title: Carbon ion radiotherapy in Japan: an assessment of 20 years of clinical experience.
abstract: Charged particle therapy is generally regarded as cutting-edge technology in oncology. Many proton therapy centres are active in the USA, Europe, and Asia, but only a few centres use heavy ions, even though these ions are much more effective than x-rays owing to the special radiobiological properties of densely ionising radiation. The National Institute of Radiological Sciences (NIRS) Chiba, Japan, has been treating cancer with high-energy carbon ions since 1994. So far, more than 8000 patients have had this treatment at NIRS, and the centre thus has by far the greatest experience in carbon ion treatment worldwide. A panel of radiation oncologists, radiobiologists, and medical physicists from the USA and Europe recently completed peer review of the carbon ion therapy at NIRS. The review panel had access to the latest developments in treatment planning and beam delivery and to all updated clinical data produced at NIRS. A detailed comparison with the most advanced results obtained with x-rays or protons in Europe and the USA was then possible. In addition to those tumours for which carbon ions are known to produce excellent results, such as bone and soft-tissue sarcoma of the skull base, head and neck, and pelvis, promising data were obtained for other tumours, such as locally recurrent rectal cancer and pancreatic cancer. The most serious impediment to the worldwide spread of heavy ion therapy centres is the high initial capital cost. The 20 years of clinical experience at NIRS can help guide strategic decisions on the design and construction of new heavy ion therapy centres.
authors: National Institute of Radiological Sciences, Chiba, Japan.
authors: Tadashi
authors: T
authors: Kamada
authors: National Institute of Radiological Sciences, Chiba, Japan.
authors: Hirohiko
authors: H
authors: Tsujii
authors: Lawrence Berkeley National Laboratory, Berkeley, CA, USA.
authors: Eleanor A
authors: EA
authors: Blakely
authors: University of Heidelberg and Heidelberg Ion Therapy Centre, Heidelberg, Germany.
authors: Jürgen
authors: J
authors: Debus
authors: University of Ghent, Ghent, Belgium.
authors: Wilfried
authors: W
authors: De Neve
authors: GSI Helmholtz Center for Heavy Ion Research and Darmstadt University of Technology, Darmstadt, Germany. Electronic address: m.durante@gsi.de.
authors: Marco
authors: M
authors: Durante
authors: University of Heidelberg and Heidelberg Ion Therapy Centre, Heidelberg, Germany.
authors: Oliver
authors: O
authors: Jäkel
authors: MedAustron, Wiener Neustadt, Austria.
authors: Ramona
authors: R
authors: Mayer
authors: CNAO Foundation, Pavia, and European Institute of Oncology, Milan, Italy.
authors: Roberto
authors: R
authors: Orecchia
authors: Medical University of Vienna, Vienna, Austria.
authors: Richard
authors: R
authors: Pötter
authors: MedAustron, Wiener Neustadt, Austria.
authors: Stanislav
authors: S
authors: Vatnitsky
authors: Lawrence Berkeley National Laboratory, Berkeley, CA, USA.
authors: William T
authors: WT
authors: Chu
mesh_terms: D002244:Carbon / Q000627:therapeutic use*; D063193:Heavy Ion Radiotherapy; D006801:Humans; D007564:Japan; D009369:Neoplasms / Q000532:radiotherapy*; D013997:Time Factors
chemical_list: D002244:Carbon