Research field

The research activities are related to 2 macroareas, i.e. biomedicine and hadron technology. It is noteworthy that, due to the interdisciplinarity approach of the PhD course, both areas may involve candidates with different backgrounds. 

Research activities in biomedicine 
The analysis of the clinical rational for the use of hadronthearpy is the core of research in biomedicine. The fundamental advantage of this therapeutic approach is the precise control of dose distribution on the patient’s tissues. The dose increment on the target, together with the dose decrease on the surrounding healthy tissues and organs allows optimizing the local control of the pathology, by reducing the toxicity risks related to radiotherapy. The presence of radioresistant tumors, or of tumors located in complex anatomical sites are among the main decision criteria in the selection of candidate patients for hadrontherapy. To avoid the risk of major damages to healthy tissues, it is necessary to accurately studying the tumor geometry and the anatomy of organs immediately out of target. Thus, the best conditions for therapy administration are individuated. Another important consideration in patients’ selection is related to the life expectation of the patients and to their global health conditions as the advantages of using hadrons rather than traditional radiotherapy are mainly related to the post-treatment toxicity. Finally, a very accurate evaluation of treatment feasibility, with a special focus on treatment set-up, tumor location and possible movements, daily reproduction of therapy treatments and planning, is needed. The application of advanced sensor techniques represents an important and innovative instrument for treatment optimization, aimed at improving precision and, as a consequence, at preserving healthy tissues surrounding the treatment areas. In addition to clinical evaluation of the effect on the tumor, it is also important to evaluate the systemic effect of hadrontherapy (abscopal effect), by studying the mechanisms of interaction with the immunological therapy nowadays considered as fundamental for cancer treatment.
Molecular Biology also represents an important field of investigation as the analysis of genetical characteristics of tumor cells has shown that cancer includes many different kinds of disease, with morphological-molecular features that strongly differ in terms of prognosis and treatment response. Finally, Artificial Intelligence algorithms undeniably represent a powerful tool in the phase of identification and characterization of tumors from radiological images with an ever more precise ability to identify and monitor all variations induced by treatment.
All these topics together represent a fundamental goal towards the concept of personalized medicine, clearly achievable by putting together different skills and different competences brought by different professional figures contributing to the success of the therapy performance. 

Research activities in instrumental technologies
The biomedical applications of high energy particles accelerators have always been an important subject in applied nuclear physics. Several structures are now in the building phase or are facing significant upgrades. Research on biomedical applications are among the most important objectives for these structures, due to the high impact on society healthcare. 
Accelerators may generate charged particles (hadrons) that, by exploiting the Bragg peak, can reduce tissue toxicity and enhance local control, if compared with conventional x-ray radiotherapy. CNAO as an institution, has 2 main objectives, i.e. research and healthcare, and offers PhD candidates the opportunity to work on radiation biophysics, radiobiology and other related research sectors. Typical activities include the development and test of beam monitor and dosimetry systems, 4D treatments (i.e. dose administration systems with improved ability of dose localization), dose control, radiobiology investigations and gantry design for carbon ions administration. In addition, at CNAO, they are studying the potentiality of employing novel heavy particles with enhanced intensity and energy and of ultrafast treatments in view of a further reduction of toxicity together with an enhanced local control of the tumor (flash radiotherapy). 
Soon, fast neutrons will be also available at CNAO, that is installing a new accelerator of low energy protons with a target for neutrons production. A new facility for patients’ treatment and for research will be soon available. This project, called Boron Neutron Capture Therapy (BNCT) is related to an experimental innovative radiotherapy based on the neutron irradiation of tumors after perfusion with a bore-enriched drug able to concentrate 10B atoms in tumor cells. Research on BNCT is a typical example of multidisciplinary activity, as it involves physicists and engineers for the design and realization of the beam and of the technology needed for patients’ irradiation. Chemists and biologists will be involved in the study and optimization of the Boron biodistribution and on the investigation of radiobiological effects. Medical physicists and physicians will set-up dosimetry and treatment planning for an optimized therapy management. 
As it can be deduced from the previous consideration, the complexity of these topics is such that the need of involving figures with different background is absolutely obvious. Our aim is that of favouring a transdisciplinary approach to complex problems in medical technology as well as that of building a scientific culture, stemming from hadrontherapy, able to promote its knowledge and diffusion not only in terms of clinical applications  but also for those technological innovations that in an interdisciplinary scenario may find the ideal background for the generation of new, industrially relevant,  products and services