                                            • Head and Neck Cancer
                                              • Childhood Head and Neck Cancers - see Unusual Cancers of Childhood
                                              • Heart Tumors, Childhood - see Unusual Cancers of Childhood
                                              • Hepatocellular (Liver) Cancer
                                              • Histiocytosis, Langerhans Cell
                                              • Hodgkin Lymphoma
                                              • Hypopharyngeal Cancer (Head and Neck Cancer)
                                              • I

                                                • Intraocular Melanoma
                                                • Islet Cell Tumors, Pancreatic Neuroendocrine Tumors
                                                • K

                                                  • Kaposi Sarcoma (Soft Tissue Sarcoma)
                                                  • Kidney (Renal Cell) Cancer
                                                  • L

                                                    • Langerhans Cell Histiocytosis
                                                    • Laryngeal Cancer (Head and Neck Cancer)
                                                      • Childhood Laryngeal Cancer and Papillomatosis - see Unusual Cancers of Childhood
                                                      • Leukemia
                                                      • Lip and Oral Cavity Cancer (Head and Neck Cancer)
                                                      • Liver Cancer
                                                      • Lung Cancer (Non-Small Cell and Small Cell)
                                                        • Childhood Lung Cancer - see Unusual Cancers of Childhood
                                                        • Lymphoma
                                                        • M

                                                          • Male Breast Cancer
                                                          • Malignant Fibrous Histiocytoma of Bone and Osteosarcoma
                                                          • Melanoma
                                                            • Childhood Melanoma - see Unusual Cancers of Childhood
                                                            • Melanoma, Intraocular (Eye)
                                                            • Merkel Cell Carcinoma (Skin Cancer)
                                                            • Mesothelioma, Malignant
                                                              • Childhood Mesothelioma - see Unusual Cancers of Childhood
                                                              • Metastatic Cancer
                                                              • Metastatic Squamous Neck Cancer with Occult Primary (Head and Neck Cancer)
                                                              • Midline Tract Carcinoma Involving NUT Gene - see Unusual Cancers of Childhood
                                                              • Mouth Cancer (Head and Neck Cancer)
                                                              • Multiple Endocrine Neoplasia Syndromes - see Unusual Cancers of Childhood
                                                              • Multiple Myeloma/Plasma Cell Neoplasms
                                                              • Mycosis Fungoides (Lymphoma)
                                                              • Myelodysplastic Syndromes, Myelodysplastic/Myeloproliferative Neoplasms
                                                              • Myelogenous Leukemia, Chronic (CML)
                                                              • Myeloid Leukemia, Acute (AML)
                                                              • Myeloproliferative Neoplasms, Chronic
                                                              • N

                                                                • Nasal Cavity and Paranasal Sinus Cancer (Head and Neck Cancer)
                                                                • Nasopharyngeal Cancer (Head and Neck Cancer)
                                                                  • Childhood Nasopharyngeal Cancer - see Unusual Cancers of Childhood
                                                                  • Neuroblastoma
                                                                  • Non-Hodgkin Lymphoma
                                                                  • Non-Small Cell Lung Cancer
                                                                  • O

                                                                    • Oral Cancer, Lip and Oral Cavity Cancer and Oropharyngeal Cancer (Head and Neck Cancer)
                                                                      • Childhood Oral Cavity Cancer - see Unusual Cancers of Childhood
                                                                      • Osteosarcoma and Malignant Fibrous Histiocytoma of Bone
                                                                      • Ovarian Cancer
                                                                        • Childhood Ovarian Cancer - see Unusual Cancers of Childhood
                                                                        • P

                                                                          • Pancreatic Cancer
                                                                            • Childhood Pancreatic Cancer - see Unusual Cancers of Childhood
                                                                            • Pancreatic Neuroendocrine Tumors (Islet Cell Tumors)
                                                                            • Papillomatosis - see Unusual Cancers of Childhood
                                                                            • Paraganglioma
                                                                              • Childhood Paraganglioma - see Unusual Cancers of Childhood
                                                                              • Paranasal Sinus and Nasal Cavity Cancer (Head and Neck Cancer)
                                                                              • Parathyroid Cancer
                                                                              • Penile Cancer
                                                                              • Pharyngeal Cancer (Head and Neck Cancer)
                                                                              • Pheochromocytoma
                                                                                • Childhood Pheochromocytoma - see Unusual Cancers of Childhood
                                                                                • Pituitary Tumor
                                                                                • Plasma Cell Neoplasm/Multiple Myeloma
                                                                                • Pleuropulmonary Blastoma - see Unusual Cancers of Childhood
                                                                                • Pregnancy and Breast Cancer
                                                                                • Primary Central Nervous System (CNS) Lymphoma
                                                                                • Primary Peritoneal Cancer
                                                                                • Prostate Cancer
                                                                                • R

                                                                                  • Rectal Cancer
                                                                                  • Recurrent Cancer
                                                                                  • Renal Cell (Kidney) Cancer
                                                                                  • Retinoblastoma
                                                                                  • Rhabdomyosarcoma, Childhood (Soft Tissue Sarcoma)
                                                                                  • S

                                                                                    • Salivary Gland Cancer (Head and Neck Cancer)
                                                                                      • Childhood Salivary Gland Tumors - see Unusual Cancers of Childhood
                                                                                      • Sarcoma
                                                                                        • Childhood Rhabdomyosarcoma (Soft Tissue Sarcoma)
                                                                                        • Childhood Vascular Tumors (Soft Tissue Sarcoma)
                                                                                        • Ewing Sarcoma (Bone Cancer)
                                                                                        • Kaposi Sarcoma (Soft Tissue Sarcoma)
                                                                                        • Osteosarcoma (Bone Cancer)
                                                                                        • Uterine Sarcoma
                                                                                        • Sézary Syndrome (Lymphoma)
                                                                                        • Skin Cancer
                                                                                          • Childhood Skin Cancer - see Unusual Cancers of Childhood
                                                                                          • Small Cell Lung Cancer
                                                                                          • Small Intestine Cancer
                                                                                          • Soft Tissue Sarcoma
                                                                                          • Squamous Cell Carcinoma of the Skin - see Skin Cancer
                                                                                          • Squamous Neck Cancer with Occult Primary, Metastatic (Head and Neck Cancer)
                                                                                          • Stomach (Gastric) Cancer
                                                                                            • Childhood Stomach (Gastric) Cancer - see Unusual Cancers of Childhood
                                                                                            • T

                                                                                              • T-Cell Lymphoma, Cutaneous - see Lymphoma (Mycosis Fungoides and Sèzary Syndrome)
                                                                                              • Testicular Cancer
                                                                                                • Childhood Testicular Cancer - see Unusual Cancers of Childhood
                                                                                                • Throat Cancer (Head and Neck Cancer)
                                                                                                  • Nasopharyngeal Cancer
                                                                                                  • Oropharyngeal Cancer
                                                                                                  • Hypopharyngeal Cancer
                                                                                                  • Thymoma and Thymic Carcinoma
                                                                                                  • Thyroid Cancer
                                                                                                    • Childhood Thyroid Tumors - see Unusual Cancers of Childhood
                                                                                                    • Transitional Cell Cancer of the Renal Pelvis and Ureter (Kidney (Renal Cell) Cancer)
                                                                                                    • U

                                                                                                      • Unknown Primary, Carcinoma of
                                                                                                        • Childhood Cancer of Unknown Primary - see Unusual Cancers of Childhood
                                                                                                        • Unusual Cancers of Childhood
                                                                                                        • Ureter and Renal Pelvis, Transitional Cell Cancer (Kidney (Renal Cell) Cancer
                                                                                                        • Urethral Cancer
                                                                                                        • Uterine Cancer, Endometrial
                                                                                                        • Uterine Sarcoma
                                                                                                        • V

                                                                                                          • Vaginal Cancer
                                                                                                            • Childhood Vaginal Cancer - see Unusual Cancers of Childhood
                                                                                                            • Vascular Tumors (Soft Tissue Sarcoma)
                                                                                                            • Vulvar Cancer
                                                                                                            • W

                                                                                                              • Wilms Tumor and Other Childhood Kidney Tumors
                                                                                                              • Y

                                                                                                                • Young Adults, Cancer in

                                                                                                                • Come to Italy to get healed
                                                                                                                  Synchrotron is an advanced machinery and there are only four prototypes in the world.
                                                                                                                  This is because the medical specialization and the required techniques are very high, and the machineries and technologies are very expensive.
                                                                                                                  It is not available in America, because it’s based on Italian and European researches:
                                                                                                                  Italy is the place to treat cancer.

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