TUMORAL DISEAS TREATED AT CNAO

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ADENOID CYSTIC CARCINOMA OF SALIVARY GLANDS

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PEDIATRIC SOLID TUMORS

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TUMORS IN PATIENTS AFFECTED BY GENETIC SYNDROMES

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RETREATMENT OF ALREADY RADIO TREATED AREAS
OTHER DISEAS OBJECT OF CLINICAL TRIAL

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(Pre-op treatment/locally advanced inoperable tumors treatment)

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Rapid technological progress in recent years has led to an evolution in all areas of medicine and has significantly influenced radiation oncology.
 
Today, a new frontier in radiation therapy is represented by the hadrontherapy, which is the use of protons and atomic nuclei (ions) called hadrons (from the Greek hadrós, strong) that are subjected to a strong nuclear force.
 
The advantages of hadrontherapy compared to traditional radiotherapy are:
  1. The release of energy (and thus the destruction of cells) is done selectively, targeting only cancer cells. The damage incurred in the body on initial penetration is relatively small and significant release of energy is confined only to the vicinity where the cancer is located (a phenomenon referred to as the Bragg Peak). This maximizes the destruction of cancerous tissues while minimizing collateral effects on healthy tissues
  2. The beam of hadronic particles remains collimated as it penetrates the biological material. The high collimation of the beams of hadrons further minimizes damage to healthy tissues
  3. The energy release mechanism for hadrontherapy causes a large amount of breaks on the chemical links present in biological macromolecules, especially DNA. The latter has the ability to repair itself, but if the number of broken links is excesive it loses its function of self-reparation and the cells remain inactive and die. In conventional radiotherapy the DNA damage is modest; on the contrary, in the hadrontherapy with carbon ions the number of breaks allows the destruction even of tumors resistant to conventional therapy
Together these three benefits result in a significant destructive effect on biological tissues, for which reason the target (tumor) must be positioned  with a degree of  accuracy which is much greater than that associated with conventional radiotherapy.
 
Effective application of hadrontherapy requires the following:
  • a proton and / or ion accelerator (such as the circular accelerator or synchrotron) producing a number of particle beams
  • a system for transporting the beam in the treatment room
  • a procedure for precisely positioning the patient for treatment
  • complete control of the energy to be released i.e. the dose
  • a three-dimensional customized patient treatment system obtained by integrating diagnostic imaging results (CT, MRI, PET).
It is important to note that since hadrontherapy is a relatively recent addition to the modern oncological treatment panorama, a number of indications are still in the experimental stage.

The National Centre of Oncological Hadrontherapy (CNAO), located in Pavia, is the first Centre of Hadrontherapy in Italy provided with a beam able to irradiate patients with protons or carbon ions for the treatment of radioresistant tumors.

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The National Centre for Oncological Hadrontherapy organizes guided tours for students from high schools, universities, research institutes and scientific organizations. Among CNAO missions, besides patients' cure, there is also education to research and innovation, as an effective tool to raise young persons' interest in their future professions.
 
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