Background:

The ultimate goal of any radiation therapy technique or technology has been to deliver the required radiation dose to the target tissue and minimise the dose to the surrounding normal tissues. By reducing the dose to the surrounding normal tissues one is able to reduce the early and delayed side effects of radiation therapy. This is especially important while treating young children because of the possible adverse impact of high dose radiation on the normal growth and development of a growing child.

The biological effect ofcharged particles is known to be higher than x-rays/ photons that are used in conventional radiation therapy machines (i.e. Cobalt & Linear Accelerator). These unique physical & biological properties of particle beams (Hadron beams) along with the complex delivery system allows highly precise delivery of radiation to the tumour with minimal dose to the surrounding normal structures, thereby allowing optimal radiation dose delivery with minimal side effects. This is of special significance in the treatment of tumours that are located close to vital body structures, tumours considered resistant to radiation, and in the treatment of children as they are highly susceptible to the long term adverse effects of radiation.The sites where particle therapy has been of maximum clinical benefit are paediatric cancers, bone & soft tissue tumours, prostate cancer, lung cancers, & head & neck tumours (skull base & paranasal sinuses).

Global Infrastructure For Particle Therapy:

Currently there are 36 Proton therapy and 6 Carbon Ion facilities functional globally. These facilities are located in the United States & Europe except for 9 centres located in Japan & Korea. Tata Memorial Centre (TMC), Mumbai will be the first academic centre in this part of the world to provide this advanced radiation therapy technology for service, research & education.

The relatively slow progress in the development & clinical use of particle therapy can be attributed primarily to four main reasons: 1) Very high cost 2) Large size of equipment/facility & the need for refinements in technology i.e. dosimetry/ gantry/ patient positioning systems/ image verification etc. 3) Higher levels of expertise required compared to conventional radiotherapy and 4) Rapid developments happening in the field of radiation therapy using photons (IMRT, IGRT, SRT, Helical Tomotherapy etc.)

Significance of TMC as National Facility For Hadron Beam Therapy:

The Tata Memorial Centre, being a comprehensive cancer care centre with a motto of Service, Research & Education is an ideal location for setting up of a National Hadron Facility (Proton & Carbon Ion)that could benefit not only the large number of deserving patients from within the country but also cater to patients from neighbouring countries.

Global statistics indicate that approx. 10-15% of patients receiving radiation therapy would be eligible/ benefit from treatment using proton beams. In India approx. 40,000 children are diagnosed with cancer every year. Approx. 1400 of them would potentially benefit with proton beams. Similarly a much larger number of patients in the adult age group would also benefit from proton beam therapy. The facility at TMC would benefit patients in both paying & non-paying categories (40:60 in TMH). The approx. cost of one course of proton beam therapy treatment in the US is 150-200,000USD (1-1.2 Crore INR), which would be beyond the reach of most patients treated in our country currently.

With the available expertise and research infrastructure at TMC and other affiliated DAE institutions, we will be able to generate valuable high quality scientific information on the use of particle therapy for treatment of cancers. It will also be an opportunity for undertaking research related to high & low LET radiation biology. Scientists/ physicists from TMC/ BARC & TIFR will also have an opportunity to work in tandem with companies involved in the development & functioning of Hadron facilities &undertake research activities related to heavy particle accelerator technology. This can translate into indigenous development of technology in the future with its impact on cost reduction & emergence of India as a hub for service, research, education in particle therapy.

The laying of the foundation stone for the National Hadron Beam Facility & the Cancer Centre for Women & Children at TMC by Honble. Prime Minister, Mr. Manmohan Singh is of immense national significance as we strive towards excellence in the delivery of state of the art medical care to our citizens & to the people in the region.