[en] Loma Linda University Proton Accelerator Facility, (LLUPAF), is being designed as a resource for: (1) the treatment of patients with cancer and some benign lesions using proton beam radiation; (2) education of medical and technical personnel for cancer patient management and research and (3) cancer and physics research. This paper examines the goals for the facility and planning strategy in the design of LLUPAF

[en] The immune responses of 60 patients undergoing therapeutic irradiation were evaluated according to four anatomical sites irradiated. In vitro lymphocyte transformation tests with PHA, Con-A, and PWM and quantitative assays of IgG, IgA, and IgM were performed on blood obtained from each patient before and during therapy, and two weeks, two months, and six months after therapy. At these same testing intervals, skin tests with PPD, mumps antigen, Candida antigen, and SD-SK were performed. During irradiation, the mean values of all lymphocyte transformation tests were depressed, varying from 48 percent to 64 percent of pretreatment baseline. This depression persisted until about two months after completion of treatment. By six months, response rose to pretreatment values. When response was evaluated according to sites irradiated with all mitogens, the pelvic and pelvic plus abdominal groups showed consistently greater depression than the chest or head and neck groups. Radiation effected no significant changes in the mean values of IgG, IgA or IgM. A decrease in skin sensitivity was noted during radiation; 73 percent of the subjects responded positively before therapy while only 53 percent had at least one positive test during therapy. By two months postirradiation, 73 percent of the group clinically free of disease had positive skin tests. A comparison of clinical condition with test results is significant when one considers the 17 patients who developed metastatic disease or died from disease. The depression for all three mitogens during radiation therapy was greater for this group. Of the 17, only four had IgG levels in the normal range, and consistently fewer positive skin tests were demonstrated

[en] High brightness synchrotron sources based on undulator radiation require both low emittance electrom beams and high precision undulators. Under many circumstances, loss of brightness due to wiggler field errors is dominated by e-beam steering from dipole errors. A simple method to calculate the allowed dipole errors is presented. The error tolerance differs depending on whether or not the emittance is large enough to preclude full spatial coherence. In the large emittance, spatially incoherent limit the storage ring betatron function can be adjusted to optimize either the spectral coherence or spatial coherence, but not both simultaneously. The calculated tolerances are compared to measured field errors of the Spectra Technology THUNDER undulator

[en] Proton beams offer superior characteristics for clinical radiation therapy, including the capability to localize precisely the dose to the desired target volume. Such precision enables the radiation therapist to give higher doses to the tumor while avoiding intolerable doses to adjacent normal tissues. Locoregional control is thus increased, and treatment morbidity and side effects are decreased. When it opens in late spring 1990, Loma Linda University Medical Center's proton treatment facility will feature the world's first accelerator and proton therapy system designed for patient care. During the next decade, other similarly-designed proton therapy systems will be built in Canada, England, France, Belgium, Germany, Japan, and South Africa, as well as at Massachusetts General Hospital in the United States

[en] The world's smallest proton synchrotron soon will begin to be used for patient treatments at Loma Linda University Medical Center in the United States, as part of an effort to apply and exploit high-energy physics technology for cancer control. Proton therapy has superior characteristics to accomplish this end, notably a dose distribution that facilitates the delivery of effective doses while sparing adjacent tissue. The characteristics are exploited in a synchrotron, designed and built in a cooperative effort among university, government and industry investigators, for treating patients. The characteristics and implications of this development are discussed. (author) 21 refs.; 2 tabs

[en] Published in summary form only

[en] Radiation oncologists recognize a continuing need to improve the radiation dose distribution between a cancer and the surrounding normal tissue. A most promising method of accomplishing this goal is the use of charged particle beam irradiation, the clinical use of which has been investigated for the past 40 years. Since the first clinical studies began at the Lawrence Berkeley Laboratory in 1954, more than 5,000 patients have been treated with protons, using accelerators designed for physics laboratories. Superior results are reported for the control of selected diseases by the ten facilities which are currently investigating proton radiation therapy. The findings have resulted in expansion plans in several of these facilities, and in the formulation of plans for two new facilities. We report on the planned development of a new facility at Loma Linda University, which has contracted with Fermi National Accelerator Laboratory for the design and fabrication of a 250 MeV synchrotron and its beam transport and delivery systems. This facility will be the first in the world to employ a proton accelerator dedicated to medical service and research. As such, it will be available as an international resource to develop and improve the modality

[en] A highly interactive on-line computer-based radiation therapy planning system has been developed to allow first-hand participation by the physician for maximum input of clinical judgement in treatment planning. The system utilizes an ultrasound scanning device for acquisition of the patient's contour and anatomical information for simultaneous evaluation by the therapist and processing by the computer. The man-machine interaction and graphic data entry are achieved through a sonic graph pen digitizer mounted on the screen of a multi-colour video monitor. A second graph pen digitizer on a radiograph view box is used for digitization and entry to the computer of other graphic data sources. Radiation treatment parameters are graphically entered directly on the echogram of the patient's cross-sectional anatomy. The radiation dose distribution for a proposed plan is then computed and displayed superimposed in a contrasting colour on the echogram for further scrutiny by the therapist and possible modification. When an acceptable plan is produced, the radiation fields are accurately marked on the patient body in reference to the radiation ports displayed. The system is used for external beam planning with simple, multiple, and irregular fields and intracavitary and interstitial implant dosimetry. Since in this system the radiation delivery is planned based on the cross-sectional anatomy, it is well suited for planning of heavy particle beam therapy which utilizes the stopping characteristics of the accelerated particles in the absorbing medium. (author)

[en] A hospital-based proton accelerator facility has emerged from the efforts of a consortium of physicists, engineers and physicians from several high-energy physics laboratories, industries and universities, working together to develop the requirements and conceptual design for a clinical program. A variable-energy medical synchrotron for accelerating protons to a prescribed energy, intensity and beam quality, has been placed in a hospital setting at Loma Linda University Medical Center for treating patients with localized cancer. Treatments began in October 1990. Scientists from Fermi National Accelerator Laboratory; Harvard Cyclotron Laboratory; Lawrence Berkeley Laboratories; the Paul Scherrer Institute; Uppsala, Sweden; Argonne, Brookhaven and Los Alamos National Laboratories; and Loma Linda University, all cooperated to produce the conceptual design. Loma Linda University contracted with Fermi National Accelerator Laboratory to design and build a 250 MeV synchrotron and beam transport system, the latter to guide protons into four treatment rooms. Lawrence Berkeley Laboratories consulted with Loma Linda University on the design of the beam delivery system (nozzle). A gantry concept devised by scientists at Harvard Cyclotron Laboratory, was adapted and fabricated by Science Applications International Corporation. The control and safety systems were designed and developed by Loma Linda University Radiation Research Laboratory. Presently, the synchrotron, beam transport system and treatment room hardware have been installed and tested and are operating satisfactorily

[en] We undertook this study to determine whether radiation (10 Gray, single dose) or water bath hyperthermia (41 degrees C, 45 min) could enhance binding of ¹¹¹In-labeled anti-p97a monoclonal antibody (MAb) to human melanoma tumors transplanted subcutaneously into nude mice. Sixty animals were given injections of 1-2 X 10(7) Brown C5513 melanoma cells. At 1-2 weeks postinjection, two-thirds of the mice were treated (one-third served as controls). Within 3 hours after treatment, each animal was given iv 2 muCi ¹¹¹In-anti-p97a MAb. At 24 and 48 hours thereafter, whole-body scans were done with the use of a MaxiCamera 300 A/M unit, and the ratio of activity at the tumor and liver was determined. Some animals were kept for 7 days posttreatment, whereas others were taken after the 48-hour scan for determination of biodistribution of the radiolabeled complex. Enhancement of MAb binding was demonstrated by either modality, although enhancement was more consistent with radiation. The therapeutic efficacy of MAb may be enhanced with increased binding of radioactive MAb complexes through single dose radiation or hyperthermia