Fondazione CNAO – National Center of Oncological Hadrontherapy
Prof.ssa Lisa Licitra
The National Centre of Oncological Hadrontherapy (CNAO) in Pavia is a non-profit Foundation established in 2001 by the Italian Health Ministry.
The CNAO is an innovative and technologically advanced oncological center providing carbon ions and protons radiation therapy treatments for radio-resistant or inoperable tumors.
CNAO is one of the six radiotherapy centres in the world providing protons and carbon ions treatment. It is equipped with a particles accelerator labelled as a CE medical device by the Istituto Superiore di Sanità.
Hadrontherapy is an advanced form of radiotherapy taking advantages of carbon ions or protons. “Conventional” radiation therapy is based on using X rays’ effects. Carbon ions cause 3 times greater damage to DNA chain than that provoked by photons in the conventional radiotherapy; sparing healthy surrounding tissues.
Hadrontherapy is included in the Essential Assistance Levels and then erogated within the National Health System..
The collaboration with highly specialized Oncological Institutes is mandatory at CNAO, providing hadrontherapy treatments, alone or combined with surgery or chemotherapy, to the patients.
CNAO is an example of multidisciplinarity where highly qualified professional staff, from radiotherapy to medical physics, to radiobiology, to bioengineering, work in synergy to provide patients with an increasingly personalized treatment.
On the basis of defined and shared clinical protocols patients are pre‐selected and referred to CNAO for hadrontherapy, maintaining the link with their referring healthcare structures.
In order to verify the indication for hadrontherapy treatment, it is necessary a preliminary medical evaluation. If, due to its characteristics, the pathology is considered treatable, the patient will be contacted within one week to arrange his first appointment at CNAO.
On CNAO website are indicated the modalities to send the clinical documentations: https://fondazionecnao.it/en/access-to-treatment/foreign-patients
Clinical research radiobiological, medical physics and bioengineering research are the pillars of CNAO mission
The clinical research carried out at CNAO aims above all at collecting data demonstrating the evidence of this innovative radiotherapy relatively widespread in the world. Clinical research leads to an improvement of the therapies offered to patients. It can boast a preclinical basis that studies radio-resistance mechanisms, at cellular and molecular level, and of interactions between hadrons and drugs and of healthy tissues response, with radiobiology research.
The radiobiology research focused on the mechanism of radio-resistance, of interactions between hadrons and medicaments and of response of the healthy tissues.
The medical physics research focused on analysis to improve the procedures of the particle beam quality control and develop more and more precise and performant tools to treat tumors. The development of new ions that can be used for radiotherapy is the aim of research, in a context of international collaborations.
The bioengineering research in addition to develop novel devices concerning patient’s positioning and the treatment of tumors located in moving organs, is aimed to radiomics applied to hadrontherapy clinical results.
CNAO is committed in national and international collaborations in clinical and research field.
Till now CNAO has treated more than 3.000 oncological patients for whom hadrontherapy has proven to be the ideal approach in terms of both efficacy, tolerability and safety. The use of subatomic particles makes it possible to treat complex tumors, for which there are no others therapeutic options.
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