Elsevier

Clinical Oncology

Volume 31, Issue 6, June 2019, Pages 352-355
Clinical Oncology

Editorial
Developing Innovative, Robust and Affordable Medical Linear Accelerators for Challenging Environments

https://doi.org/10.1016/j.clon.2019.02.002Get rights and content

Section snippets

Taking Action

Motivated by these factors and the sustainable development goals of the United Nations [4], two multidisciplinary international workshops were hosted by CERN [5], [6]: Design Characteristics of a Novel Linear Accelerator for Challenging Environments, November 2016, sponsored by the ICEC [7] and Innovative, Robust and Affordable Medical Linear Accelerators for Challenging Environments, October 2017, sponsored by ICEC and the UK STFC. Recommendations from the latter workshop are the focus of this

Radiofrequency Power Systems

To get a better understanding of the performance of radiofrequency power systems, the characteristics of klystron and magnetron radiofrequency sources in terms of cost, reliability and complexity as a function of radiofrequency frequency and power delivery levels are being investigated. Additional studies are evaluating, the performance of solid-state radiofrequency power supply systems with regard to their cost and the possibility of modularity to improve efficiency and servicing without

Durable and Sustainable Power Supplies

Operational experience with modern medical linacs was reviewed to include control systems, cooling requirements of various subsystems, stability of operation as well as servicing and costs associated with these features. To make radiation therapy treatment equipment broadly available in ODA countries, as well as in other countries with similar environments, it is necessary to simplify the machine and its control system while improving the overall quality of all of its components. It would be

Linac Beam Production and Control

The essential elements of a linac include beam energy, average beam current and beam size on the X-ray target. It was agreed that ideally a single electron beam energy between 6 and 10 MeV should be made available to avoid activation of materials that would minimise unnecessary background radiation, thereby reducing the extent of shielding needed, the servicing costs and the overall mass of the machine. The overall full-width-half-maximum (FWHM) of the electron beam diameter on the target needs

Linac Safety and Operability

Key operational features of linacs include integrated safety and quality assurance subsystems, including ion chambers, feedback controls and safety interlocks. Other critical features are simplified controls with diagnostics for remote operation, remote control and monitoring and the possibility of integrated shielding with low leakage and optimised systems to improve portability. Engineering challenges include coupling existing trends in computing, sensors and readout systems; avoiding complex

Computer Applications in Radiation Therapy

In the Clinical Oncology special issue on radiotherapy in LMICs [3], Feain et al. [13] describe several computer-based initiatives to improve the planning, delivery and quality assurance of radiotherapy in LMICs. Two of the authors (Court and Palta) are participating in the project described in this editorial. Among the many opportunities to reduce the possibility of computer errors in the design of software for radiotherapy applications is automated monitoring of treatment delivery by record

Summary

This unique multidisciplinary collaboration on innovative technology involving CERN, ICEC and STFC included high-energy accelerator physicists, medical physicists, clinical and radiation oncologists, health policy and epidemiological scientists as well as medical physicists and clinical oncologists from ODA countries. The five technical research topics defined and outlined here provide a foundation for the potential design of an innovative linac and associated radiation therapy treatment system

Conflict of Interest

The authors declare no conflict of interest

Acknowledgement

Much of the information in this editorial was the result of a workshop at CERN in October 2017 that made further progress in addressing the need for global cancer care. The workshop would not have been possible without CERN's generosity in hosting the workshop and support from the STFC and the ICEC. Funding for travel by ODA country personnel as well as STFC invitees and for workshop logistics was provided by STFC. No funds were provided from the National Institutes of Health (NIH). C. Norman

Cited by (13)

  • Collaboration: The Force That Makes the Impossible Possible

    2022, Advances in Radiation Oncology
    Citation Excerpt :

    The project will help in the building of mutual trust in the SEE region in the spirit of “Science for Peace” as it will foster collaboration among all relevant stakeholders such as hospitals, universities, policymakers and industry, enabling rapid translation of research to the optimal treatment of cancer patients (Fig. 6A and B). Along the same lines, we are supporting the initiative of linear accelerators for other developing countries, including in Africa.12–14 The project,15 launched again at CERN, is called Smart Technologies to Extend Lives with Linear Accelerators and it aims at improving access to cancer treatment in those regions where there is either almost no care at all or where there is limited availability of Radiation therapy, which is often delivered using cobalt-60, a radioactive source that carries with it the potential problems of illicit use for terrorist threats as well as environmental and economic challenges related to source end-of-life disposal.

  • Surveying the Challenges to Improve Linear Accelerator-based Radiation Therapy in Africa: a Unique Collaborative Platform of All 28 African Countries Offering Such Treatment

    2021, Clinical Oncology
    Citation Excerpt :

    All participants have a common goal of developing an affordable and high-quality LINAC-based radiation therapy systems solution for challenging environments based on recognition that there are substantial opportunities for scientific and technical advancement in the design of the LINAC and the associated elements of a radiation therapy system. These considerations have been discussed and debated in several subsequent design workshops that included LMIC stakeholders [14–16]. The results of the subject survey will benefit the funded ITAR (Innovative Technologies towards building Affordable and equitable global Radiotherapy capacity) initiative by providing critical information on persistent shortfalls in basic facility infrastructure, radiation therapy equipment and the specialist workforce [17,18].

View all citing articles on Scopus
View full text