Radiotherapy is an important pillar of modern multidisciplinary tumor treatment and is an essential element for tumor recovery in more than 50% of all cancer patients. Advanced radiotherapy was born in Trentino more than 70 years ago, in 1953, with the first European telecobalt radiotherapy unit in Borgo Valsugana and subsequently in Trento. The Proton Therapy Center now has 10 years of clinical service in the field of Radiotherapy network of Trentino Alto Adige (Radiotherapy oncology of Trento, Protontherapy of Trento, Radiotherapy of Bolzano, which, together, provide all types of high-tech radiotherapy available) and is fully integrated into all oncology activities in Trentino and in national and international networks.
The Proton Therapy Center, the only completely public center in Italyserves patients from Trentino and South Tyrol (approximately 20% of the activity) and is also available, approximately 70% of its volume of activity, to patients coming from outside the region and 10% to international patients.
To date, the center has treated more than 2400 patients of which approximately 25% are pediatric, all falling within the categories covered by the Essential Levels of Assistance (LEA) and currently authorised, for patients coming from outside Trentino, on an individual basis, given the The activation of the National Tariff Nomenclature is now expected no earlier than January 2025.
«The indications for proton therapy include the “classic” ones, for which the physical characteristics of protons – he explained the director of the Center Frank Lohr – translate into favorable clinical results in the case of chordomas, chondrosarcomas and other soft tissue tumors, as well as in some particular head and neck tumors, a subgroup of tumors of the parotid and paranasal sinuses, some brain tumors, pediatric malignancies and malignant tumors in young adults (in addition to tumors of the central nervous system and sarcomas, also lymphomas and other mediastinal tumors), in which proton therapy is increasingly considered a favorable option. Proton therapy is also increasingly used in retreatment situations (i.e. when the patient has already undergone radiotherapy to the same disease site in previous years), for example in breast or lung cancer for individual patients. A significant amount of high-quality clinical data currently published or arriving in the near future could broaden the indications for the use of protons, further strengthening the position of radiotherapy as a determining factor in the treatment of tumors.”
After the clinical launch of the center in 2014 and the first treatment of a pediatric patient in 2015, the physicists, doctors and medical radiology technicians, in collaboration with the center’s radiologists, anesthetists and nursing staff, introduced several new treatment techniques borrowing from what is in progress in photon radiotherapy, such as verification of treatment near-line, l’imaging pre-treatment on-line, il gating respiratory for the treatment of tumors that move with breathing, radiosurgery and, more recently, quasi-rotational treatments implemented in Trento for the first time in the world.
This has led to several records at the national and international level and has allowed the center to become one of the few in the world capable of performing treatments, when indicated, on every part of the body with the highest quality, in optimal integration with photon radiotherapy and systemic oncological treatments.
These results have allowed Apss, in a collaborative effort between different operational units, to enter one international study potentially able to change practice for a subgroup of patients with esophageal cancer and to promote one national multicenter study on the treatment of malignant cardiac arrhythmias. Both studies will launch in early 2025.
The Trento proton therapy center is also unique on an international level as it has in addition to two rooms for clinical treatments, Of an experimental room which offers the possibility, in collaboration for example with the Institute of Fundamental and Applied Physics of Trento (TIFPA) and UniTN, to carry out preclinical studies that will prepare for the clinical application of new biological treatment paradigms such as ultrafast radiotherapy (FLASH) and the application of inhomogeneous doses, which can further improve the immune response against tumors and their metastases together with systemic immunotherapy.
Investments recently approved by the Autonomous Province of Trento and financing provided by CariTRO will allow, on the one hand, to create a imaging online fast on a clinical Gantry, further facilitating the treatment of moving tumors, and on the other to allow the execution of preclinical experiments on the experimental beam with the same characteristics as the clinical beam (beam scanning), to further improve the transfer from preclinical experiments to clinical application.
The center will therefore bethe only Italian center equipped with a full rotation Gantry and also with Imaging volumetric pre-treatment on-boardand one of the few centers in the world with the above-mentioned possibilities of experimental beam activity, preparing for further improvements in oncological outcomes in a multidisciplinary context in the next decade.
The one who brought the greetings and the “warm happy birthday from Mayor Ianeselli” was deputy mayor of the Municipality of Trento Elisabetta Bozzarelli: «It is an honor to be here to celebrate ten years of this center of excellence. Betting, as Trentino did, on the search for increasingly innovative treatments has proven to be a highly prospective choice for our community, not only local, but national. For Trento it is a source of great pride to know that here patients receive high-level care and also the precious assistance of social volunteers. The families return home with Trento in their hearts, for the high value of the care received and the welcome reserved for them.”
«These ten years – declared the general director of Apss Antonio Ferro – I am part of a Trentino story that started a long time ago, in Borgo Valsugana, with the first cobalt therapy. In the field of radiotherapy, Trentino has been innovative and continues to be, with this proton therapy centre, the only public one in Italy.” Ferro does not hide the difficulties in confirming the initial economic balance sheet prospects, but he convincingly maintains that «the School of Medicine has given us the opportunity to relaunch a center that has enormous potential in terms of research. The prospect will therefore be to develop experimental lines of work that will offer very interesting treatment opportunities, in terms of cardiac arrhythmias, retinal, lung and breast tumors. These ten years are therefore not the point of arrival but an important relaunch point that opens up lines of study that demonstrate the effectiveness of proton therapy. To conclude, I want to thank all the professionals of the centre, physicists, technicians, nurses, doctors and administrators represented by their coordinators Lorentini, Fava, Occoffer and the directors Amichetti, Cianchetti and Lohr, and finally the volunteers of the associations who with their precious contribution help us they help make a difference in terms of the quality of care provided. All together and in close collaboration with the APSS operational units, they have been able to give a strong boost to the future development of the center and in terms of numbers: we hope to reach 340-350 patients treated by the end of the year.”
«I am very happy to celebrate 10 years of the Trento Proton Therapy Center – he highlighted councilor Mario Tonina – a structure which, since its opening, has represented a point of reference for excellence in the treatment of tumors with the use of protons, for both adult and pediatric patients. In these ten years, more than 2,400 patients, of which 25% pediatric, have been able to benefit from cutting-edge care, thanks to the commitment of a multidisciplinary team and the innovative technologies of this Trentino excellence. An excellence that integrates well with the territory and in which we are investing with perspective: in fact, I want to remind you that the important process for the creation of the new Trentino pediatric hospice is continuing, which will be built in a strategic area close to the proton therapy center and the university hospital, a project that marks a further step towards the integration of health services to respond in an increasingly effective and above all humane manner to the needs of younger patients and their families”. The councilor also wanted to highlight the many agreements that link the Trentino Center with other regions, including the latest one with the autonomous Province of Bolzano, which «confirm the supra-regional role of the Center – explained Tonina –. We work to guarantee highly specialized care and continue to be a model of excellence at a national level, and this in perspective also with the birth of Asuit, the integrated territorial university healthcare company, increasingly in synergy with the School of Medicine and Surgery of the University of Trento, active for four years and committed to training the professionals of the future, and with the future university hospital center of Trentino”, concluded the councilor.
Interview with health councilor Mario Tonina
Interview with director of the proton therapy unit Frank Lohr
Downloadable photos by the Apss communications office Who .
Downloadable video report by the Pat press office Who .
