2.2 Passage of Charged Particles Through Matter 19
down particles (that is, at the end of range) is very high. A beam of charged
hadrons therefore releases the greatest part of its destructive energy on the
target tumor. The dose received at the tumor can therefore be very high while
the healthy tissue is saved. Hadron therapy was initially specially relevant
for tumors located in the cranial base or along the vertebral column and for
ocular cancers. Recently, hadron therapy has successfully treated pediatric
tumors, tumors residing in the central nervous system, prostate, liver, and of
the gastroenterological apparatus.
Many countries are investing in this anticancer tool. The clinics which
use proton accelerators largely dominate, and the number of new clinics
has rapidly increased in the last few years. In 2008, there was nearly the
same number of clinics in Europe (11), North America (8) and Japan (8),
and more than 16 clinics will enter into operation within the next 5 years
[2L07]. The total number of patients treated with protons was about 10,000 in
1993 and 50,000 in 2006, that is, the progression appears to be exponential.
Many excellent clinics exist or are in construction in Europe. A dedicated
heavy ion therapy clinic is being constructed in Heidelberg (Germany). The
construction of ETOILE, the French National Hadron Therapy Centre, was
approved by the French Ministries of Health and Research in 2006. This
carbon therapy clinic will be built within the framework of a Public – Private
Partnership near Lyon. The TERA Foundation [2w1] aims at the development
of the techniques based on the use of hadrons and, more generally, of the
applications of physics and computer science for medicine and biology. In
particular, in Italy, since 2001, the South National Laboratories of INFN
are operating a beam of 62 MeV protons used to treat ocular melanoma
and other non-deep tumors. In 2003, the TERA Foundation completed the
specifications and the technical design of the CNAO, the Italian National
Centre for Oncologic Hadron Therapy aiming at the treatment of deep tumors
with protons and carbon ions, which will be built in Pavia.
An appreciable fraction of the energy lost through ionization can be delivered
more “violently” to some electrons which consequently acquire a relatively high
energy and therefore have a relatively longer path length: they are the so-called
knock-on electrons and they have enough energy to ionize (they are the so-called ı
rays along the path of a charged particle). The number of ı rays increases with the
energy of the primary particle. Fluctuations in the energy loss through ionization are
mainly due to the small number of energetic knock-on electrons. Some detectors, for
example, the Nuclear Track detectors, are sensitive to the Restricted Energy Loss
(REL), that is, the energy deposited in a cylinder, having for an axis the direction of
the particle of about 100
˚
A diameter, corresponding to ı rays with less than 200 eV
energy.