Abstract
Charged particles can achieve better dose distribution and higher biological effectiveness compared to photon radiotherapy. Carbon ions are considered an optimal candidate for cancer treatment using particles. The National Institute of Radiological Sciences (NIRS) in Chiba, Japan was the first radiotherapy hospital dedicated for carbon ion treatments in the world. Since its establishment in 1994, the NIRS has pioneered this therapy with more than 69 clinical trials so far, and hundreds of ancillary projects in physics and radiobiology. In this review, we will discuss the evolution of carbon ion radiotherapy at the NIRS and some of the current and future projects in the field.
Highlights
Particle therapy (PT), especially with heavy ions such as carbon, is an attractive radiation modality with significant physical and biological advantages over photon irradiation and deserves special attention with respect to patient selection, treatment planning, and delivery
Building on prior experiences with PT and the collaboration with the Lawrence Berkeley National Laboratory (LBNL) which has previously treated some patients with carbon particles in the 1970s, the decision to build the Heavy Ion Medical Accelerator in Chiba (HIMAC) was born in 1984 as part of a long-term cancer control plan in Japan
The National Institute of Radiological Sciences (NIRS) has realized the importance of accurate treatment planning in carbon ion radiotherapy (CIRT) and has developed its own software (HIPLAN) [38]
Summary
Particle therapy (PT), especially with heavy ions such as carbon, is an attractive radiation modality with significant physical and biological advantages over photon irradiation and deserves special attention with respect to patient selection, treatment planning, and delivery. The main debate, has always been whether these physical and biological advantages translate into clinical value to justify the high cost of construction and maintenance of PT centers and the increased treatment cost. This debate continues with strong opinions on both sides especially in the wider context of the socio-economic status of health-care delivery. The history of CIRT at the NIRS, the evolution of the technology and clinical practice, and the future advances in the field will be discussed
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