Reengineering of radiotherapy

The kick-off meeting of the ICEC–CERN project, STELLA, “Re-engineering the Next Generation of Medical Linear Accelerators for Use in Challenging Environments” was held at CERN from 29 to 30 May. (Image: CERN)

The annual number of cancer cases is expected to increase by more than 40% by 2040, with the vast majority of cancer deaths expected to occur in low- and middle-income countries (LMICs). More than 15,000 electron linear accelerators (linacs) are used worldwide to treat tumors with X-ray beams, but only a fraction of patients in LMICs who could benefit from radiotherapy have access to them. In African countries, for example, there is approximately one radiotherapy machine for every 3.5 million people, compared with one for every 80,000 to 100,000 people in the United States and many European countries. LMICs also face challenges such as ageing devices, delays in obtaining spare parts, frequent power outages that affect the lifespan of equipment, lack of certified and qualified personnel to operate and maintain linacs, and continued reliance on cobalt-60 external beam radiotherapy devices.

The STELLA (Smart Technologies to Extend Lives with Linear Accelerators) project aims to change the paradigm of cancer care worldwide. Launched at a CERN workshop in 2016 by the International Cancer Expert Corps (ICEC) in collaboration with the UK Science and Technology Facilities Council, UK universities and partners from African countries, the project aims not only to design and prototype a radiotherapy treatment system suitable for harsh environments, but also to significantly change the way the industry meets the needs of people with cancer around the world. Central to this effort is the development of integrated software that accurately predicts failures, streamlines maintenance and guides physicians, as well as the use of creative training and maintenance approaches that build local expertise and reduce downtime of radiotherapy facilities.

“While the linac is a central element of STELLA, the fastest growing areas of radiotherapy are imaging and data analysis systems for diagnosis and the use of AI and machine learning for treatment planning,” says CERN’s Steinar Stapnes, who is leading the design studies for the STELLA radiotherapy system. “CERN has expertise in all these areas, including the integration of accelerator and detector systems, using open hardware and software solutions, with clear interfaces for maintenance and future improvements.”

From 29 to 30 May 2024, members of the multidisciplinary STELLA alliance returned to CERN to launch the next phase of the project. Thanks to funding of 1.75 MUSD granted to ICEC by the United States Department of Energy, CERN and ICEC have signed an agreement to conduct an 18-month “pre-design” study in collaboration with the UK universities of Oxford, Cambridge and Lancaster and a network of 28 low- and middle-income countries. The aim is to develop the specifications of a radiotherapy device to a level where the collaboration can begin discussions with industrial partners, foundations, non-governmental organisations and governments interested in investing in cheaper and more robust solutions.

“Powered by a recently signed agreement between CERN and ICEC and funding from the United States Department of Energy, “The STELLA project continues to move forward with great enthusiasm and determination,” says Manjit Dosanjh, ICEC Project Manager and Visiting Professor at the University of Oxford. “STELLA is a great opportunity for CERN and the particle physics community to demonstrate how their ingenuity, skills and expertise can contribute to solving global health problems.”

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For more information, visit:

https://www.iceccancer.org/innovative-radiotherapy-technologies/

https://cerncourier.com/a/linacs-to-narrow-radiotherapy-gap/

https://cerncourier.com/how-to-democratise-radiation-therapy/

https://cerncourier.com/a/developing-medical-linacs-for-challenging-regions/