HollandPTC R&DHollandPTC infrastructure for fundamental research up to clinical implementation in proton therapy R&D


Mw. Charlotte Nijhoff
Huismansingel 4, 2629 JH Delft
Erasmus MC, Leiden UMC, Technical University Delft

The HollandPTC R&D facilities for proton research are part of an independent outpatient center for proton therapy, scientific research and education, founded by Erasmus MC, LUMC and TU Delft. HollandPTC hosts a R&D beam line capable for ultrahigh dose rates (FLASH), laboratory space, clinical treatment facilities, and medical imaging equipment. We aim to become a world-leading research facility for the fundamental investigation, translation, clinical implementation and evaluation of novel approaches in proton therapy, such as FLASH therapy. We therefore aim to further develop our preclinical infrastructure, an experimental facility for research on novel image-guidance technology, computational infrastructure for research on treatment plan optimization, uncertainty analysis, risk management, and full Health Technology Assessment. The unique combination of an on-campus clinic and human-centric design facilities at TU Delft warrant a patient-focused, value-based approach.

The HollandPTC R&D infrastructure is set up as a workplace facilitating a broad range of research: from fundamental investigation to translation, clinical implementation, and evaluation of novel approaches in proton therapy. At present, the HollandPTC R&D infrastructure comprises the following facilities:

R&D facilities at HollandPTC
The dedicated R&D bunker at HollandPTC is equipped with a stationary, horizontal proton beamline. Beam time for research is available outside normal treatment hours in plentiful quantities for approximately 20 hours per week. The R&D beam line will uniquely be enabled for ultra-high dose rates (> 40 Gy/s) to facilitate breakthrough research on FLASH proton therapy. HollandPTC furthermore features radiochemical, physics and biology labs to enable researchers to prepare their experiments at the site.

R&D in Clinical treatment rooms
HollandPTC has two treatment gantries and a dedicated treatment station for ocular tumors that are available for R&D purposes outside the designated treatment hours. The two clinical proton therapy systems use pencil beam scanning technology in 360-degree gantries and are mounted with KV/cone-beam CT, for patient position verification. Furthermore, each treatment room is equipped with in-room sliding Siemens SOMATOM Definition AS CT scanner and a robotic treatment couch to move the patient from imaging to treatment position, without altering the positioning. The ocular station consists of a fixed horizontal beamline and a single-scattering nozzle. It is fitted with orthogonal X-ray imaging equipment, utilizing digital flat-panel detectors, for patient position verification. A robotic treatment chair allows positioning and immobilization of the patient with respect to the proton beam.

R&D on Clinical imaging equipment The following clinical-grade imaging equipment is also available for R&D and in close vicinity to the treatment rooms: a Siemens SOMATOM Definition Edge 128-slice single-source TwinBeam dual-energy CT scanner, a Siemens Biograph Horizon PET-CT scanner with TrueV axial gantry-extension, and a Philips Ingenia MR-RT 3T MRI scanner. All imaging equipment is equipped with flat, hard-top couches and external lasers. Radiotherapy immobilization moulds and indexing devices can be used.

Research Database of Clinical Data
HollandPTC has a research database consisting of prospectively-collected patient information. This database consists of health, treatment and follow-up information including patient-reported outcome measures, medical imaging data of all consenting patients treated at HollandPTC. Approval from the Medical Ethics Review Committee has been obtained to share anonymized or coded data sets. Data on health care resource use will become available as well facilitating research on (early) cost-effectiveness analyses of proton therapy from a societal perspective.

Distributed R&D facilities
Use can be made of (bio)physics and technology R&D facilities at TU Delft as well as biology and biomedical research facilities at LUMC and Erasmus MC. Together with bioinformatics and modelling infrastructure, this enables research at the molecular, cell, tissue, and organism levels. We furthermore aim to establish an experimental facility for research on novel image-guidance technology, as well as computational infrastructure for research on plan optimization, uncertainty analysis, and risk management. The unique combination of an on-campus proton clinic and human-centric design facilities at TU Delft will be exploited to warrant a patient-focused approach.

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