A proton therapy cycle consists of administering multiple doses of radiation during weekly therapy sessions, performed daily from Monday to Friday based on what was defined in the specific treatment plan. Generally, a cycle lasts five to six weeks.

Daily treatments are performed based on the indications received from the medical radiation technicians at the gantry, the treatment room.

Proton Therapy is a precision radiation treatment that uses heavy particles, protons, to irradiate tumour cells. The physical characteristics of the proton beams allow extremely precise dose delivery, thus preventing the involvement of the surrounding healthy tissues.

To deliver the therapy, a particle production device, or cyclotron, is required along with the beam transport and release system.

During the treatment, the patient is positioned on a bed inside the gantry, the structure that directs the radiation by rotating 360° around the patient.

The Trento Proton Therapy Centre is equipped with two treatment rooms for patients and one for experimental use and research, with a fixed beam.

Useful information

Patients do not need to fast in order to undergo proton beam therapy. If fasting is required, the medical staff at the Trento Proton Therapy Centre will inform the patient.

During treatment, the patient may be in contact with their family members, including children, and conduct a normal work and social life.

The patient may feel particularly tired and need to reduce or modify their activities and daily habits, especially during the conclusive stages of the therapy.

Treatment calls for several sessions and it is recommended that they be performed without interruptions. If treatment must be suspended due to technical or medical reasons (possible side effects) or for major personal problems, the Trento Proton Therapy Centre guarantees the complete recovery of the sessions that were not performed.

Evaluation of the clinical case

The choice to undergo a proton therapy cycle is up to the patient, in agreement with the physicians at the operating unit, and is authorized following the evaluation of the clinical documentation and physical condition, and after discussion within the group of specialists at the facility.

After having performed the evaluations, the patient is provided supplementary information on proton beam therapy in relation to the specific case, potential advantages, possible side effects, and execution methods.

Once treatment with protons is indicated as being suitable for the particular case, the nursing staff will provide the patient with all information that will help them deal with therapy in the best possible manner, including tips related to conduct and dietary indications aimed at limiting the occurrence of side effects.

Simulation of the proton therapy treatment

Before the patient undergoes the actual therapy, a treatment simulation must be performed.

The patient must report to the Proton Therapy Centre on the date of the appointment. After checking in, the nurse or a medical technician will accompany them to the CT/MRI area.

This simulation phase is important because it allows certain aspects that go along with the therapy and are useful for effectively performing the treatment in a personalized and reproducible manner.

In particular, the following will be done:

• identification of a position that can be reproduced during the proton beam therapy sessions and a custom immobilizing system made up of pillows, masks, and positioning systems;
• a CT simulation scan that will acquire the images needed to develop a personalized treatment plan. This operation could require a contrast agent and, if so, the patient will need to sign a consent form.

In some cases, an MRI may need to be performed in order to acquire further indications needed to define a treatment plan. A contrast agent may also be needed in this case and, if so, the patient will need to sign a consent form. Usually, the MRI is performed on a different day than the CT scan.

Once the simulation phase is complete, the patient will need to wait for the treatment plan to be processed and verified by the medical group. This operation requires about a week.

Once all of the aspects related to the proton beam therapy have been defined, the patient will be informed of the day and time treatment will commence.

Treatment and checks

On the days dedicated to the proton beam therapy, the patient will be greeted and accompanied to the treatment room by the medical personnel at the Trento Proton Therapy Centre. They will be asked to sit on the gantry bed and will be immobilized according to the positioning defined during the simulation.

Once the radiographic checks have been performed to make sure the positioning is correct, the patient will receive the actual proton treatment.

During the radiation treatment, the gantry staff continuously monitor and explain the different phases of the procedure from an adjacent room using a closed-circuit video camera system and via an intercom. 

Each week during treatment, or more frequently if necessary, the medical and nursing staff performs medical examinations that may require blood tests. During these stages, the patient may be asked to fill out questionnaires regarding the treatment or illness.

Once the proton beam treatment is complete, the patient will be examined. At this time, any home medical treatments will be prescribed, they will be given the programme for follow-up medical check-ups, and they will receive the conclusive report to be taken to their family doctor and/or specialist.

Check-up frequencies and methods vary from case to case. During each visit, the clinical response, any side effects, and any diagnostic tests prescribed will be evaluated. Once again, questionnaires regarding the treatment or illness may be required.

The question of where the patient receiving proton beam therapy and their family will stay is very important because patients and their families must be peaceful and comfortable.

Information on hotels and accommodation with special fees for patients and their carers is available on the website of the Trento, Monte Bondone, and Valle dei Laghi Tourism Company: Accommodations for patients at the Trento Proton Therapy Centre .

Those who prefer may consider the possibility of staying in dedicated flats.  

For adults, the Casa Accoglienza LILT (Lega Italiana per la Lotta contro i Tumori Sezione Provinciale di Trento ONLUS) is available and is located near the Ospedale Santa Chiara in Trento, which makes accommodations available to patients who must undergo proton beam therapy and do not need to be hospitalized, along with the families or carers. In particular, the following are available:

• double or single rooms with bath, sleeping a total of 22;
• two shared kitchens for preparing meals;
• two sitting areas;
• appliances for washing, drying, and ironing clothes;
• bed and kitchen linens.

For more information: tel. 0461.390546 | casaaccoglienza@lilttrento.it
Casa Accoglienza LILT, Via Nicolodi n. 19, Trento

For paediatric patients and their families:

For paediatric patients, LILT offers a flat near the Proton Therapy Centre with two double rooms and baths, sleeping a total of five.

Guests will have a shared kitchen, sitting area, and appliances to wash, dry, and iron clothes. Bed linens are also provided.

For information call 0461.922733

Plus, the diocese of Trento makes a flat available which has: three double and two single rooms, all equipped with baths; a shared kitchen for preparing meals; and appliances to wash, dry, and iron clothes. Bed linens are also provided upon request.

The flat is located in via Endrici no. 27, Trento

For more information: silvia.iseppi@hotmail.it