The National Centre for Oncological Hadron therapy (CNAO): Present Status and Future Perspectives

Some elementary particles used for experiments of fundamental physics have properties useful to the treatments of patients affected by oncological pathologies. They are protons and carbon ions, collectively named hadrons, hence the term hadron therapy. Hadrons, in particular carbon ions, are more precise on the target than conventional X-rays and possess radiobiological characteristics suited to treat radioresistant or inoperable tumors. Italy is at the forefront of these techniques, and in Pavia a clinical facility called CNAO (Italian acronym that stands for National Centre for Oncological Hadron therapy) has treated so far more than 2800 patients with very good results. The CNAO was created by the Health Ministry and was realized by the CNAO Foundation in collaboration with the Italian Institute of Nuclear Physics (INFN), CERN, GSI and other institutions in Italy and abroad. The facility in Pavia delivers beams of hadrons in three treatment rooms with four fixed beam ports: three horizontal and one vertical. A new room, with an horizontal beamline and multiple isocenters, was completed and will be fully devoted to research applications. The CNAO has also launched a development programe to add a new single room for proton therapy with a gantry and a dedicated accelerator. Attention is also devoted to the most interesting aspects of research and development in the hadron therapy domain, like the creation of a new BNCT (Boron Neutron Capture Therapy) facility and the design of a novel gantry for carbon ions.