Andalus Proton Therapy Center

 

Structure

Functions

Aims

Methodology

 

(Complete Picture of the National Proton Center)

www.andalus-ptc.com

Prepared by

Dr. Eng. Maan Ammar (Professor)

Scientific Consultant

Annual Scientific Harvest (8/11/2014)

 

 

Maan Ammar Date of Birth: 1953 This email address is being protected from spambots. You need JavaScript enabled to view it.

He received BSC in Electronic Engineering from Damascus University in 1977 and attended a training course on design, operating and maintenance of sounder equipment station at Barry Research Corporation, Sunnyvale, Silicon Valley, California in 1977-1978.

He Received MSc in information science and PhD in Information Engineering from Nagoya University, Nagoya, Japan in 1986 and 1989, respectively. He is professor at the department of Biomedical Eng. Dept., Damascus University since 2003. He was the head of department for 8 years (1995-2001, 2007-2009). His achievements in the department attracted the attention of the highest level in the country.

He Taught 10 subjects in the fields of Image Processing, Artificial Intelligence, Knowledge-Based Systems and System Analysis and Design, for last year undergraduate, Master and Doctor students in Computer Science and Information Systems departments at Jordanian Universities in the period 2001-2006.

He stayed as visiting professor at Nagoya University, Japan, (this university received 3 Nobel Prizes in the last 13 years), in the period Oct. 2009-Feb. 2010. They asked him for an Invited Lecture to explain how he could transfer his PhD research into a commercial system with USA and International patents, that detect forgery signatures in checks and serves tens of banks in the 50 states of the USA. The lecture was delivered on Feb. 19, 2010 for 150 minutes.

He wrote and translated 5 books published locally, regionally and one of them internationally. He Published 30 papers in refereed journals and conferences, most of them are international.

In 2011, he published a unique research in the International Journal of Pattern Recognition and Artificial Intelligence (IJPRAI), about developing a new decision making technique that surpasses what was considered as the maximum limit, for decades. He is the cofounder of Asvtechnologies Inc. Company, NY, USA, which exploits his invention.

 


Contents

Title

Page

Summary

5

1- Introduction

6

1-1 Conventional methods for cancer treatment

6

1-2 The need for Proton Therapy

6

1-3 Death due to local therapy failure

7

1-4 Proton Therapy

7

1-4-1 What is Proton Therapy?

8

1-4-2 Fifty years a go

8

1-4-3 The proton therapy story

9

1-4-4 Forming irradiation dose according to tumor shape

12

1-4-5 The merit of proton therapy over photon therapy

12

1-4-6 An example of Proton Therapy treatment result

13

1-4-7 Actual coverage of Proton Therapy

13

1-4-8- Proton Therapy Centers around the world

14

1-4-9 Proton therapy centers and accelerators near us

16

1-4-10 Proton centers and accelerators in the ME

16

1-4-11 What does having a PTC in Syria mean?

19

1-4-12 Does Syria need a Proton Therapy Center?

19

1-4-13 Why did we choose Proton Therapy?

20

2- Structure of the aimed center

20

2-1 Equipment structure

20

2-2 Hierarchy and management

21

2-3 Physical shape of the APTC

22

2-4 The APTC Website

22

2-5 The APTC in approximate numbers

23

3- Functions

23

3-1 Treatment functions

23

4- Overall Aims of the Andalus Proton Therapy Center

26

5-The Methodology adopted to achieve the aimed objectives

27

5-1 Implementation methodology

27

5-1 Implementation methodology

27

5-1-2 Implementation and the teamwork

28

5-1-3 Work of the committees outlined in the IA

29

5-1-4 Work organization via IA

29

5-1-5 Structures and members of the committees

30

5-1-6 Authorization of the committees work program

30

5-1-7 Work plan updating

31

5-1-8 Urgent updating

31

5-1-9 Initial work plan array

31

5.2 Tables of the IA

33

6-Exploitation methodology

51

6-1 Operation methodology

51

6-1-1 Distributing APTC revenues

52

6-2 Methodology of scientific research support

52

7- What have we already realized in the project?

52

REFERENCES

57

Related Articles and reports

60

 


 

Summary

This booklet sheds light onto The Andalus Proton Therapy Center (APTC) project, which can be considered as the first one of its type in the region. The center will use the latest technology in the world developed to fight cancer and cure cases for which classical treatment techniques fail, and preserves to a large extent the healthy tissues. It will contain three treatment rooms with gantries, one fixed-beam room, and one research room. With this treatment and research facilities, it will be one of the largest centers in the world.

This booklet will briefly explain about the need for proton therapy in the world in general and in Syria in special, highlights the real need for such a center in Syria and the region, explains about the methodology that will be used to implement this center which can really be considered as a real challenge for a country like Syria. It will also explain about the methodology of implementing and exploiting the APTC as a non-profit national project that provides a rare and necessary cancer treatment, and supports effectively the scientific research in Syria in the fields of medical applications and clinical research.

This booklet constitutes with the other one "Clinical and Technical Specifications of the Andalus Proton Therapy Center" a full description of the center in both introductory and technical parts. Both of them are published in this harvest (8/11/2014).

If the reader has any remark about the content of this booklet, we will be grateful if he/she sends them to us using this email address:

This email address is being protected from spambots. You need JavaScript enabled to view it.


1- Introduction

The Andalus Proton Therapy Center (APTC) is used to treat locally cancer regions in human body where conventional treatment methods fail. Therefore it is useful to define "cancer" first.

What is cancer? Cancer is uncontrolled growth of human body cells that develop to produce a "mass" called "tumor". Tumor is two types: Benign Tumor (BT), and Malignant Tumor (MT). BT is not harmful, but MT is harmful, and may lead to death if not treated. BT can be local in body parts like brain, eye, head, neck, liver, lung, lymph nodes, and prostate cancer. Treating the cancer early gives high curing probability.

1-1 Conventional methods for cancer treatment

Conventional treatment methods of cancer are conventional radio- therapy using X-rays and surgery for local tumors, and Chemical and palliative for Metastasised tumors.

Conventional therapy fails in case of local tumors in sites where it is difficult to reach by surgery like the bottom of the skull and the eye. For those tumors where the conventional local therapy fails, Proton Therapy is needed.

1-2 The need for Proton Therapy

Tumors that inflict human body are essentially two types: (1)Metastasised tumors, and (2)Localized tumors, as shown in Fig. 1. The ratio of the first one is 42% and that of the second one is 58%. Chemical therapy is used for 5% of the metastasised tumors, and palliative therapy is used for the remaining 37%. Localized tumors are treated in three ways: surgery is used for 22%, conventional radiotherapy for 12%, and surgery and radiotherapy together are used for 6%. For the remaining 18%, the local therapy fails due to the lack of sufficient control of tumors, and the result will be, unfortunately, unpleasant for patients.

For the 18% where the conventional therapy fails, we need Proton Therapy which gives more than 90% of success.

Fig. 1: Main types of tumors and the conventional methods used for treatment.

1-3 Death due to local therapy failure

Before talking about proton therapy, it is meaningful to show by actual numbers how the result of failure of local therapy of cancer can be bad.

A study conducted by M D Anderson Center for cancer treatment (Huston, Texas) and (Massachusetts General Hospital) in 2011 led to the results shown in Table 1. This study has shown that there are 1350000 new cancer patients every year, and 488000 death cases caused by cancer, and 35% (171820) of them are a result of local therapy failure. This large number of death cases can be highly reduced if Proton Therapy used.

 

1-4 Proton Therapy

When it comes to getting rid of cancer, the sharpest scalpel may be a proton beam since using heavy ion beam is still considered in experimentation stage. This technology born in high energy physics labs is now treating thousands of patients every year with much fewer side effects. Research conducted in the last 10 years came with smaller, cheaper and in some sense more effective proton therapy systems.

 

Table 1: Death annual rates in USA due to cancer site and local failure.

1-4-1 What is Proton Therapy?

The Proton Therapy is a particle therapy against cancer using proton beam, which minimizes useless irradiation towards adjacent normal tissues and concentrates its doses on the lesion. Even for a lesion which is located in a place nearly inaccessible by the conventional radiotherapy, proton radiation allows to give a sufficient dose, and thus to irradiate a wider range of lesions than is possible with the conventional photon radiotherapy. This technology contributes to improvement of QOL (Quality of Life) and is applied for clinical use.

1-4-2 Fifty years a go

When doctors started to treat a five-years-old boy who had lymphocyte predominant Hodgkin's cancer with X-rays because this type of cancer responds well to radiation treatment, they repeatedly beamed his lymph nodes under arms, on his neck, and in the middle of his chest, and the cancer went away. The boy was cured but his health would never be the same. When he reached puberty, the result was disastrous. All his body parts beamed with X-ray never grew naturally, so that in the 34 age he had to change heart valves, had heart attacks, and developing cancers.

1-4-3 The proton therapy story

Before radio therapy became widespread, Robert Wilson suggested using protons instead of X-rays to deliver more radiation to tumors while sparing healthy tissues.

Soon a handful of physics labs were offering experimental proton therapy on the side. In the late 1980s Fermi National Accelerator Laboratory in Illinois built a proton accelerator for Loma Linda University Medical Center in Southern California making it the first hospital in the world to offer proton treatment.

Today, with 43 multi-rooms centers around the world, about half of them in USA and Japan, more than 100000 (hundred thousand) patients have been treated with proton therapy, and a new generation of single-room proton therapy facility entered the market.

Doctors have treated cancer with radiation for more than 100 years by implanting small pieces of radioactive material in tumors, for instance. Today X-ray machines are the work horses of radiotherapy.

Since then, the technology has come a long way. Doctors can now get a clear 3-D picture of the tumor with CT or MRI scans and shape the radiated area to fit the tumor, using advanced treatment-planning software. But collateral damage is still inevitable because most X-rays deposit their destructive energy in healthy tissue before they even get to the tumor, and some cause additional damage on the way out of the body.

By using accelerators, it has been possible to make the heavy mass protons (compared with X-ray electrons) penetrate the body to more than 30 centimeters to reach body tumors. At the same time, they lose energy at an increasing rate as they slow down. So they would deposit very little of that damaging energy going in and deliver most of their punch when they come to a stop inside the tumor. What is called Bragg peak curves explain these facts. Fig. 2 shows the curves for X-ray and Bragg peak for proton and heavy ion beams.

Fig. 2: Relative-Dose vs. Penetration Depth curves of photons, protons and ions.

By changing the protons’ energy, doctors could get them to stop at any depth they chose with an accuracy of millimeters with much higher average dose than skin dose.

The first experimental proton treatments took place in 1954 at what is now Lawrence Berkeley National Laboratory followed by one in Uppsala in Sweden in1957.

By using several beams with suitable intensity and energy, the Bragg peak can be spread out according to the tumor dimensions to produce what is known as Spread-Out-Bragg-Peak (SOBP). Fig. 3 explains this process. Irradiating tumor using SOBP can be better understood using 3-D displayed curves as in Fig. 4.

Fig. 3: Spreading Out Bragg Peak

 

Fig. 4: Three-Dimensional photon and SOBP curves.

 

1-4-4 Forming irradiation dose according to tumor shape

By using specialized software, the Proton Therapy System has been able to give irradiating beams the 2-D shape of the tumor region to maximize protection of healthy tissues. Fig. 5 shows a demonstration of how such process is done.

Fig. 5: Shaping the irradiating dose according to the shape of the tumor region.

 

1-4-5 The merit of proton therapy over photon therapy

The performance of proton therapy is much better than that of photon (X-ray) therapy because it provides the possibility of irradiating the tumor region with higher dose, narrowing the healthy tissues area around the tumor subjected to radiation, and lowering the dose value hitting the tissues surrounding the tumor. Fig. 6 shows that for photon therapy, (left), in order to irradiate the tumor area marked by yellow line, we have to irradiate the rectangle including it which contains healthy tissues more than tumor ones. For the middle image which corresponds to what is called Intensity Modulated Radio Therapy Photons, the situation is better where the highest dose is concentrated on the tumor region but the surrounding tissues still receive appreciable dose.

However, for the right image which correspond to Proton Therapy, we find that the irradiation does is concentrated on the tumor, and irradiation decrease sharply departing towards healthy tissues. This actual example of treating a brain tumor shows clearly that the Proton Therapy is the superior among the three methods.

Fig. 6: The merit of Proton Therapy treatment over that of Photon therapy.

1-4-6 An example of Proton Therapy treatment result

Fig 7 below shows an actual example of treating a brain cancer. The left image shows the cancer region (bright one in the middle) before treatment, the right image shows the plan of treatment, and the down one shows the result after 3 months of treatment by Proton Therapy where the cancer disappeared completely.

1-4-7 Actual coverage of Proton Therapy

The statistics of the American Cancer Society (ACS) in 2011 have shown that:

1– 1.500000 (one and half million) new cancer cases appear every year.

2 – 60% of them are treated with radiation, among them 70% are treated with Photon Therapy.

3 – The remaining 30% have to be treated with Proton Therapy.

4 – Only 5% of those who need PT are actually treated, and the remaining 95% are not served. In other words, The US needs 175 more centers to treat them. Fig. 8 highlights these facts as found by the ACS.

Fig. 7: The left image is the cancer before treatment, the right one is the plan of proton treatment, and the down is the result after 3 months of treatment.

 

1-4-8- Proton Therapy Centers around the world

Proton Therapy Centers around the world in 2008 were as follows: 6 in operation in both of USA and Japan, 9 in Europe and Russia, and 4 additional ones in UK, China, Korea, and South Africa. Centers in developments worldwide were 14. Fig. 9 shows these centers in 2011 for both operational and planned which are expected to reach 60 by 2016.

Fig. 8: The percentage of cancer patients treated by Proton Therapy in the US. Only 5% of patients are covered by treatment.

 

Fig. 9: Proton Therapy Centers worldwide in 2011 (Danish study) in operation and in development.

Operating centers worldwide already became 43 according to MEDraysintell center with 120 treatment rooms, with 12% increase per year.

What is obvious from Fig. 9 is that till now there is no operational PTC in the region (Middle East), although Saudi Arabia signed a contract with Varian to build a multi-room PTC to be finished in 2014, and Qatar announced similar contracting process. Turkey plans to have a PTC facility by 2025.

1-4-9 Proton therapy centers and accelerators near us

When working in some environment, it is wise to know what is around and where we stand. For a project of this kind and quality, it is important to know what is around us. An extensive survey of the reality of proton centers and accelerators in the region (Middle East) will be posted below.

Related research centers (among them "MEDraysintell"), mention that Proton Therapy market will be tripled by 2018 reaching 300 treatment rooms compared with 110 in 2012. In August 2013 there were 43 centers working overall the world with 121 treatment rooms. This number represents 9% of the total traditional radio therapy systems in the world. The growth of PTS was 13% between 1990 and 2013, from 8 to 121 rooms. It is expected that number of rooms will reach 1500 in 2030, which means a market of 5 billion US dollars.

 

1-4-10 Proton centers and accelerators in the ME

It was obvious from the studies mentioned above and our extensive search on the web that (until October 2014) there is no PTC in the region in operation.

Due to the high cost of this technology, thinking of it remained confined to Gulf countries.

Gulf Countries

Varian company offered to build a PTC for Saudi Arabia and a contract was signed to build a Multi-Room PTC in King Fahd University. Soon later, Qatar announced signing a similar contract, may be because of competition between the two countries. Deadline seems to be very loose. They intended to put it in operation in 2014, but till now they are in building construction stage, according to Alriad newspaper.

Turkey

Turkey is working in this field on the long term principle. They will build the accelerator first, and one of its applications will be the PT. They finished the feasibility study of the accelerator in 2000. The design was finished in 2005. The technical design was finished in 2013 for Turkish Accelerator Complex, TAC. The first part of equipment was received in Ankara in 2013. The accelerator is a Synchrotron type. In an coming stage, one of its applications will be the PT. The accelerator management signed cooperation agreements with several scientific and educational establishments in Europe and China. They plan to have PT in 2025.

Occupied Palestine (OP)

There is no study or survey that indicates the availability of a PTC in OP. The situation there can be summarized as follows:

The research nuclear reactor SOREQ website of OP mentioned that:

1 – SOREQ contains several sections: optoelectronics, nondestructive tests, space environment center, national radio safety center, research nuclear reactor, IRR-1, .., the equipment include a 10 MeV cyclotron accelerator as well as the research reactor. SOREQ builds now a reactor for application researches including a linear accelerator with super conductive technology and produces protons and ions from hydrogen atoms. It is expected that this project will be completed in 2013 (according to the announcement). According to classified researches of defense ministry, researches of nuclear weapons are done routinely there.

2 – There is a company for partly manufacturing proton therapy equipment called P-Cure. It signed recently a contract with Philips Company to exploit Philips new imaging technology to use it in PT equipment for American ProCure Company.

3 – What assures that there is no PTC is that the most famous health centers like "Rabin" and "Hadassah", although they contain the most advanced conventional radio therapy equipment, they do not have PT facilities.

4- Most important is the Israel Proton Therapy Initiative on facebook that try to convince decision makers to adopt the principle of building PT facilities for Israeli and their "Arab neighbors", as the say. These facts assure that there is no PT facilities in OP. In fact, they send their patients to USA for treatment.

SESAME accelerator in Jordan

Its name is an abbreviation of "Synchrotron-light for Experimental Science and Applications in the Middle East". It is opened in 2011 and an Israeli physics scientist was elected as vice president in 2013. This accelerator called Middle East Accelerator has an interesting story mentioned in brief below:

SESAME "Middle East accelerator for experimental sciences"

When the physics scientist Herman Wink in Stanford University knew that Germany will throw away an electronic accelerator, he said: why don't we present it to the Middle East? He gave his idea and it was agreed upon easily by American, European and other physics societies, as well as UNISCO, and finally, after many years, it was deployed in Jordan where the host countries (Turkey, Jordan, ..) bear the operation costs. The most interesting thing related is that an Israeli is a vice president, and Israeli, Jordanian, Turkish, Iranians, and Pakistani scientists are working there.

Iranian accelerator

Iran wants to enter this field from the wide door. They want to build their own accelerator with their own technology. They devoted 300 million dollars for this purpose in September 2012. In 2013, they announce the start of the project.

On the other side of the Mediterranean, Europe with more than 20 countries had only five PTCs in 2013. Holland for example does not have a PTC.

1-4-11 What does having a PTC in Syria mean?

We can conclude simply from the above explanation that having such center in Syria puts it in the rank of the few developed countries that provide this precious humanitarian service. This service is described as the best and the worst cancer treatment, at the same time. It is the best because of its best results, and it is the worst because of its very high cost.

The management of AU in charge of the APTC project took the second description in consideration by devoting 25% of the therapy capacity to ministries of Higher Education, Defense, Health, Tartous prefecture where the center will be built, as well some incapable people, 5% each. The second benefit of the APTC will be its support of scientific research in Syrian Universities and research centers which is priceless.

1-4-12 Does Syria need a Proton Therapy Center?

According to International Health Association, (1-1.5)/1000 get cancer yearly. In USA and Russia this ratio becomes 3/1000. If we take the most optimistic statistics (1/1000), we find that 23000 get caner in Syria every year. As we found in Fig. 1, 18% of them need Proton Therapy. This means that about 4000 cancer patient in Syria need Proton therapy. This means that we need four 3-rooms Proton Therapy centers for Syria. In other words, we are in real need for a PTC.

 

1-4-13 Why did we choose Proton Therapy?

If we go back to Fig. 2 we find that two curves are presented for Proton and Heavy ions particles, as well as Photon curve.

Hdron therapy refers to therapy using protons or heavy ions. Proton therapy has been used for about 60 years and tens of thousands of patients have been treated worldwide till now, with 43 centers in operation now. However, until 2008 only 3 heavy ion centers were available only in Japan. In the USA, treating with ions is still considered in the experimentation stage, although Fig. 1 shows that ions have some advantages over protons like the narrow Bragg peak, the little higher peak, and most important is the Relative Biological Effect RBE which is higher for ions (1.7 – 2) which permit making treatment session less. However, the cost an ions facility is about 3 times that of proton one. Moreover, according to extensive study we made, we found that the number of patients treated in Heavy Ion Centers is 1/10 (a tenth) of that done in similar proton centers. Considering the above factors, we can easily conclude that Proton Therapy Centers are more efficient than heavy ion ones, at least for many years to come.

2- Structure of the aimed center

We will explain in the following paragraphs the structure of the aimed PTC including equipment, managerial research hierarchy, website and size and cost.

2-1 Equipment structure

Proton Therapy Centers are mainly two types: Multi-Room and Single-Room. The first one may contain 2, 3, or even 4 treatment rooms, and the second one contains only one treatment room. The single-room center is suitable the budget is very limited and the number of patients to be treated is not big, however, if such center has to be enlarged in the future, it will not be possible, besides, its options for treatment are less that the multi-room one. For the above reasons, we certainly need a Multi-Room PTC.

This center will contain three treatment rooms with rotating Gantries, one horizontal-beam treatment room, and a research and experimentation room. Fig. 10 shows how the structure of the center will be. The accelerator could be in principle a Cyclotron or a Synchrotron, and the second one is most probable.

Fig. 10: The structure of a PTC with 3 Gantries, 1 fixed-beam room, and a research room. The accelerator generates the beam that feeds all rooms.

 

2-2 Hierarchy and management

The structure and hierarchy of the APTC is intended to enable top class research and top class clinical treatment with optimal collaboration and synergy between center management, staff and personnel. A close collaboration must exist between the research center, patient treatment facility and accelerator team and between projects across the sections of the center. Fig. 11 shows the hierarchy and managerial structure of the APTC suggested to realize the objectives mentioned above.

 

2-3 Physical shape of the APTC

The APTC may take a shape like that appears in the homepage of the website of the center launched this month (October 2014), shown in Fig. 12 (home page).

Fig. 11: Hierarchical and managerial structure of the APTC.

 

2-4 The APTC Website

The APTC website has been already designed and programmed as shown in Fig. 12 (the homepage). It is aimed to be a window for communication with companies, researchers, qualified job seekers and donators. It is also aimed to be an announcement board for the center activities and requirements. It was launched in October 2014 (www.andalus-ptc.com).

2-5 The APTC in approximate numbers

 

Size

6000 m2

Concrete

36000 tons

Cables

40 Km.

Electricity Power

5 MVA

Cost

200 Million US Dollars

Operating staff

100 persons

Therapy capacity

1200 patients per year

Operating time

16 H / day (two periods)

Implementation period

6-10 years.

3- Functions

Equipment of the center performs a set of functions to complete the treatment process. These functions are summarized the following paragraph.

3-1 Treatment functions

The diagram in Fig. 13 show the flow of processes applied to the patient from treatment planning until the end of treatment session by confirming the enhancement result, which should be contraction in tumor area, to take it in consideration in the next treatment planning. This diagram gives a clear idea about the functions provided by the facility to enable performing the required process. This diagram enables also understanding what kind of working staff should be available to operate the APTC. The processes appear in the diagram are:

Fig. 12: The homepage of the website of the APTC.

Fig. 13: Functions workflow of the APTC.

1 – Treatment planning by determining the regions to be irradiated and the intensity of the radiations to be applied to each region. It is worth noting that this process is done manually now, and there are research efforts in the universities and research centers to make it automatic.

2 – Handling the patient which includes:

  • Robotic patient positioning system
  • Positioning according to treatment plan
  • Robotic imaging system

3 – Accelerator

· Accelerator Control System acts as a slave to the Treatment Control System.

· Predefined beams are requested from a library according to treatment plan

These functions and system performance are addressed in their finest detail in the Clinical and Technical specifications book ( publications of this harvest). In the following, the processes done during a treatment session is summarized:

1 – Taking a CT image to determine the form and size of the tumor.

2 – The result of imaging is used for positioning the patient using robotic positioning system for accuracy.

3 – The proton beam is brought from the accelerator through the beam line transfer to be applied to the patient using the accurate scanning mode.

4 – Taking a CT image after the treatment to confirm the result and take it in consideration in the next session. Taking the CT after treatment and comparing the result with the situation before treatment to confirm the enhancement is called "Quality Assurance".

4- Overall Aims of the Andalus Proton Therapy Center

The overall aims of the proton therapy center are:

1 – To offer proton therapy to people who are in real need for it in Syria and the region.

2 – To reduce the cost of treatment for Syrians by treating them in their country and paying the cost in Syrian currency, and for those in the neighborhood by treating them in a nearby and cheaper country, compared with USA and Europe.

3 – To dedicate the APTC as a national project by:

· Sharing the services of its facilities with some ministries, and sharing planning and scientific research support with other governmental universities (Damascus, Aleppo, Tishreen and Al Baath) on an equal basis with Al Andalus University which initiated the project.

· Planning and implementing the research plan under the supervision of Higher Education Ministry.

4- To provide some free treatments to incapable people by coordinating with some donators.

5 – To create an active research environment in the APTC, Al Andalus University, the other Syrian universities, and other universities and research centers willing to cooperate. This will be done by selecting top class research subjects and working on feeding the research team with distinguished researchers and talents.

The Center will not save any effort to attract distinguished researchers and detect talents to push research efforts forward qualitatively and quantitatively.

6 – To design, conduct and analyze the outcome of the clinical trials with the aim of developing an evidence based indications and test novel strategies for proton therapy in the multimodality management of different cancer diseases.

5- The Methodology adopted to achieve the aimed objectives

The methodology adopted by the APTC to achieve aimed objectives is two-fold:

  • The project implementation methodology
  • The project exploitation methodology

The exploitation methodology is, in turn, two-fold:

  • Operation methodology
  • Research and development methodology.

In the following we highlight these methodologies.

5-1 Implementation methodology

The project implementation will depend on two main concepts:

  • Careful planning and organization
  • Team work

5-1-1 Project Plan

Carefully drawn plan and well organized implementation will lead to success. The project plan has been put taking in consideration all factors that may affect the implementation through the different stages of the project. Fig. 14 shows the project implementation plan.

Fig. 14: The APTC project plan.

5-1-2 Implementation and the teamwork

A big project like the APTC must not depend on one person or few persons so that if any one left the work for some reason, the project may have real problems in implementation. The teamwork is the solution in this case. If a suitable team is selected, the work will continue with the same quality and momentum even if one member or a few people left the team. Based on this concept, 12 committees will be involved in in the implementation process of the project. The work to be done by the 12 committees during the 10 years of the project life is outlined in what we called Implementation Array (IA). The IA is shown in Fig. 15.

Fig, 15: Implementation Array.

5-1-3 Work of the committees outlined in the IA

The outlined work in the IA was set according to the following criterions:

1 - Taking in consideration the project stages shown in Fig. 14.

2 – Considering the interrelations between the wok of the different committees so that their overall work integrates without redundancy.

3 – Covering all works necessary for the perfect implementation of the project.

5-1-4 Work organization via IA

As IA table shows, there are 12 committees. These committees are as follows:

Array Development Committee

Scientific Research Committee

Human Resources Committee

Financial Affairs Committee

Management Affairs Committee

Scientific Equipment Committee

Missions Affairs Committee

Public Affairs Committee

Technical Specifications Books Committee

FIDIC Based Contracts Committee

Next Project Committee

Follow up and Automation Committee

The structure, work and duties of these committees are explained as follows:

5-1-5 Structures and members of the committees

Every committee is two classes: "Implementation" and "Receiving and Authorization". Every class of the committee consists of one Ph. D. holder and four higher education student (Master or Doctor) course. The number of members in each committee 10: (five for Implementation and five for Receiving and Authorization). The members of the 12 committees team becomes 120. Those members will be distributed between the five universities on an equal basis (24 members will be assigned by each university). If any university can't provide the 24 members as described for any reason, Al Andalus University (the initiator of the project) will cover the deficiency. It is planned that this team will be specified and become ready for work at the beginning of 2016.

5-1-6 Authorization of the committees work program

The initial work program of each committee is outlined by three general titles by the scientific consultant as general orientations. The committee will broaden these orientations to become about one page for each title during 2016. The resultant (roughly) 30 pages (3x10) become the work plan for each committee.

At the beginning of 2016, the general council of AU will discuss and authorize the work plans of the twelve committees, one each month, in the order shown in (5-1-4) and in the IA table. In other words, in the first session in 2016, the work plan of the Array Development committee will be discussed and authorized, and in last session of 2016, the work plan of Follow up and Automation committee will be discussed and authorized.

The Secretaries Council which meets biannually will discuss the work plan of the first six committees in the first session of 2016, and the last six committees in the last session.

By the end of 2016, the roughly estimated 250 pages of the twelve committees will be the general work plan for the implementation of the Proton Therapy project (2016 issue).

5-1-7 Work plan updating

It is evident that the work plans of the years (2017-2025) will be affected by the development and progress of the work in the project, therefore, the work plan will be updated annually by the committees as implied by the developments of the project. The updating authorization will be done according to the procedure explained above.

5-1-8 Urgent updating

If, for any reason, it became necessary to update or modify the work plan of a specific year for any committee, the committee must manage this issue with the scientific consultant and the Management of AU.

5-1-9 Initial work plan array

The initial work plan array, as outlined by the scientific consultant is shown in Fig. 16. A click on any cell in the array will bring out the three broad lines that outline the work of the committee for the specific year. For example, a click on (2, 2016) entry will display the screen shown in Fig. 17 which contains the initial three broad lines that determines the work of the Scientific Research Committee for the first year. In a similar way, the contents of the remaining 119 entries can be displayed.

Fig. 16: The random access IA.

The above mentioned method of displaying the contents of the IA is very handy to see the broad lines of work of any committee for any year directly. However, if we wish to see all contents of the array in one step, we have to see the 12 tables shown below. Every table shows the contents of the ten entries of the concerned committee.

Fig. 17: The screen displayed by clicking on the cell (2, 2016) in the IA.

5.2 Tables of the IA

The IA contains 12 tables. Every table characterizes the duties of the committee for 10 years which is the expected to be the life time of the project. It is worth noting that as the year gets farther from 2016, the broad lines become less accurate but remain able to draw the general directions. With the progress in the project, these broad lines become more mature and obvious in the light of the progress in the project. With this background of understanding, it was stated that in every year, a new issue of the work plan should be prepared by the committees. Every issue must be authorized as explained in previous sections. We show in the following the 12 tables that characterize the duties of the committees.

Characterization of Array Development committee duties

2016

1- Characterization of status reports that must be raised by other committees, their periodicity (quarterly, biannually or yearly), their studying bases and evaluation.

2- Setting a mechanism for developing the structure of the committees, their way of working and interaction between them for the final objective which is the best implementation of the project.

3- Characterization of the annual report of the array development committee.

2017

Evaluation of committees' structures and follow up mechanism, and suggesting any changes seems to be necessary, including adding or merging committees, in the light of the previous year evaluation.

Reconsidering the general characterization of reports in the light of the previous year experience.

Reconsidering the detailed items of the reports according to necessity.

2018

1- Reviewing the status of the project taking into account any new events.

Reevaluation of performance.

Reconsidering duties.

2019

1- Reviewing the status of the project taking into account any new events.

2-Reevaluation of performance.

3-Reconsidering duties.

2020

1- Reviewing the status of the project taking into account any new events.

2-Reevaluation of performance.

3-Reconsidering duties.

2021

Reviewing.

Revaluation.

Reconsideration.

2022

Reviewing.

Revaluation.

3-Reconsideration.

2023

1-Reviewing.

2-Reevaluation.

3-Reconsideration.

2024

1-Reviewing.

2-Reevaluation.

3-Reconsideration.

2025

1 – General review.

2 – General evaluation.

Concluding report.

Characterization of Scientific Research committee duties

2016

1- Setting appropriate scientific research axes and the aimed levels in accordance with the project level and nature.

2- Specifying local and international institutions and groups (universities, faculties, departments, research centers, etc.) that seem to be qualified to participate in the aimed research axes and topics.

3-Setting an appropriate mechanism to communicate with institutions and groups mentioned above, and coordinate with them to ensure effective and fruitful research cooperation.

2017

Laying down a plan to start research on topics agreed upon within AU and with other parties.

Laying down a plan to follow up the research activities according to the related plan for (graduation projects, Master and Ph. D. subjects, and research article topics).

Putting a mechanism for the actual start an follow up and directing the research work in the active subjects stressing on the necessity of reaching concrete achievements for subjects that need only one year period (graduation projects of the under graduate-last year, as an example).

2018

Updating and following up the short term subjects (graduation projects and Master topics, for example).

Continuing general supervision and evaluation of the status of the aimed scientific research program.

Laying down the broad lines of the research topics appropriate for intermediate level and advanced (long term) research work.

2019

Continuing supervision and following up to get specific results from the short term subjects (graduation projects and Master degree) started two years ago.

Follow up and general evaluation of the overall research program.

Reaching conclusion about the efficiency of the current research program, what have been realized and what can be suggested for improvement and development.

2020

Supervision, follow up, and new research subjects.

Evaluation of the results of the higher education (Master and Ph. D.) subjects, and reporting the conclusions.

Encouraging qualitative research subjects and suggesting a plan to apply for local and international patents high quality researches.

2021

Follow up classical studies done periodically and evaluation of the general status of the research program.

Discussing carefully and deeply the current status of the research activities for the purpose of reaching future outlook of better situation.

Crystallization of the Dedicated Labs for hot topics and assigning appropriate labs and advisors.

2022

Evaluation of completed Master and Ph. D. researches done individually and in common according to subject interrelations in order to specify the subjects of long term research topics.

Specifying the long term research topics and discovering their relations with internationally active topics and trying to integrate with them whenever possible.

Setting the long term research topics depending on the findings from 1 &2.

2023

1 – Follow up and evaluation of long term research worked on.

2- Pushing on working toward getting international prizes from the results of long term researches in the medical fields, and assigning good motivations for that purpose.

Laying down appropriate plan for the international prizes.

2024

1 – Obtaining detailed reports from the cooperating parties about the researches agreed about in the medium and long term researches with evaluation of the reached results.

2 - Evaluation of these reports.

3 –Conclusions and suggestions.

2025

General evaluation of the research activities (short, medium and long term) initiated by the APTC including those in cooperation with other parties.

Reevaluation of the overall status of the research program and its achievements, reconsidering the plans as seems to be necessary.

As far as research is concerned, where are we? Where should we reach? And how (What to do?).

Characterization of Human resources committee duties

2016

Specifying officers classes who must be employed by the APTC to work in full capacity (MD, Physician, Biomedical Engineer, etc.).

Preparing appropriate application forms to be filled by probable workers.

Exploring the ability of finding all aimed workers in Syria. In case that workers of some class are not available, thinking from where they can be attracted.

2017

Preparing addresses to start distributing application forms to qualified people willing to work in the APTC (Electronic application forms whenever possible).

Distributing application forms to aimed destinations.

Studying the incoming filled AFs and classifying candidates according to scientific degree, experience, etc.).

2018

Dividing accepted candidates into groups according to specialization (Physician, physicist, biomedical engineer, management, etc.).

Starting employment procedures according to necessity.

Coordinating with the company installing the equipment to prepare for appropriate training courses.

2019

Finding out candidates accepted to work in the center.

Preparing to launch a new wave of application forms for specializations of which insufficient or nobody applied.

Preparing to dispatch appropriate people to specialize in critical jobs if nobody applied after the second application forms campaign.

2020

Completing search for insufficient human resources.

Completing assignment procedures for accepted candidates.

Follow up affairs of officers dispatched for training or specialization.

2021

Completing assignment procedures for newly accepted candidates (if any).

Completing assignment procedures for specialists returned (if any).

Taking care of officers returned from training courses (if any).

2022

Taking care of experts of the company installing proton equipment.

Coordination between company experts and concerned officers in the center to gain required knowledge.

Taking care of affairs of dispatched officers and returning specialists and trainees, and distributing application forms according to necessity.

2023

Follow up affairs of returned specialists and trainees, and making sure that all staff required to operate the rooms to be delivered are available.

Taking the necessary procedures to provide any staff has to be but not available yet.

Follow up routine procedures in the center which should has provided the vast majority of operating team.

2024

Work on providing experts from AEC of Syria to make sure that shielding of the APTC facility is sufficient in preparation for center operation.

Taking care of providing any external experts might be necessary for center delivery.

Continuing taking care of installation experts who should have been almost finished their work.

2025

Making sure that the whole APTC operating team has been available.

Continuing routine duties towards the center.

Paying full attention to experts who will leave, and others to come for regular maintenance of the center.

Characterizing the duties of Financial Affairs committee

2016

Coordinating with the financer of the project to work with a very clear and firm mechanism.

Setting a plan to provide finance to treat some financially incapable patients.

Work on using electronic accounting system to provide accuracy, flexibility and speed in work.

2017

Looking after the routine financial affairs of the center.

Preparing a feasibility study considering the exploitation policy of the center and the current treatment costs.

Working on preparing a general accounting system including: income, inventories, investment, donations, salaries, wages, budget, etc.

2018

Routinely done affairs.

Continuing work on item 3 of last year titles and putting it in actual implementation.

2019

1 - Routine affairs.

2 - Preparing for testing the accounting system within the full automation system of the center.

2020

Routine affairs.

Testing the financial automation system within the general automation system of the center.

2021

Testing financial automation system within the general automation system and putting it in actual use.

2022

Continuing work with financial automation system and registering any remarks about it usage.

2023

Testing financial patients treatment system (reservation, cash advances, enrollment, treatment, etc.

2024

Continuing using financial patient treatment system and registering any remarks to be considered.

2025

Execution of the final test of the financial system and authorizing it in case of full functionality.

Characterizing the duties of Managerial Affairs committee

2016

Setting a managerial hierarchy in consistence with the structure of the APTC project.

The structure must include the necessary subjective information about staff (personal information, qualifications, experience, upgrades, dispatching, etc.).

Laying down a convenient mechanism to link the staff directories with concerned pivots in the center (general director, financial affairs, dispatching section, etc.).

2017

Providing a computer program to automate the managerial affairs taking in consideration its future integration with the full automating system of the project.

The managerial automating program must be built based on System Analysis and Design techniques. Due to the special nature of the APTC, it is not recommended to be bought as off-shelf program.

Taking in consideration linking the APTC with the AU in several pivots (Hospital, scientific research, etc.).

2018

Continuing work on managerial automation.

2019

Continuing work in managerial automation.

Taking in consideration the integration with the full automation project.

2020

Continuing work on managerial automation.

Taking in consideration the integration with the full automation project.

2021

Continuing work on managerial automation.

Taking in consideration the integration with the full automation project.

2022

Working on finishing the managerial automation to put it in actual use.

2023

Testing the managerial automation system individually and within the automation system of the APTC.

2024

Finishing the complete test process of the managerial automation system within the full automation system of the APTC and putting it in actual use.

2025

Making any final modification or refinement in the light of the actual use of the last year, and authorizing the system.

Characterizing the duties of Scientific Equipment committee

2016

Preparing a list of the equipment needed (or might be needed) by the APTC.

Preparing a table including the technical specifications of each device with current estimated prices.

Dividing equipment in item 1 into groups such that each group covers the need of a section or an integrated area in the center.

2017

Updating the equipment list according to necessity (discovered deficiencies, appearing of new technologies or approaches and any renewal or expansion in the center).

Updating the technical specifications and prices according to necessity.

Updating devices groups appropriately.

2018

– Updating equipment list.

- Updating technical specifications and prices.

Updating groups.

2019

1– Updating equipment list.

2- Updating technical specifications and prices.

3- Updating groups.

2020

1– Updating equipment list.

2- Updating technical specifications and prices.

3- Updating groups.

2021

1– Updating equipment list.

2- Updating technical specifications and prices.

3- Updating groups.

2022

1– Updating equipment list.

2- Updating technical specifications and prices.

3- Updating groups.

2023

1– Updating equipment list.

2- Updating technical specifications and prices.

3- Updating groups.

2024

1– Updating equipment list.

2- Updating technical specifications and prices.

3- Updating groups.

2025

1– Updating equipment list.

2- Updating technical specifications and prices.

3- Updating groups.

Characterizing the duties of Scientific Missions committee

2016

Specifying fields in which appropriate staff should be dispatched for specialization, training, research or whatever necessary for the APTC.

Determining number of people to be dispatched in every field and in all fields with the approximate date expected according to the project implementation plan.

Coordinating with Human Resources committee for item 2, especially upon receiving the application forms.

2017

Announcement of the need for candidates for the specializations the center needs according to the Human resources findings.

Selection of accepted candidates and working on their dispatching procedures.

Taking care of any other dispatching the center project may need.

2018

Preparing a dispatching system for specialization, training, exploring, coordination, special tasks, etc.

Coordination with Financial Affairs committee for item 1.

Coordination with Financial Affairs committee and Human Resources committee.

2019

Laying down an extensive mechanism for coordination with Human Resources committee.

Laying down an extensive mechanism for coordination with Managerial Affairs committee.

Laying down an extensive mechanism for coordination with Financial Affairs committee.

2020

Continuation of work according to systems and mechanisms reached last years.

Continuing of development and refinement in systems and mechanisms towards reaching better performance in the center.

Issuing an annual report about dispatches in the center with suggestions to reach better performance.

2021

Continuing work according to systems and mechanisms reached till now. These systems and mechanisms should have reached maturity.

Modifying systems and mechanisms, when necessary to accommodate any changes in the developing project.

2022

Continuing work according to systems and mechanisms reached till now.

Modifying systems and mechanisms, when necessary to accommodate any changes in the developing project.

2023

Continuing work according to systems and mechanisms reached till now.

Modifying systems and mechanisms, when necessary to accommodate any changes in the developing project.

2024

Continuing work according to systems and mechanisms reached till now.

Modifying systems and mechanisms, when necessary to accommodate any changes in the developing project.

2025

Continuing work according to systems and mechanisms reached till now.

Modifying systems and mechanisms, when necessary to accommodate any changes in the developing project.

Characterizing the duties of General Relationscommittee

2016

Specifying the essential pivots that may have an influence on the project.

Setting a plan to take care of relations with theses pivots.

Setting a plan for activities and procedures to provide the convenient atmosphere for coming foreigners like company experts and other related people to ensure fluency in work and goodness in quality of implementation. (For example: a meeting for all members of the committees with appropriate program to sharpen mettles and raise spirits. This must be after signing the contract with some company . This meeting may become periodical.

2017

Evaluation of performance in the last year and the effect of the used plan.

Suggesting any necessary modification in the plan in the light of the experience of the last year.

Taking in consideration getting approvals, starting manufacturing equipment and start building the center, and any modification in the plan.

2018

Evaluation of performance in the last year and the effect of the used plan.

Updating the plan in the light of the experience of the last year.

Planning and implementing some activities that gather the workers in the center in all levels, and improve domesticity and mutual understanding between them (Japanese style).

2019

Evaluation of performance in the last year and the effect of the used plan.

Updating the plan in the light of the experience of the last year.

Planning and implementing some activities that gather the workers in the center in all levels, and improve domesticity and mutual understanding between them (Japanese style).

2020

Evaluation of performance in the last year and the effect of the used plan.

Updating the plan in the light of the experience of the last year.

Planning and implementing some activities that gather the workers in the center in all levels, and improve domesticity and mutual understanding between them (Japanese style).

2021

Evaluation of performance in the last year and the effect of the used plan.

Updating the plan in the light of the experience of the last year.

Taking in consideration the start of equipment installation on the current plans.

2022

Evaluation of performance in the last year and the effect of the used plan.

Updating the plan in the light of the experience of the last year.

Taking in consideration the start of equipment installation on the current plans.

2023

Evaluation of performance in the last year and the effect of the used plan.

Updating the plan in the light of the experience of the last year.

Taking in consideration the start of the commissioning process and start of treatment of patients on the plans.

2024

Evaluation of performance in the last year and the effect of the used plan.

Updating the plan in the light of the experience of the last year.

Taking in consideration the start of the commissioning process and technical tests as well as having new treatment rooms in operation on the current plans.

2025

Evaluation of performance in the last year and the effect of the used plan.

Updating the plan in the light of the experience of the last year.

Taking in consideration the start the final authorization of the equipment and operation on the plans.

Characterizing the duties of Technical Specifications Books committee

2016

Coordinating with Scientific Equipment committee to get the necessary materials for the technical specifications book they wish to make.

Coordinating with the Contracts committee to get the materials they need for the specifications book.

Writing the specifications book using the material they got and complete it with needed conditions, guarantee, etc.

2017

Coordinating with Scientific Equipment committee to get the necessary materials to the technical specifications book they wish to make.

Coordinating with the Contracts committee to get the materials they need for the specifications book.

Writing the specifications book using the material they got and complete it with needed conditions, guarantee, etc.

2018

Same as above

2019

Same as above

2020

Same as above

2021

Same as above

2022

Same as above

2023

Same as above

2024

Same as above

2025

Same as above

Characterizing the duties of Contractscommittee

2016

Work to become familiar with external contract forms according to Fidic.

Preparing a form for typical contract for buying equipment, in general.

Preparing what might be necessary for external contract in Fidic form according to Syrian laws.

2017

Using the technical specifications book of the Proton Facility for the APTC prepared by the scientific consultant and reforming it in FIDIC form.

Taking care of any procedures necessary to sign the contract with the company which will install the equipment of the APTC.

2018

1 – Preparing any forms or conditions necessary for possible buying any secondary equipment (non-proton-use) according to local Syrian laws.

2- Keeping the external contract form updated according to any developments in this regard.

2019

Do what is necessary to have updated ready forms for any kind of local and external contracts that might be needed by the APTC.

2020

Do what is necessary to have updated ready forms for any kind of local and external contracts that might be needed by the APTC.

2021

Do what is necessary to have updated ready forms for any kind of local and external contracts that might be needed by the APTC.

2022

Do what is necessary to have updated ready forms for any kind of local and external contracts that might be needed by the APTC.

2023

Do what is necessary to have updated ready forms for any kind of local and external contracts that might be needed by the APTC.

2024

Do what is necessary to have updated ready forms for any kind of local and external contracts that might be needed by the APTC.

2025

Do what is necessary to have updated ready forms for any kind of local and external contracts that might be needed by the APTC.

Characterizing the duties of New Projectcommittee

2016

Working on this project starts after signing the contract with the Proton company.

2017

Exploring the need for a quality project in the medical field. This project should be unavailable or available with real need for its services.

Exploration involve types of illnesses in Syria where no (or much less than necessary) opportunities to treat them.

Performing a feasibility study for the new project.

2018

Continuing searching and exploration until a new project is found.

2019

Continuing searching and exploration until a new project is found.

2020

Continuing searching and exploration until a new project is found.

2021

Continuing searching and exploration until a new project is found.

2022

Continuing searching and exploration until a new project is found.

2023

Continuing searching and exploration until a new project is found.

2024

Continuing searching and exploration until a new project is found.

2025

Preparing a detailed study for the new project.

Characterizing the duties of Follow up and Automationcommittee

2016

Follow up the work status in the project whenever this was possible, and from periodical reports from all committees except Array development and the new project.

Preparing a general status report about the project using all reports from the other committees and the committee findings and raising it to the ADC.

Determining the periodicity of reports by coordination with Array Development committee.

2017

General status report.

Preparing a structural study for the project.

Preparing the Document Flow (DF) study for the projects.

2018

Periodical general status report.

Starting with Document Flow Diagrams (DFDs).

2019

1 - Periodical general status report.

2 – continuing with DFDs.

2020

1 - Periodical general status report.

2 – Logical and Design Diagrams.

2021

1 - Periodical general status report.

2 – Starting with programming automation programs.

2022

1 - Periodical general status report.

2 – Continuing with programming.

2023

- Periodical general status report.

2– testing patient reservation programs and fee payments with its related programs.

– registering any remarks about using the programs.

2024

- Periodical general status report.

– Putting reservation and payments programs in actual use.

–Testing automation programs with the Medical Information System of the proton facility, registering any remarks and repairing as necessary.

2025

1 –The extensive general status report.

– Final test of the automation system with all its related programs.

– Authorization of the automation system after considering any remarks about it.

 

6-Exploitation methodology

As we mentioned earlier, the exploitation methodology includes operation methodology and scientific research methodology. In other words, the way the project will be used to treat patients in a non-profit manner, and the way the scientific research in Syria will be supported.

 

6-1 Operation methodology

The APTC will devote 25% of treatment opportunities for ministries of defense, health and higher education, and Tartous prefecture, as well as some of financially incapable people, on an equal basis (5% each).

The remaining treatment opportunities will be divided half and half between Syrians and people from nearby countries. Syrians will pay using Syrian pounds according to formal exchange rate, and the others will pay using Dollars.

 

6-1-1 Distributing APTC revenues

The center will devote 25% of revenues to investors. Those who do not want to receive revenues, their share of the revenues will be devoted to incapable people treatment.

For operation and development of the center, 50% will be devoted.

6-2 Methodology of scientific research support

What remains from the APTC income, which is 25%, will be devoted to support scientific research in the five Syrian universities (Damascus, Aleppo, Tishreen, and AU), 5% each. The detailed rules of this support will be put later.

In fact, a share of the scientific research support will go to the other private universities through the in-common research projects that will be supported (see the scientific research committee plan). Some private universities may receive appreciable portion if it has active researchers who will participate in the scientific projects. Projects will be approved upon merit, not upon any other criterion.

7- What have we already realized in the project?

We have already done the following:

1 – The existence of Andalus Proton Therapy Center (APTC) in Syria has already been accepted and recognized by two of the most famous PTCs in the world: The Sweden Center "Uppsala" and the Japanese "PMRC". They accepted also to cooperate with us (letters show below).

2 – We have formed good background knowledge of proton therapy and its importance in cancer treatment in minds of wide slice of students, teaching staff and decision makers in the scientific harvest of 19/4/2014.

3– We have upgraded the knowledge level of fine details of proton therapy system constituents in Al Andalus University to an outstanding level by asking two teams to prepare a technical specification book for the AUPTC (one book by each team, independently). The two books are already prepared.

4– A piece of land of 10000 (ten thousands) square meters has been reserved for the project.

5– We have prepared a "clinical and technical specifications" book based on international standards prepared by the most famous laboratories in the world upon the request of National Institute of Health of the USA for proton facilities for the 21st century.

6- We have acquired the necessary knowledge of proton therapy process and its equipment so that we can negotiate with manufacturing companies to obtain the best performance with the best conditions for the APTC we are going to establish and operate.

7– We are establishing a scientific cooperation relation with Swedish Uppsala PTC where the first patient in the world outside USA was treated in 1957, 3 years after USA (the invitation letter from Uppsala to the Managerial and Financial consultant of the APTC shown below).

8– We are establishing for a scientific cooperation with the Japanese Proton Medical Research Center PMRC in Tsukuba University in Japan (near Tokyo). This center is the only one in Japan owned by a university, although there are more than 12 Hadron (proton and ion) Therapy Centers in Japan. This center has been treating patients with protons since 30 years, and it is Hospital-Based since 20 years.

9– We have scientific communications with LBL, the most famous proton therapy lab in the world (first patient was treated there in 1954).

Andalus Proton Therapy Center is doing its best to carry out Uppsala and PMRC visits as soon as possible to pursue efforts towards implementing the APTC project.

Andalus University has the full determination, the high confidence and the great hope to make the APTC a reality.

The invitation letter directed to the Managerial and Financial consultant Dr. Sami Azrak to visit the Swedish Uppsala proton therapy center.

The invitation letter directed to the scientific consultant Dr. Maan Ammar to visit the Japanese PMRC.

REFERENCES

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This publication is aimed at students and teachers involved in programmes that trains professionals for work in radiation oncology.it provides a comprehensive overview of the basic medical physics knowledge required in the form of syllabus for modern radiation oncology. It will be particularly useful for graduate students and residents in the in medical physics programmes, to residents in radiation oncology as well as to students in dosimetry and radiotherapy technology programmes. It will assist those preparing for their professional certifications in radiation oncology, medical physics, dosimetry or radiotherapy technology. It has been endorsed by several international and national organizations and the material presented has already been used to define the level of knowledge expected of medical physics worldwide.

Cyclotron Produced Radionuclides: Principles and Practice

Technical Reports Series No. 465, IAEA, 2008, ISBN 978–92–0–100208–2ISSN 0074–1914.

 

This book provides a comprehensive treatment of cyclotrons, with a special emphasis on production of radionuclides. Individual sections are devoted to accelerator technology, theoretical aspects of nuclear reactions, the technology behind targetry, techniques for preparation of targets, irradiation of targets under high beam currents, target processing and target recovery. This book will appeal to scientists and technologists interested in translating cyclotron technology into practice, as well as postgraduate students in this field

Egido Mauro, Radiation protection studies for CERN linac4/SPL accelerator complex, 2009, Lauzanne, Switzerland.

This doctoral dissertation conducted detailed studies on the CERN linac4/SPL complex, covering the following topics: radiation protection, proton accelerators, induced radioactivity, shielding design, FLUKA code.

Roelf Slopema, Basic Physics of Proton therapy, University of Florida, Proton Therapy Institute, 2011.

This document covers extensively the basic physics of proton therapy including Basic Interactions and Clinical Beams: Energy loss, scattering and nuclear interactions, lateral penumbra, excitation and ionization of atoms, loss per interaction, range secondary, stopping power, Bragg peak, nuclear interactions, skin dose, distal fall-off, proton vs. photon, integral dose, range compensator, aperture, clinical penumbra, air gap and penumbra and scanning penumbra.

E. M. Syresin, Centers of hadron therapy on the basis of cyclotron, joint institute for nuclear research, Dubna, Russia, 2008.

This document covers the following topics: JINR medical technical complex, requirement to medical proton beams, cyclotron centers of proton therapy, Dubna cyclotron center of proton therapy, formation of carbon radioactive primary beams.

Zuofeng lee, Proton therapy physics and techniques, Proton therapy institute, University of Florida, 2011.

This document covers comprehensively the physics and techniques of proton therapy with concentration on application techniques. Essentially, the following titles are covered: physical characteristics of charged particles beams, charged particles interactions, RBE of photons, carbon ions and proton delivery techniques.

E. B. Podgorsak, Treatment machines for external beam radiotherapy, McGill University, Montreal, Canada, 2007.

This lectures material consisting of 126 is slides based on chapter 5 of "Radiation Oncology Physics" book, IAEA, and its objective is: to familiarize students with basic principle of equipment used for external beam radiotherapy and all related considerations.

Richard P. Walker, the diamond light source: the synchrotron light source, Diamond, UK, 2009.

This document explains in details the biggest scientific investment in the history of UK. This synchrotron center produces a light with billions times the intensity of the sun light reaching the earth. This light has many applications in different fields of science.

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This document covers the physics of accelerators including: basic concepts in the study of particles accelerators, methods of accelerations linacs and rings), controlling the beam (confinement, acceleration, focusing), electrons and protons (synchrotron radiation, luminacity).


 

Related Articles and reports

1 – V. A. Anferov, et al, Indiana University cyclotron operation for proton therapy facility, Cyclotrons and their applications, 8 Int. Conf., pp. 231-233, 2007.

2- J. Kim, Proton therapy facility project in National Cancer Center, Korea, Journal of Korean Physical Society, Vol. 43, pp. 54-54, 2003.

3 – K. Noda, Status of particle therapy in Japan, Journal of Korean Physical Society, Vol. 59, No.2, pp.528-538, 2011.

4 – C. C. Kao, Synchrotron light sources: Review and perspectives, 15th International Conference on accelerator and beam applications, Gyeongiju, Korea, September, 29-30, 2011.

5 – M. Umezawa, Hitachi proton beam therapy system, Particle Beam Therapy Symposium, AAPM 55th meeting, 2013.

6 – A. Smith and H. Paganetti, Proton therapy, AAPM 50th annual meeting, 2008.

7- H. Pagnetti and T. Bortfeld, proton beam therapy: the state of the art, Springer Verlag Heidelberg, ISBN-3-540-00321-5, (36 pages), 2005.

8– Y. Kumata, Current status of proton therapy in Japan #2, the Japan-Russia cooperation seminar, Moscow, 2013.

9- Data collected from tens of proton related websites and used appropriately.