Proton beam therapy (PBT) has gone through several stages along the path of its development: experimental studies and the accumulation of clinical data, then, starting in 1990, the construction of clinical multi-room PBT centers, which after 2011 was supplemented by the development of single-room complexes. The clinical results accumulated to date in a number of cases show that there is no alternative to PBT for the treatment of a number of oncological diseases, which suggests the feasibility of developing both multi-room and specialized single-room PBT complexes. The review is devoted to the role of the National Research Center “Kurchatov Institute” in the development of PBT in Russia, namely, the development of two PBT complexes as part of the creation of the Scientific and Educational Medical Center for Nuclear Medicine of the National Research Center “Kurchatov Institute.”

The article provides a brief overview and trends in the development of proton beam therapy (PBT) in the world. The current results of the work on the implementation of the Federal Scientific and Technical Program approved by the Government of the Russian Federation in March 2020 are presented. The program provides for the development and launch of two centers for proton beam therapy on the basis of the National Research Center "Kurchatov Institute" and the National Research Center "Kurchatov Institute" - PNPI.

We present the current trends in proton therapy of patients with intraocular malignancies as reflected in the materials of the First PTCOG ocular proton therapy symposium, held on March 3–4, 2022.

An oncological-ophthalmological complex of proton-beam therapy based on the C-80 cyclotron is being created at Konstantinov St. Petersburg Institute of Nuclear Physics, National Research Center “Kurchatov Institute.” An analysis of publications devoted to the issues of quality control of specialized systems with a fixed proton beam direction in the horizontal plane for solving the problems of proton-beam therapy for patients with oncological-ophthalmological diseases is carried out. The analysis shows that since there are fewer than twenty such centers in the world, data on the frequency and content of quality-control tests for such installations is extremely contradictory. Quality-control tests based on the AAPM TG 224 protocol, supplemented by tests specific to proton oncology-ophthalmology, are presented. The levels of permissible deviations for various tests are developed on the basis of published data and technical-design data. These parameters will be included in the specialized software being created for quality control, which will allow data to be obtained on various parameters of all subsystems of the complex.

It is generally accepted that a proton therapy is one of the most effective method of external beam radiotherapy. Proton therapy has the highest conformal factor even compared with the most modern facilities for radiotherapy which use electron beam or gamma rays. Accuracy of combination of the 90–95 % isodose surface with PTV is better and dose gradients outside PTV is steeper, also integral dose of radiation from proton therapy for a healthy tissue is less than two times that for gamma irradiation. We can clearly see it comparing a HDV of treatment plan for gamma irradiation and proton therapy for the same clinical cases. In last years a lifespan of patient after radiotherapy treatment is a quit extended, so a question for quality of life for them is more significant. Decreasing of integral dose for a healthy tissue reduces a chance of negative effects from radiotherapy that would mostly appear after a lot years after treatment, so named late side effects. Quality of life is even more important in the case of pediatric oncology, when we not only expect a long healthy life for them, but also have aim to exclude side effects from their development. There was a long term clinical investigation in 1954–1990 years in ten experimental centers (among them clinical data: 50% in USA, 30% in USSR/Russia) that had confirmed the described advantages of proton therapy. These clinical results formed a foundation of quick development proton therapy clinical centers in developed countries in 1990s. These centers are based on oncology and multidisciplinary hospitals and treat 1000 and more patients per year. There are 96 working and 38 constructing PTCs in the world for today. Although we have a lot of experience in proton therapy in Russia, we didn’t take part in this new stage. In fact a patient treatment was over in all of three experimental PTCs (Moscow, Dubna, St. Petersburg) up to 2014. Thus we have a delay in a development of proton therapy for 30 years from a world level. Government of the Russian Federation Decree № 287 of 16th March 2020 establishes Program, which has to overcome this delay in development. Main science executer of the Program is National Research Center «Kurchatov Institute», which has an experience, scientific potential and competence for it. The main aims, stages and objects of the Program are presented.

In March 2020, the Government of the Russian Federation approved the Federal Scientific and Technical Program for the Development of Synchrotron and Neutron Research and Re-search Infrastructure for 2019–2027 (FSTP). In accordance with the Decree, the Federal State Budgetary Institution “National Research Center “Kurchatov Institute” (NRC “Kur-chatov Institute”) is designated as the lead scientific organization of the Program. The program provides for the development and launch at the National Research Center "Kur-chatov Institute" of the Proton Beam Therapy Complex for long-term multi-year development of new generations of PBT facilities and technologies, training of personnel (medical physi-cists and clinicians, treatment of a limited number of cancer patients and clinical trials). The complex of proton beam therapy will include two treatment rooms, one room with a rotating proton beam rotation system - gantry and one with a fixed beam. A synchrotron with a maxi-mum energy of 250 MeV will supply each treatment room with proton beams. The beam energy can vary from 70 to 250 MeV directly in the process of proton acceleration. The features of the developed proton beam therapy system are compared with other systems. Currently, the development of all non-standardized equipment of the complex being created is underway. The building is being designed, construction should begin in 2023. The calculation of radia-tion-protective walls has been analytically performed, a more detailed calculation is being carried out.

An integral part of the modern oncology service is the high-tech equipment based on nuclear physics methods. An interdisciplinary approach to the development of nuclear medicine and radiotherapy in Russia’s healthcare will improve not only the access to nuclear and accelerator technologies in our country, but also their efficiency and safety. Here, we review the role of the National Research Centre “Kurchatov Institute” (NRC KI) in the development of nuclear physics methods used in medicine, as well as new opportunities and prospects opened up by the creation of the Scientific and Educational Nuclear Medicine Center, NRC KI. The structure and main engineering characteristics of five developed medical radiology complexes, including a radionuclide production complex and four hadron radiation therapy complexes, are considered in detail.

The paper is a continuation of the previous paper with the same title published in ROJ, 2015; 8 (2): 14-20, which focused on theoretical issues of topometry and dosage/anatomical planning of proton radiation of intraocular targets and presented technical aspects of the development of a special radiation installation for proton therapy of intraocular malignant neoplasms. The present paper discusses positioning issues, i.e. exact placement of the target (tumor) with regard to the dosage distribution field envisaged by the treatment plan. The paper describes the unit supplied with a positioning system aligning the eye with the proton beam: it traces the location of the eye during irradiation and stops the dose delivery if the eye is misplaced // Russian Ophthalmological Journal, 2016; 2: 11-17. doi: 10.21516/2072-0076-2016-9-2-11-17 .

Aim: This study evaluated the frequency and long-term dynamics of early and late post irradiation damage after proton-photon or photon therapy for locally advanced prostate cancer. Background: The results of a randomized study of proton-photon or photon therapy using several fractionation regimes were analyzed in 272 patients with high and intermediate risk of progression. Materials and methods: Three variants of proton boost fractionation were studied sequentially: 3.0 (8 daily fractions), 4.0 (5 fractions, 3 or 5 fractions/week), and 5.5 (3 fractions, 3 fractions/week) Gy(RBE). Results: A significant decrease in the severity o f both acute and late gastrointestinal injuries is achievable with a proton beam. The dynamics of late gastrointestinal and genitourinary toxicity over a 10 -year period were generally characterized by a decrease in severity of morbidity by 30% and 15%, respectively. Conclusions: Local irradiation with a fractional dose of 3.0-5.5 Gy(RBE) and a cumulative dose of 28.0-28.8 Gy(RBE) for protons significantly reduces the early and late rectitis severity, but does not reduce the risk of lower urinary tract injuries. Fractionation regimens do not significantly differ in toxicity levels. (C) 2017 Greater Poland Cancer Centre. Published by Elsevier Sp. z o.o. All rights reserved.

A brief historical review is given of external radiation therapy (RT), one of the main cancer treatment methods along with surgery and chemotherapy. Cellular mechanisms of radiation damage are described. Special attention is paid to hadron (proton and ion) therapy, its history, results, problems, challenges, current trends, and prospects. Undeniably great contributions to proton therapy have been made by Russian researchers, notably at the experimental centers that have operated since the mid-20th century at the Joint Institute for Nuclear Research, the A I Alikhanov Institute for Theoretical and Experimental Physics (ITEP), and the B P Konstantinov Petersburg Institute of Nuclear Physics. A quarter of the global clinical experience was accumulated by 1990 at the world's largest ITEP-hosted multicabin proton therapy center.

Показано теоретически и экспериментально, что измерение параметров импульсного протонного пучка с последовательным поворотом воздушной многоэлектродной ионизационной камеры позволяет существенно повысить точность определения как положения центра тяжести поперечного сечения пучка, так и создаваемого им продольного распределения дозы. Определены режимы линейной работы камер и исследованы характеристики системы. Погрешность определения положения центра тяжести поперечного сечения пучка составила менее 2% ( 0.4 мм), что подтверждает работоспособность метода для мониторинга пучка.

It has been theoretically and experimentally shown that, using stepwise rotation of a multielectrode free-air ionization chamber to measure the parameters of a pulsed proton beam, it is possible to substantially increase the accuracy in determining both the centroid position of the beam cross section, as well as the transverse distribution of the dose produced by the beam. The linear operation modes of the chambers are identified and the system characteristics are investigated. The inaccuracy in determining the centroid position of the beam cross section is <2% (∼0.4 mm), which confirms the applicability of the method for beam monitoring.

The aim was to evaluate the effectiveness of various fractionation proton boost in the proton-photon radiation therapy of locally advanced prostate cancer. The study included 272 patients with prostate cancer and intermediate-to-high risk of progression. 114 patients received 3-D conformal local irradiation of the prostate by proton beam 220Mev. The focal dose of 28-28,8 SoGy-eq was fed to the prostate for 8, 5 or 3 fractions for 3, 4 or 5.5 Gy-eq, respectively. Given the photon component (44 Gy in 22 fractions to the whole volume of the pelvis), the dose to the prostate was 72.8., 72 and 72SoGr-eq, respectively. In 158 patients in the control group the similar doses to the pelvis were supplemented by local 4-dipole photon irradiation of the prostate to 68-72 Gy in 12-14 fractions of 2 Gy. Acute gastro-intestinal (GI) toxicity maximum, 2 St expression, were found significantly less frequently after the proton-photon therapy: in 54.4% of cases, versus 69.2% in the controls (p <0,01). Differences between acute genito-urinary (GU) toxicity were not observed. The frequency of late GI damage of 2 St. was 3 times less frequently observed in the study group: 10.2% versus 34,8 +/-% in controls. Damages of 3-4 St. were found in 1 patient of the main group and in 2 patients in the control group. GU damages of 2 St. were equally common after the proton-photon or just photon irradiation in 8.3% and 9.1% of patients respectively. Damages of 3-4 St. were diagnosed in 2.8% and 3.8%, respectively (p> 0.05). A 5-year survival without biochemical recurrence was in the study and control groups 60,0 +/- 5,4% and 61,9 +/- 4,4%, and a 9-year survival--45,5 +/- 8,5% and 42,8 +/- 7 1%, respectively (p > 0.05). Thus, precise local irradiation by a proton beam with ROD 3-5.5 Gy-eq. and SOD 28-28,8 Gy-eq supplementing photon irradiation of total small pelvis significantly reduces the severity of early and late post-radiation proctitis but does not reduce the risk of damage to the lower urinary tract and does not influence the anti-tumor treatment effectiveness compared to conventional conformal photon radiotherapy. In this case, the proton boost modes: 8 fractions for 3 Gy, 5 fractions for 4 Gy and 3 fractions for 5.5 Gy does not significantly differ in the level of toxicity.

Purpose. At RSCRR and ITEP a method of combined proton-photon radiation therapy of the prostate cancer was elaborated. Methods. The method is distinguished by the use of a special free rectal marker - endostat for X-ray positioning of the therapeutic beam, and by the mean regime of the dose fractionation at the prostate local irradiation with the proton beam 220 MeV: 22.4 Gy for 8 daily fractions in 2.8.Gy, or 18 Gy for 5 daily fractions in 3.6 Gy. Taking into account the photon component (44 - 46 Gy in 22 - 23 fractions for the whole volume of small pelvis or for prostate and seminal vesicles only) the dose on the prostate was brought up to 72 - 74.8.CoGy E (RBE for protons being 1.1 and α/β for prostate tumor - 3.0 Gy).

The history of external radiation beam therapy (radiotherapy)-in particular, proton therapy (PT)-is brietly outlined. Two possible strategies in increasing the efficacy of radiotherapy are considered. The radiotherapy methods and techniques are brietly described. The possibilities of PT in providing effective treatment and the main achievements are demonstrated. The state of the art in the PT development involving the active creation of large clinical PT centers since 1990 is analyzed.

Energetic ion beams are produced during the interaction of ultrahigh-intensity, short laser pulses with plasmas. These laser-produced ion beams have important applications ranging from the fast ignition of thermonuclear targets to proton imaging, deep proton lithography, medical physics, and injectors for conventional accelerators. Although the basic physical mechanisms of ion beam generation in the plasma produced by the laser pulse interaction with the target are common to all these applications, each application requires a specific optimization of the ion beam properties, that is, an appropriate choice of the target design and of the laser pulse intensity, shape, and duration.