The CATANA (Centro di AdroTerapia e Applicazioni Nucleari Avanzate) facility was born from a collaboration between Laboratori Nazionali del Sud (LNS) of the Istituto Nazionale di Fisica Nucleare, the Physics Department, the Ophtalmology Institute and the Radiology Institute of the Catania University and of the CSFNSM (Centro Siciliano di Fisica Nucleare e Struttura della Materia).
CATANA was the first Italian center where protontherapy for tumors treatment was applied and still is the unique Italian center where is possible to treat ocular melanoma with proton beams.
The first patient was treated in 2002 and, since then, 300 patients (2016) have been successfully treated. Ocular protontherapy is the treatment of choice in most ocular and orbital tumors, due to the high conformal treatment isodoses and the ability to spare the healthy surrounding tissues better than photon-beam treatment techniques. Despite this, due to the local extension and location of disease onset, the development of radiation-induced damages is often unavoidable. In our experience, radiation retinopathy of various degree was seen in 22% of patients, radiation-induced cataract was detected in 35% of patients, neovascular glaucoma developed in 18% of patients. Cause-specific survival was 92%, since 18 patients affected by uveal melanoma and 3 affected by other tumors died from metastatic disease. Ocular melanoma, both uveal or conjunctival, has a strong tendency to metastasize, especially in the liver, after many years from diagnosis, regardless of the local control of the primary tumor.
In addition to the clinical treatments, many activities have been carried out and are currently ongoing around the proton therapy facility: new detectors and dosimeters characterization, radiation damage studies, irradiation of cellular samples for biological studies, Monte Carlo simulations, studies of new irradiation and treatments modalities.