How is process

The professional experts who lead the Hospital’s Proton Therapy Unit adopt a clear, multidisciplinary approach to plan the best-possible treatment for your cancer.

Personalized medicine

Our specialists, who are internationally renowned in cancer treatment, work as a team to offer the best solution for each patient.

The Clinica Universidad de Navarra´s Proton Therapy Unit is the first facility of its kind located within an inpatient cancer center, with all the patient-care, academic and research support this entails. 

It is part of the Cancer Center Clínica Universidad de Navarra, an international reference center in cancer diagnosis and treatment, as well as in the development of the most advanced bespoke therapies against cancer, with interdisciplinary oncological areas and access to clinical trials and international research projects.

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Learn about the proton treatment process

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Initial evaluation appointment

The patient will be evaluated by our specialists to establish the indication for treatment with proton therapy. This process is carried out with their referring physicians through personalized communications and with sufficient documentation.

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A simulation is then programmed, i.e. high-quality radiological images are obtained through CT scan, MRI and/or PET–CT of the anatomical region that is affected by cancer and susceptible to treatment, as well as the nearby organs.

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Dosimetry planning

The clinical team (oncologists, dosimetrists and radio physicists) prepares an irradiation plan aimed at the most beneficial technical option for optimal dose distribution. The irradiation plan is accepted by consensus on the part of the specialists involved (physicians and physicists), and is then tested in dosimetry phantoms.

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Pretreatment appointment

During this appointment, the details of the treatment are explained (number of sessions, number and incidence of radiation beams, characteristics and duration of the process in the treatment room, schedules established, expected side effects, monitoring of progress during a weekly medical checkup or nursing appointment depending on the need for symptomatic support, and a request for informed consent). 

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Lastly, the specific treatment phase is started in the proton therapy room. This includes positioning on a 6D robotic table with automated programmed movements and daily verification of the reproducibility of the positioning established in the initial planning. This means the use of masks or immobilization devices, verification using (external) lasers, obtaining a cone-beam volume CT (internal anatomy registration), using fusion software to check the concordance of daily positioning images with the initial CT planning and finally gantry (head guiding the protons) movement to its firing angle(s) (incidence).

Once the radiation has been applied, the immobilization systems are removed, and the patient is moved to the changing room. Most patients can resume their daily activities.

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Discharge appointment

After proton therapy treatment, a discharge appointment is scheduled to evaluate tolerance and determine the care guidelines to be followed over the first few weeks. A final treatment report is handed over, and a medium- and long-term progress follow-up plan is presented.