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href="#Passive_scattering_beam_delivery"> <div class="vector-toc-text"> 3.1 Passive scattering beam delivery </div> </a> <ul id="toc-Passive_scattering_beam_delivery-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Pencil_beam_scanning_beam_delivery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Pencil_beam_scanning_beam_delivery"> <div class="vector-toc-text"> 3.2 Pencil beam scanning beam delivery </div> </a> <ul id="toc-Pencil_beam_scanning_beam_delivery-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Application" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Application"> <div class="vector-toc-text"> 4 Application </div> </a> <button aria-controls="toc-Application-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Application subsection </button> <ul id="toc-Application-sublist" class="vector-toc-list"> <li id="toc-Pediatric" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Pediatric"> <div class="vector-toc-text"> 4.1 Pediatric </div> </a> <ul id="toc-Pediatric-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Eye_tumor" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Eye_tumor"> <div class="vector-toc-text"> 4.2 Eye tumor </div> </a> <ul id="toc-Eye_tumor-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Base_of_skull_cancer" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Base_of_skull_cancer"> <div class="vector-toc-text"> 4.3 Base of skull cancer </div> </a> <ul id="toc-Base_of_skull_cancer-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Head_and_neck_tumor" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Head_and_neck_tumor"> <div class="vector-toc-text"> 4.4 Head and neck tumor </div> </a> <ul id="toc-Head_and_neck_tumor-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Left-side_breast_cancer" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Left-side_breast_cancer"> <div class="vector-toc-text"> 4.5 Left-side breast cancer </div> </a> <ul id="toc-Left-side_breast_cancer-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Lymphoma" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Lymphoma"> <div class="vector-toc-text"> 4.6 Lymphoma </div> </a> <ul id="toc-Lymphoma-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Prostate_cancer" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Prostate_cancer"> <div class="vector-toc-text"> 4.7 Prostate cancer </div> </a> <ul id="toc-Prostate_cancer-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Gastrointestinal_malignancy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Gastrointestinal_malignancy"> <div class="vector-toc-text"> 4.8 Gastrointestinal malignancy </div> </a> <ul id="toc-Gastrointestinal_malignancy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Hepatocellular_carcinoma" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Hepatocellular_carcinoma"> <div class="vector-toc-text"> 4.9 Hepatocellular carcinoma </div> </a> <ul id="toc-Hepatocellular_carcinoma-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Reirradiation_for_recurrent_cancer" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Reirradiation_for_recurrent_cancer"> <div class="vector-toc-text"> 4.10 Reirradiation for recurrent cancer </div> </a> <ul id="toc-Reirradiation_for_recurrent_cancer-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Comparison_with_other_treatments" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Comparison_with_other_treatments"> <div class="vector-toc-text"> 5 Comparison with other treatments </div> </a> <button aria-controls="toc-Comparison_with_other_treatments-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Comparison with other treatments subsection </button> <ul id="toc-Comparison_with_other_treatments-sublist" class="vector-toc-list"> <li id="toc-X-ray_radiotherapy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#X-ray_radiotherapy"> <div class="vector-toc-text"> 5.1 X-ray radiotherapy </div> </a> <ul id="toc-X-ray_radiotherapy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Surgery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Surgery"> <div class="vector-toc-text"> 5.2 Surgery </div> </a> <ul id="toc-Surgery-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Side_effects_and_risks" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Side_effects_and_risks"> <div class="vector-toc-text"> 6 Side effects and risks </div> </a> <ul id="toc-Side_effects_and_risks-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Costs" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Costs"> <div class="vector-toc-text"> 7 Costs </div> </a> <ul id="toc-Costs-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Treatment_centers" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Treatment_centers"> <div class="vector-toc-text"> 8 Treatment centers </div> </a> <button aria-controls="toc-Treatment_centers-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Treatment centers subsection </button> <ul id="toc-Treatment_centers-sublist" class="vector-toc-list"> <li id="toc-United_States" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#United_States"> <div class="vector-toc-text"> 8.1 United States </div> </a> <ul id="toc-United_States-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Outside_the_US" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Outside_the_US"> <div class="vector-toc-text"> 8.2 Outside the US </div> </a> <ul id="toc-Outside_the_US-sublist" class="vector-toc-list"> <li id="toc-Australia" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Australia"> <div class="vector-toc-text"> 8.2.1 Australia </div> </a> <ul id="toc-Australia-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-India" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#India"> <div class="vector-toc-text"> 8.2.2 India </div> </a> <ul id="toc-India-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Israel" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Israel"> <div class="vector-toc-text"> 8.2.3 Israel </div> </a> <ul id="toc-Israel-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Spain" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Spain"> <div class="vector-toc-text"> 8.2.4 Spain </div> </a> <ul id="toc-Spain-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-United_Kingdom" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#United_Kingdom"> <div class="vector-toc-text"> 8.2.5 United Kingdom </div> </a> <ul id="toc-United_Kingdom-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> 9 See also </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> 10 References </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> 11 Further reading </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> 12 External links </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Table of Contents" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" > Toggle the table of contents </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading">Proton therapy</h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 27 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-27" aria-hidden="true" > 27 languages </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%B9%D9%84%D8%A7%D8%AC_%D8%A8%D8%A7%D9%84%D8%A8%D8%B1%D9%88%D8%AA%D9%88%D9%86%D8%A7%D8%AA" title="علاج بالبروتونات – Arabic" lang="ar" hreflang="ar" data-title="علاج بالبروتونات" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target">العربية</a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%9F%D1%80%D0%BE%D1%82%D0%BE%D0%BD%D0%BD%D0%B0_%D1%82%D0%B5%D1%80%D0%B0%D0%BF%D0%B8%D1%8F" title="Протонна терапия – Bulgarian" lang="bg" hreflang="bg" data-title="Протонна терапия" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target">Български</a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Ter%C3%A0pia_de_protons" title="Teràpia de protons – Catalan" lang="ca" hreflang="ca" data-title="Teràpia de protons" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target">Català</a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Protonov%C3%A1_l%C3%A9%C4%8Dba" title="Protonová léčba – Czech" lang="cs" hreflang="cs" data-title="Protonová léčba" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target">Čeština</a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Protonterapi" title="Protonterapi – Danish" lang="da" hreflang="da" data-title="Protonterapi" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target">Dansk</a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Protonentherapie" title="Protonentherapie – German" lang="de" hreflang="de" data-title="Protonentherapie" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target">Deutsch</a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Protonterapia" title="Protonterapia – Spanish" lang="es" hreflang="es" data-title="Protonterapia" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target">Español</a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Protonoterapio" title="Protonoterapio – Esperanto" lang="eo" hreflang="eo" data-title="Protonoterapio" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target">Esperanto</a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%BE%D8%B1%D9%88%D8%AA%D9%88%D9%86%E2%80%8C%D8%AF%D8%B1%D9%85%D8%A7%D9%86%DB%8C" title="پروتون‌درمانی – Persian" lang="fa" hreflang="fa" data-title="پروتون‌درمانی" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target">فارسی</a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Protonth%C3%A9rapie" title="Protonthérapie – French" lang="fr" hreflang="fr" data-title="Protonthérapie" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target">Français</a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%96%91%EC%84%B1%EC%9E%90_%EC%B9%98%EB%A3%8C" title="양성자 치료 – Korean" lang="ko" hreflang="ko" data-title="양성자 치료" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target">한국어</a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D5%8A%D6%80%D5%B8%D5%BF%D5%B8%D5%B6%D5%A1%D5%B5%D5%AB%D5%B6_%D5%A9%D5%A5%D6%80%D5%A1%D5%BA%D5%AB%D5%A1" title="Պրոտոնային թերապիա – Armenian" lang="hy" hreflang="hy" data-title="Պրոտոնային թերապիա" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target">Հայերեն</a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Protonterapia" title="Protonterapia – Italian" lang="it" hreflang="it" data-title="Protonterapia" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target">Italiano</a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%94%D7%A7%D7%A8%D7%A0%D7%AA_%D7%A4%D7%A8%D7%95%D7%98%D7%95%D7%A0%D7%99%D7%9D" title="הקרנת פרוטונים – Hebrew" lang="he" hreflang="he" data-title="הקרנת פרוטונים" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target">עברית</a></li><li class="interlanguage-link interwiki-mn mw-list-item"><a href="https://mn.wikipedia.org/wiki/%D0%9F%D1%80%D0%BE%D1%82%D0%BE%D0%BD_%D1%8D%D0%BC%D1%87%D0%B8%D0%BB%D0%B3%D1%8D%D1%8D" title="Протон эмчилгээ – Mongolian" lang="mn" hreflang="mn" data-title="Протон эмчилгээ" data-language-autonym="Монгол" data-language-local-name="Mongolian" class="interlanguage-link-target">Монгол</a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Protonentherapie" title="Protonentherapie – Dutch" lang="nl" hreflang="nl" data-title="Protonentherapie" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target">Nederlands</a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E9%99%BD%E5%AD%90%E7%B7%9A%E6%B2%BB%E7%99%82" title="陽子線治療 – Japanese" lang="ja" hreflang="ja" data-title="陽子線治療" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target">日本語</a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Proton_terapiyasi" title="Proton terapiyasi – Uzbek" lang="uz" hreflang="uz" data-title="Proton terapiyasi" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target">Oʻzbekcha / ўзбекча</a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Terapia_protonowa" title="Terapia protonowa – Polish" lang="pl" hreflang="pl" data-title="Terapia protonowa" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target">Polski</a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Terapia_de_pr%C3%B3tons" title="Terapia de prótons – Portuguese" lang="pt" hreflang="pt" data-title="Terapia de prótons" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target">Português</a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%9F%D1%80%D0%BE%D1%82%D0%BE%D0%BD%D0%BD%D0%B0%D1%8F_%D1%82%D0%B5%D1%80%D0%B0%D0%BF%D0%B8%D1%8F" title="Протонная терапия – Russian" lang="ru" hreflang="ru" data-title="Протонная терапия" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target">Русский</a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Obsevanje_s_hitrimi_protoni" title="Obsevanje s hitrimi protoni – Slovenian" lang="sl" hreflang="sl" data-title="Obsevanje s hitrimi protoni" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target">Slovenščina</a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%9F%D1%80%D0%BE%D1%82%D0%BE%D0%BD%D1%81%D0%BA%D0%B0_%D1%82%D0%B5%D1%80%D0%B0%D0%BF%D0%B8%D1%98%D0%B0" title="Протонска терапија – Serbian" lang="sr" hreflang="sr" data-title="Протонска терапија" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target">Српски / srpski</a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Protonstr%C3%A5lning" title="Protonstrålning – Swedish" lang="sv" hreflang="sv" data-title="Protonstrålning" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target">Svenska</a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%AA%E0%AF%81%E0%AE%B1%E0%AF%8D%E0%AE%B1%E0%AF%81%E0%AE%95%E0%AF%8D%E0%AE%95%E0%AF%81_%E0%AE%AE%E0%AE%9F%E0%AF%8D%E0%AE%9F%E0%AF%81%E0%AE%AE%E0%AF%8D_%E0%AE%AA%E0%AF%81%E0%AE%B0%E0%AF%8B%E0%AE%9F%E0%AF%8D%E0%AE%9F%E0%AE%BE%E0%AE%A9%E0%AF%8D_%E0%AE%AE%E0%AE%B0%E0%AF%81%E0%AE%A4%E0%AF%8D%E0%AE%A4%E0%AF%81%E0%AE%B5%E0%AE%AE%E0%AF%8D" title="புற்றுக்கு மட்டும் புரோட்டான் மருத்துவம் – Tamil" lang="ta" hreflang="ta" data-title="புற்றுக்கு மட்டும் புரோட்டான் மருத்துவம்" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target">தமிழ்</a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Proton_tedavisi" title="Proton tedavisi – Turkish" lang="tr" hreflang="tr" data-title="Proton tedavisi" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target">Türkçe</a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a 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You may <a class="external text" href="https://en.wikipedia.org/w/index.php?title=Proton_therapy&action=edit">improve this article</a>, discuss the issue on the <a href="/wiki/Talk:Proton_therapy" title="Talk:Proton therapy">talk page</a>, or <a href="/wiki/Wikipedia:Article_wizard" title="Wikipedia:Article wizard">create a new article</a>, as appropriate. (March 2018) (<a href="/wiki/Help:Maintenance_template_removal" title="Help:Maintenance template removal">Learn how and when to remove this message</a>)</div></td></tr></tbody></table> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical intervention</div> <style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: lightblue">Proton therapy</th></tr><tr><td colspan="2" class="infobox-image"><a href="/wiki/File:MayoProton.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e0/MayoProton.jpg/280px-MayoProton.jpg" decoding="async" width="280" height="218" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e0/MayoProton.jpg/420px-MayoProton.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e0/MayoProton.jpg/560px-MayoProton.jpg 2x" data-file-width="3206" data-file-height="2494" /></a><div class="infobox-caption">Proton therapy equipment at the Mayo Clinic in Rochester, Minnesota</div></td></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Proton beam therapy</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/ICD-10_Procedure_Coding_System" title="ICD-10 Procedure Coding System">ICD-10-PCS</a></th><td class="infobox-data">Z92.3</td></tr><tr class="noprint"><td colspan="2" class="infobox-full-data"><div style="text-align: right;">[<a href="https://www.wikidata.org/wiki/Q507667" class="extiw" title="d:Q507667">edit on Wikidata</a>]</div></td></tr></tbody></table> In medicine, proton therapy, or proton radiotherapy, is a type of <a href="/wiki/Particle_therapy" title="Particle therapy">particle therapy</a> that uses a beam of <a href="/wiki/Proton" title="Proton">protons</a> to <a href="/wiki/Irradiation" title="Irradiation">irradiate</a> diseased <a href="/wiki/Tissue_(biology)" title="Tissue (biology)">tissue</a>, most often to treat <a href="/wiki/Cancer" title="Cancer">cancer</a>. The chief advantage of proton therapy over other types of <a href="/wiki/External_beam_radiotherapy" title="External beam radiotherapy">external beam radiotherapy</a> is that the dose of protons is deposited over a narrow range of depth; hence in minimal entry, exit, or scattered radiation dose to healthy nearby tissues. When evaluating whether to treat a tumor with photon or proton therapy, physicians may choose proton therapy if it is important to deliver a higher radiation dose to targeted tissues while significantly decreasing radiation to nearby organs at risk.<a href="#cite_note-Yuan-1">[1]</a> The <a href="/wiki/American_Society_for_Radiation_Oncology" title="American Society for Radiation Oncology">American Society for Radiation Oncology</a> Model Policy for Proton Beam therapy says proton therapy is considered reasonable if sparing the surrounding normal tissue "cannot be adequately achieved with photon-based radiotherapy" and can benefit the patient.<a href="#cite_note-2">[2]</a> Like photon radiation therapy, proton therapy is often used in conjunction with surgery and/or chemotherapy to most effectively treat cancer. <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Description">Description</h2>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=1" title="Edit section: Description">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Radiation_therapy#Mechanism_of_action" title="Radiation therapy">Radiation therapy § Mechanism of action</a></div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Comparison_of_dose_profiles_for_proton_v._x-ray_radiotherapy.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/37/Comparison_of_dose_profiles_for_proton_v._x-ray_radiotherapy.png/273px-Comparison_of_dose_profiles_for_proton_v._x-ray_radiotherapy.png" decoding="async" width="273" height="294" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/37/Comparison_of_dose_profiles_for_proton_v._x-ray_radiotherapy.png/410px-Comparison_of_dose_profiles_for_proton_v._x-ray_radiotherapy.png 1.5x, //upload.wikimedia.org/wikipedia/commons/3/37/Comparison_of_dose_profiles_for_proton_v._x-ray_radiotherapy.png 2x" data-file-width="546" data-file-height="588" /></a><figcaption>In a typical treatment plan for proton therapy, the spread out <a href="/wiki/Bragg_peak" title="Bragg peak">Bragg peak</a> (SOBP, dashed blue line) shows how the radiation is distributed. The SOBP is the sum of several individual Bragg peaks (thin blue lines) at staggered depths. Note that the vast majority of the proton radiation is delivered to the tumor, not to the skin and shallow tissues in front of the tumor or to the deep tissues behind the tumor. The red line shows the <a href="/wiki/Percentage_depth_dose_curve" title="Percentage depth dose curve">depth-dose</a> plot of an X-ray beam (photon or conventional radiation therapy) for comparison. The pink area represents additional doses of X-ray radiotherapy in front and behind the tumor – which can damage normal tissues and cause secondary cancers, especially of the skin.<a href="#cite_note-SOBP-3">[3]</a></figcaption></figure> Proton therapy is a type of external beam radiotherapy that uses <a href="/wiki/Ionizing_radiation" title="Ionizing radiation">ionizing radiation</a>. In proton therapy, medical personnel use a <a href="/wiki/Particle_accelerator" title="Particle accelerator">particle accelerator</a> to target a <a href="/wiki/Tumor" class="mw-redirect" title="Tumor">tumor</a> with a beam of protons.<a href="#cite_note-Jakel-4">[4]</a><a href="#cite_note-zap-5">[5]</a> These <a href="/wiki/Charged_particle" title="Charged particle">charged particles</a> damage the <a href="/wiki/DNA" title="DNA">DNA</a> of cells, ultimately killing them by stopping their reproduction and thus eliminating the tumor. Cancerous cells are particularly vulnerable to attacks on DNA because of their high rate of <a href="/wiki/Cell_division" title="Cell division">division</a> and their limited ability to repair DNA damage. Some cancers with specific defects in DNA repair may be more sensitive to proton radiation.<a href="#cite_note-Liu-6">[6]</a> Proton therapy lets physicians deliver a highly conformal beam, i.e. delivering radiation that conforms to the shape and depth of the tumor and sparing much of the surrounding, normal tissue.<a href="#cite_note-Slater-7">[7]</a> For example, when comparing proton therapy to the most advanced types of photon therapy—intensity-modulated radiotherapy (<a href="/wiki/IMRT" class="mw-redirect" title="IMRT">IMRT</a>) and volumetric modulated arc therapy (VMAT)—proton therapy can give similar or higher radiation doses to the tumor with a 50%-60% lower total body radiation dose.<a href="#cite_note-Kandula-8">[8]</a><a href="#cite_note-Yuan-1">[1]</a> Protons can focus energy delivery to fit the tumor shape, delivering only low-dose radiation to surrounding tissue. As a result, the patient has fewer side effects. All protons of a given energy have a certain <a href="/wiki/Range_(particle_radiation)" title="Range (particle radiation)">penetration range</a>; very few protons penetrate beyond that distance.<a href="#cite_note-OncoLink_-_Cancer_Treatment_Information-9">[9]</a> Also, the <a href="/wiki/Absorbed_dose" title="Absorbed dose">dose</a> delivered to tissue is maximized only over the last few millimeters of the particle's range; this maximum is called the spread out <a href="/wiki/Bragg_peak" title="Bragg peak">Bragg peak</a>, often called the SOBP (see visual).<a href="#cite_note-10">[10]</a> To treat tumors at greater depth, one needs a beam with higher energy, typically given in MeV (mega <a href="/wiki/Electron_volts" class="mw-redirect" title="Electron volts">electron volts</a>). Accelerators used for proton therapy typically produce protons with energies of 70 to 250 <a href="/wiki/MeV" class="mw-redirect" title="MeV">MeV</a>. Adjusting proton energy during the treatment maximizes the cell damage within the tumor. Tissue closer to the surface of the body than the tumor gets less radiation, and thus less damage. Tissues deeper in the body get very few protons, so the dose becomes immeasurably small.<a href="#cite_note-OncoLink_-_Cancer_Treatment_Information-9">[9]</a> In most treatments, protons of different energies with Bragg peaks at different depths are applied to treat the entire tumor. These Bragg peaks are shown as thin blue lines in the figure in this section. While tissues behind (or deeper than) the tumor get almost no radiation, the tissues in front of (shallower than) the tumor get radiation dosage based on the SOBP. <div class="mw-heading mw-heading3"><h3 id="Equipment">Equipment</h3>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=2" title="Edit section: Equipment">edit</a>]</div> Most installed proton therapy systems use isochronous <a href="/wiki/Cyclotron" title="Cyclotron">cyclotrons</a>.<a href="#cite_note-11">[11]</a><a href="#cite_note-12">[12]</a> Cyclotrons are considered simple to operate, reliable and can be made compact, especially with use of <a href="/wiki/Superconducting_magnets" class="mw-redirect" title="Superconducting magnets">superconducting magnets</a>.<a href="#cite_note-13">[13]</a> <a href="/wiki/Synchrotron" title="Synchrotron">Synchrotrons</a> can also be used, with the advantage of easier production at varying energies.<a href="#cite_note-14">[14]</a> <a href="/wiki/Linear_accelerator" class="mw-redirect" title="Linear accelerator">Linear accelerators</a>, as used for photon radiation therapy, are becoming commercially available as limitations of size and cost are resolved.<a href="#cite_note-15">[15]</a> Modern proton systems incorporate high-quality imaging for daily assessment of tumor contours, treatment planning software illustrating 3D dose distributions, and various system configurations, e.g. multiple treatment rooms connected to one accelerator. Partly because of these advances in technology, and partly because of the continually increasing amount of proton clinical data, the number of hospitals offering proton therapy continues to grow. <div class="mw-heading mw-heading3"><h3 id="FLASH_therapy">FLASH therapy</h3>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=3" title="Edit section: FLASH therapy">edit</a>]</div> FLASH radiotherapy is a technique under development for photon and proton treatments, using very high dose rates (necessitating large beam currents). If applied clinically, it could shorten treatment time to just one to three 1-second sessions, and further reducing side effects.<a href="#cite_note-16">[16]</a><a href="#cite_note-17">[17]</a><a href="#cite_note-18">[18]</a><a href="#cite_note-19">[19]</a> <div class="mw-heading mw-heading2"><h2 id="History">History</h2>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=4" title="Edit section: History">edit</a>]</div> The first suggestion that energetic protons could be an effective treatment was made by <a href="/wiki/Robert_R._Wilson" title="Robert R. Wilson">Robert R. Wilson</a> in a paper published in 1946<a href="#cite_note-20">[20]</a> while he was involved in the design of the <a href="/wiki/Harvard_Cyclotron_Laboratory" title="Harvard Cyclotron Laboratory">Harvard Cyclotron Laboratory</a> (HCL).<a href="#cite_note-21">[21]</a> The first treatments were performed with <a href="/wiki/Particle_accelerators" class="mw-redirect" title="Particle accelerators">particle accelerators</a> built for physics research, notably <a href="/wiki/Berkeley_Radiation_Laboratory" class="mw-redirect" title="Berkeley Radiation Laboratory">Berkeley Radiation Laboratory</a> in 1954 and at <a href="/wiki/Uppsala_University" title="Uppsala University">Uppsala</a> in Sweden in 1957. In 1961, a collaboration began between HCL and <a href="/wiki/Massachusetts_General_Hospital" title="Massachusetts General Hospital">Massachusetts General Hospital</a> (MGH) to pursue proton therapy. Over the next 41 years, this program refined and expanded these techniques while treating 9,116 patients<a href="#cite_note-PTCOG-22">[22]</a> before the cyclotron was shut down in 2002. In the <a href="/wiki/USSR" class="mw-redirect" title="USSR">USSR</a> a therapeutic proton beam with energies up to 200 MeV was obtained at the <a href="/wiki/Synchrocyclotron" title="Synchrocyclotron">synchrocyclotron</a> of <a href="/wiki/Joint_Institute_for_Nuclear_Research" title="Joint Institute for Nuclear Research">JINR</a> in <a href="/wiki/Dubna" title="Dubna">Dubna</a> in 1967. The <a href="/wiki/Institute_for_Theoretical_and_Experimental_Physics" title="Institute for Theoretical and Experimental Physics">ITEP</a> center in <a href="/wiki/Moscow" title="Moscow">Moscow</a>, <a href="/wiki/Russia" title="Russia">Russia</a>, which began treating patients in 1969, is the oldest proton center still in operation. The <a href="/wiki/Paul_Scherrer_Institute" title="Paul Scherrer Institute">Paul Scherrer Institute</a> in Switzerland was the world's first proton center to treat eye tumors beginning in 1984. In addition, they invented pencil beam scanning in 1996, which became the state-of-the art form of proton therapy.<a href="#cite_note-PSI-23">[23]</a> The world's first hospital-based proton therapy center was a low energy cyclotron centre for eye tumors at <a href="/wiki/Clatterbridge_Cancer_Centre_NHS_Foundation_Trust" title="Clatterbridge Cancer Centre NHS Foundation Trust">Clatterbridge Centre for Oncology</a> in the UK, opened in 1989,<a href="#cite_note-ptcog.ch-24">[24]</a> followed in 1990 at the <a href="/wiki/Loma_Linda_University_Medical_Center" title="Loma Linda University Medical Center">Loma Linda University Medical Center</a> (LLUMC) in <a href="/wiki/Loma_Linda,_California" title="Loma Linda, California">Loma Linda, California</a>. Later, the Northeast Proton Therapy Center at <a href="/wiki/Massachusetts_General_Hospital" title="Massachusetts General Hospital">Massachusetts General Hospital</a> was brought online, and the HCL treatment program was transferred to it in 2001 and 2002. At the beginning of 2023, there were 41 proton therapy centers in the United States,<a href="#cite_note-25">[25]</a> and a total of 89 worldwide.<a href="#cite_note-26">[26]</a> As of 2020, six manufacturers make proton therapy systems: <a href="/wiki/Hitachi" title="Hitachi">Hitachi</a>, <a href="/wiki/Ion_Beam_Applications" title="Ion Beam Applications">Ion Beam Applications</a>, Mevion Medical Systems, <a rel="nofollow" class="external text" href="http://pronovasolutions.com">ProNova Solutions</a>, ProTom International and <a href="/wiki/Varian_Medical_Systems" title="Varian Medical Systems">Varian Medical Systems</a>. <div class="mw-heading mw-heading2"><h2 id="Types">Types</h2>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=5" title="Edit section: Types">edit</a>]</div> The newest form of proton therapy, pencil beam scanning, gives therapy by sweeping a proton beam laterally over the target so that it gives the required dose while closely conforming to shape of the targeted tumor. Before the use of pencil beam scanning, oncologists used a scattering method to direct a wide beam toward the tumor. <a href="#cite_note-ASTRO_model_policies_PBT-27">[27]</a> <div class="mw-heading mw-heading3"><h3 id="Passive_scattering_beam_delivery">Passive scattering beam delivery</h3>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=6" title="Edit section: Passive scattering beam delivery">edit</a>]</div> The first commercially available proton delivery systems used a scattering process, or passive scattering, to deliver the therapy. With scattering proton therapy the proton beam is spread out by scattering devices, and the beam is then shaped by putting items such as <a href="/wiki/Collimator" title="Collimator">collimators</a> and compensators in the path of the protons. The collimators were custom made for the patient with milling machines.<a href="#cite_note-Mohan-28">[28]</a> Passive scattering gives homogeneous dose along the target volume. Therefore, passive scattering gives more limited control over dose distributions proximal to target. Over time many scattering therapy systems have been upgraded to deliver pencil beam scanning. Because scattering therapy was the first type of proton therapy available, most clinical data available on proton therapy—especially long-term data as of 2020—were acquired via scattering technology. <div class="mw-heading mw-heading3"><h3 id="Pencil_beam_scanning_beam_delivery">Pencil beam scanning beam delivery</h3>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=7" title="Edit section: Pencil beam scanning beam delivery">edit</a>]</div> A newer and more flexible delivery method is pencil beam scanning, using a beam that sweeps laterally over the target so that it delivers the needed dose while closely conforming to the tumor's shape. This conformal delivery is achieved by shaping the dose through magnetic scanning of thin beamlets of protons without needing apertures and compensators. Multiple beams are delivered from different directions, and magnets in the treatment nozzle steer the proton beam to conform to the target volume layer as the dose is painted layer by layer. This type of scanning delivery provides greater flexibility and control, letting the proton dose conform more precisely to the shape of the tumor.<a href="#cite_note-Mohan-28">[28]</a> Delivery of protons via pencil beam scanning, in use since 1996 at the <a href="/wiki/Paul_Scherrer_Institute" title="Paul Scherrer Institute">Paul Scherrer Institute</a>,<a href="#cite_note-Mohan-28">[28]</a> allows for the most precise type of proton delivery: intensity-modulated proton therapy (IMPT). IMPT is to proton therapy what <a href="/wiki/IMRT" class="mw-redirect" title="IMRT">IMRT</a> is to conventional photon therapy—treatment that more closely conforms to the tumor while avoiding surrounding structures.<a href="#cite_note-PBT101-29">[29]</a> Virtually all new proton systems provide pencil beam scanning exclusively. A study led by <a href="/wiki/Memorial_Sloan_Kettering_Cancer_Center" title="Memorial Sloan Kettering Cancer Center">Memorial Sloan Kettering Cancer Center</a> suggests that IMPT can improve local control when compared to passive scattering for patients with nasal cavity and paranasal sinus malignancies.<a href="#cite_note-MingFan-30">[30]</a> <div class="mw-heading mw-heading2"><h2 id="Application">Application</h2>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=8" title="Edit section: Application">edit</a>]</div> It was estimated that by the end of 2019, a total of ≈200,000 patients had been treated with proton therapy. Physicians use protons to treat conditions in two broad categories: <ul><li>Disease sites that respond well to higher doses of radiation, i.e., dose escalation. Dose escalation has sometimes shown a higher probability of "cure" (i.e. local control) than conventional <a href="/wiki/Radiotherapy" class="mw-redirect" title="Radiotherapy">radiotherapy</a>.<a href="#cite_note-ReferenceA-31">[31]</a> These include, among others, <a href="/wiki/Uvea" title="Uvea">uveal</a> <a href="/wiki/Melanoma" title="Melanoma">melanoma</a> (ocular tumor), skull base and paraspinal tumor (<a href="/wiki/Chondrosarcoma" title="Chondrosarcoma">chondrosarcoma</a> and <a href="/wiki/Chordoma" title="Chordoma">chordoma</a>), and unresectable <a href="/wiki/Sarcoma" title="Sarcoma">sarcoma</a>. In all these cases proton therapy gives significant improvement in the probability of local control, over conventional radiotherapy.<a href="#cite_note-32">[32]</a><a href="#cite_note-33">[33]</a><a href="#cite_note-34">[34]</a> For eye tumors, proton therapy also has high rates of maintaining the natural eye.<a href="#cite_note-35">[35]</a></li> <li>Treatment where proton therapy's increased precision reduces unwanted side effects by lessening the dose to normal tissue. In these cases, the tumor dose is the same as in conventional therapy, so there is no expectation of increased probability of curing the disease. Instead, emphasis is on reducing the dose to normal tissue, thus reducing unwanted effects.<a href="#cite_note-ReferenceA-31">[31]</a></li></ul> Two prominent examples are pediatric <a href="/wiki/Neoplasms" class="mw-redirect" title="Neoplasms">neoplasms</a> (such as <a href="/wiki/Medulloblastoma" title="Medulloblastoma">medulloblastoma</a>) and <a href="/wiki/Prostate_cancer" title="Prostate cancer">prostate cancer</a>. <div class="mw-heading mw-heading3"><h3 id="Pediatric">Pediatric</h3>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=9" title="Edit section: Pediatric">edit</a>]</div> Irreversible long-term side effects of conventional radiation therapy for pediatric cancers are well documented and include growth disorders, neurocognitive toxicity, ototoxicity with subsequent effects on learning and language development, and renal, endocrine and gonadal dysfunctions. Radiation-induced secondary malignancy is another very serious adverse effect that has been reported. As there is minimal exit dose when using proton radiation therapy, dose to surrounding normal tissues can be significantly limited, reducing the acute toxicity which positively impacts the risk for these long-term side effects. Cancers requiring craniospinal irradiation, for example, benefit from the absence of exit dose with proton therapy: dose to the heart, mediastinum, bowel, bladder and other tissues anterior to the vertebrae is eliminated, hence a reduction of acute thoracic, gastrointestinal and bladder side effects.<a href="#cite_note-Kahalley-36">[36]</a><a href="#cite_note-Eaton-37">[37]</a><a href="#cite_note-Hill-Kayser-38">[38]</a> <div class="mw-heading mw-heading3"><h3 id="Eye_tumor">Eye tumor</h3>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=10" title="Edit section: Eye tumor">edit</a>]</div> Proton therapy for <a href="/wiki/Eye_neoplasm" title="Eye neoplasm">eye tumors</a> is a special case since this treatment requires only relatively low energy protons (≈70 MeV). Owing to this low energy, some particle therapy centers only treat eye tumors.<a href="#cite_note-PTCOG-22">[22]</a> Proton, or more generally, <a href="/wiki/Hadron" title="Hadron">hadron</a> therapy of tissue close to the eye affords sophisticated methods to assess the alignment of the eye that can vary significantly from other patient position verification approaches in image guided particle therapy.<a href="#cite_note-39">[39]</a> Position verification and correction must ensure that the radiation spares sensitive tissue like the optic nerve to preserve the patient's vision. For ocular tumors, selecting the type of radiotherapy depends on tumor location and extent, tumor radioresistance (calculating the dose needed to eliminate the tumor), and the therapy's potential toxic side effects on nearby critical structures.<a href="#cite_note-Thariat-40">[40]</a> For example, proton therapy is an option for retinoblastoma <a href="#cite_note-41">[41]</a> and intraocular melanoma.<a href="#cite_note-42">[42]</a> The advantage of a proton beam is that it has the potential to effectively treat the tumor while sparing sensitive structures of the eye.<a href="#cite_note-Papakostas-43">[43]</a> Given its effectiveness, proton therapy has been described as the "gold standard" treatment for ocular melanoma.<a href="#cite_note-Mishra-44">[44]</a><a href="#cite_note-45">[45]</a> The implementation of momentum cooling technique in proton therapy for eye treatment can significantly enhance its effectiveness.<a href="#cite_note-46">[46]</a> This technique aids in reducing the radiation dose administered to healthy organs while ensuring that the treatment is completed within a few seconds. Consequently, patients experience improved comfort during the procedure. <div class="mw-heading mw-heading3"><h3 id="Base_of_skull_cancer">Base of skull cancer</h3>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=11" title="Edit section: Base of skull cancer">edit</a>]</div> When receiving radiation for skull base tumors, side effects of the radiation can include pituitary hormone dysfunction and visual field deficit—after radiation for pituitary tumors—as well as cranial neuropathy (nerve damage), radiation-induced osteosarcoma (bone cancer), and osteoradionecrosis, which occurs when radiation causes part of the bone in the jaw or skull base to die.<a href="#cite_note-Stelzer-47">[47]</a> Proton therapy has been very effective for people with base of skull tumors.<a href="#cite_note-48">[48]</a> Unlike conventional photon radiation, protons do not penetrate beyond the tumor. Proton therapy lowers the risk of treatment-related side effects from when healthy tissue gets radiation. Clinical studies have found proton therapy to be effective for skull base tumors.<a href="#cite_note-Amichetti-49">[49]</a><a href="#cite_note-Weber-50">[50]</a><a href="#cite_note-Zhou-51">[51]</a> <div class="mw-heading mw-heading3"><h3 id="Head_and_neck_tumor">Head and neck tumor</h3>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=12" title="Edit section: Head and neck tumor">edit</a>]</div> Proton particles do not deposit exit dose, so proton therapy can spare normal tissues far from the tumor. This is particularly useful for head and neck tumors because of the anatomic constraints found in nearly all cancers in this region. The dosimetric advantage unique to proton therapy translates into toxicity reduction. For recurrent head and neck cancer requiring reirradiation, proton therapy is able to maximize a focused dose of radiation to the tumor while minimizing dose to surrounding tissues, hence a minimal acute toxicity profile, even in patients who got multiple prior courses of radiotherapy.<a href="#cite_note-52">[52]</a> <div class="mw-heading mw-heading3"><h3 id="Left-side_breast_cancer">Left-side breast cancer</h3>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=13" title="Edit section: Left-side breast cancer">edit</a>]</div> When <a href="/wiki/Breast_cancer" title="Breast cancer">breast cancer</a> — especially in the left breast — is treated with conventional radiation, the lung and heart, which are near the left breast, are particularly susceptible to photon radiation damage. Such damage can eventually cause lung problems (e.g. lung cancer) or various heart problems. Depending on location of the tumor, damage can also occur to the esophagus, or to the chest wall (which can potentially lead to leukemia).<a href="#cite_note-Brownlee-53">[53]</a> One recent study showed that proton therapy has low toxicity to nearby healthy tissues and similar rates of disease control compared with conventional radiation.<a href="#cite_note-Jimenez-54">[54]</a> Other researchers found that proton pencil beam scanning techniques can reduce both the mean heart dose and the internal mammary node dose to essentially zero.<a href="#cite_note-Stick-55">[55]</a> Small studies have found that, compared to conventional photon radiation, proton therapy delivers minimal toxic dose to healthy tissues<a href="#cite_note-DaBush-56">[56]</a> and specifically decreased dose to the heart and lung.<a href="#cite_note-JABradley-57">[57]</a> Large-scale trials are underway to examine other potential benefits of proton therapy to treat breast cancer.<a href="#cite_note-58">[58]</a> <div class="mw-heading mw-heading3"><h3 id="Lymphoma">Lymphoma</h3>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=14" title="Edit section: Lymphoma">edit</a>]</div> Though chemotherapy is the main treatment for lymphoma, consolidative radiation is often used in Hodgkin lymphoma and aggressive non-Hodgkin lymphoma, while definitive treatment with radiation alone is used in a small fraction of lymphoma patients. Unfortunately, treatment-related toxicities caused by chemotherapy agents and radiation exposure to healthy tissues are major concerns for lymphoma survivors. Advanced radiation therapy technologies such as proton therapy may offer significant and clinically relevant advantages such as sparing important organs at risk and decreasing the risk for late normal tissue damage while still achieving the primary goal of disease control. This is especially important for lymphoma patients who are being treated with curative intent and have long life expectancy following therapy.<a href="#cite_note-59">[59]</a> <div class="mw-heading mw-heading3"><h3 id="Prostate_cancer">Prostate cancer</h3>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=15" title="Edit section: Prostate cancer">edit</a>]</div> In <a href="/wiki/Prostate_cancer" title="Prostate cancer">prostate cancer</a> cases, the issue is less clear. Some published studies found a reduction in long term rectal and genito-urinary damage when treating with protons rather than <a href="/wiki/Photons" class="mw-redirect" title="Photons">photons</a> (meaning <a href="/wiki/X-ray" title="X-ray">X-ray</a> or <a href="/wiki/Gamma_ray" title="Gamma ray">gamma ray</a> therapy). Others showed a small difference, limited to cases where the prostate is particularly close to certain anatomical structures.<a href="#cite_note-60">[60]</a><a href="#cite_note-L._Zietman_2005-61">[61]</a> The relatively small improvement found may be the result of inconsistent patient set-up and internal organ movement during treatment, which offsets most of the advantage of increased precision.<a href="#cite_note-L._Zietman_2005-61">[61]</a><a href="#cite_note-Crevoisier_2005-62">[62]</a><a href="#cite_note-63">[63]</a> One source suggests that dose errors around 20% can result from motion errors of just 2.5 mm (0.098 in).[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] and another that prostate motion is between 5–10 mm (0.20–0.39 in).<a href="#cite_note-64">[64]</a> The number of cases of prostate cancer diagnosed each year far exceeds those of the other diseases referred to above, and this has led some, but not all, facilities to devote most of their treatment slots to prostate treatments. For example, two hospital facilities devote ≈65%<a href="#cite_note-MTRO1999-65">[65]</a> and 50%<a href="#cite_note-U.S._News_and_World_Report-66">[66]</a> of their proton treatment capacity to prostate cancer, while a third devotes only 7.1%.<a href="#cite_note-67">[67]</a> Worldwide numbers are hard to compile, but one example says that in 2003 ≈26% of proton therapy treatments worldwide were for prostate cancer.<a href="#cite_note-68">[68]</a> <div class="mw-heading mw-heading3"><h3 id="Gastrointestinal_malignancy">Gastrointestinal malignancy</h3>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=16" title="Edit section: Gastrointestinal malignancy">edit</a>]</div> A growing amount of data shows that proton therapy has great potential to increase therapeutic tolerance for patients with GI malignancy. The possibility of decreasing radiation dose to organs at risk may also help facilitate chemotherapy dose escalation or allow new chemotherapy combinations. Proton therapy will play a decisive role for ongoing intensified combined modality treatments for GI cancers. The following review presents the benefits of proton therapy in treating hepatocellular carcinoma, pancreatic cancer and esophageal cancer.<a href="#cite_note-69">[69]</a> <div class="mw-heading mw-heading3"><h3 id="Hepatocellular_carcinoma">Hepatocellular carcinoma</h3>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=17" title="Edit section: Hepatocellular carcinoma">edit</a>]</div> Post-treatment liver decompensation, and subsequent liver failure, is a risk with radiotherapy for <a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">hepatocellular carcinoma</a>, the most common type of primary liver cancer. Research shows that proton therapy gives favorable results related to local tumor control, progression-free survival, and overall survival.<a href="#cite_note-Joong-WonPark-70">[70]</a><a href="#cite_note-Fuduka-71">[71]</a><a href="#cite_note-Yu-72">[72]</a><a href="#cite_note-Chadha-73">[73]</a> Other studies, which examine proton therapy compared with conventional photon therapy, show that proton therapy gives improved survival and/or fewer side effects; hence proton therapy could significantly improve clinical outcomes for some patients with liver cancer.<a href="#cite_note-Sanford1-74">[74]</a><a href="#cite_note-Sanford-75">[75]</a> <div class="mw-heading mw-heading3"><h3 id="Reirradiation_for_recurrent_cancer">Reirradiation for recurrent cancer</h3>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=18" title="Edit section: Reirradiation for recurrent cancer">edit</a>]</div> For patients who get local or regional recurrences after their initial radiation therapy, physicians are limited in their treatment options due to their reluctance to give additional photon radiation therapy to tissues that have already been irradiated. Re-irradiation is a potentially curative treatment option for patients with locally recurrent head and neck cancer. In particular, pencil beam scanning may be ideally suited for reirradiation.<a href="#cite_note-Badiyan-76">[76]</a> Research shows the feasibility of using proton therapy with acceptable side effects, even in patients who have had multiple prior courses of photon radiation.<a href="#cite_note-Romesser-77">[77]</a><a href="#cite_note-Verma-78">[78]</a><a href="#cite_note-Chao-79">[79]</a> <div class="mw-heading mw-heading2"><h2 id="Comparison_with_other_treatments">Comparison with other treatments</h2>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=19" title="Edit section: Comparison with other treatments">edit</a>]</div> A large study on comparative effectiveness of proton therapy was published by teams of the <a href="/wiki/University_of_Pennsylvania" title="University of Pennsylvania">University of Pennsylvania</a> and <a href="/wiki/Washington_University_in_St._Louis" title="Washington University in St. Louis">Washington University in St. Louis</a> in <a href="/wiki/JAMA_Oncology" title="JAMA Oncology">JAMA Oncology</a>, assessing if proton therapy in the setting of concurrent chemoradiotherapy is associated with fewer 90-day unplanned hospitalizations and overall survival compared with concurrent photon therapy and chemoradiotherapy.<a href="#cite_note-Baumann-80">[80]</a> The study included 1483 adult patients with nonmetastatic, locally advanced cancer treated with concurrent chemoradiotherapy with curative intent and concluded, "proton chemoradiotherapy was associated with significantly reduced acute adverse events that caused unplanned hospitalizations, with similar disease-free and overall survival". A significant number of randomized controlled trials is recruiting, but only a limited number have been completed as of August 2020. A phase III <a href="/wiki/Randomized_controlled_trial" title="Randomized controlled trial">randomized controlled trial</a> of proton beam therapy versus radiofrequency ablation (RFA) for recurrent hepatocellular carcinoma organized by the National Cancer Center in Korea showed better 2-year local progression-free survival for the proton arm and concluded that proton beam therapy (PBT) is "not inferior to RFA in terms of local progression-free survival and safety, denoting that either RFA or PBT can be applied to recurrent small HCC patients".<a href="#cite_note-Joong-WonPark-70">[70]</a> A phase IIB <a href="/wiki/Randomized_controlled_trial" title="Randomized controlled trial">randomized controlled trial</a> of proton beam therapy versus <a href="/wiki/IMRT" class="mw-redirect" title="IMRT">IMRT</a> for locally advanced <a href="/wiki/Esophageal_cancer" title="Esophageal cancer">esophageal cancer</a> organized by <a href="/wiki/University_of_Texas_MD_Anderson_Cancer_Center" class="mw-redirect" title="University of Texas MD Anderson Cancer Center">University of Texas MD Anderson Cancer Center</a> concluded that proton beam therapy reduced the risk and severity of adverse events compared with IMRT while maintaining similar <a href="/w/index.php?title=Progression_free_survival&action=edit&redlink=1" class="new" title="Progression free survival (page does not exist)">progression free survival</a>.<a href="#cite_note-Lin-81">[81]</a> Another Phase II <a href="/wiki/Randomized_Controlled_Trial" class="mw-redirect" title="Randomized Controlled Trial">Randomized Controlled Trial</a> comparing photons versus protons for <a href="/wiki/Glioblastoma" title="Glioblastoma">Glioblastoma</a> concluded that patients at risk of severe <a href="/wiki/Lymphopenia" class="mw-redirect" title="Lymphopenia">lymphopenia</a> could benefit from proton therapy.<a href="#cite_note-Mohan1-82">[82]</a> A team from <a href="/wiki/Stanford_University" title="Stanford University">Stanford University</a> assessed the risk of secondary cancer after primary cancer treatment with external beam radiation using data from the National Cancer Database for 9 tumor types: head and neck, gastrointestinal, gynecologic, lymphoma, lung, prostate, breast, bone/soft tissue, and brain/central nervous system.<a href="#cite_note-Xiang-83">[83]</a> The study included a total of 450,373 patients and concluded that proton therapy was associated with a lower risk of second cancer. The issue of when, whether, and how best to apply this technology is still under discussion by physicians and researchers. One recently introduced method, 'model-based selection', uses comparative treatment plans for IMRT and IMPT in combination with normal tissue complication probability (NTCP) models to identify patients who may benefit most from proton therapy.<a href="#cite_note-Tambas-84">[84]</a><a href="#cite_note-Langendijk-85">[85]</a> Clinical trials are underway to examine the comparative efficacy of proton therapy (vs photon radiation) for the following: <ul><li>Pediatric cancers—by St. Jude Children's Research Hospital,<a href="#cite_note-86">[86]</a> Samsung Medical Center <a href="#cite_note-87">[87]</a></li> <li>Base of skull cancer—by Heidelberg University <a href="#cite_note-88">[88]</a></li> <li>Head and neck cancer—by MD Anderson,<a href="#cite_note-89">[89]</a> Memorial Sloan Kettering and other centers<a href="#cite_note-90">[90]</a></li> <li>Brain and spinal cord cancer—by Massachusetts General Hospital,<a href="#cite_note-91">[91]</a> Uppsala University and other centers,<a href="#cite_note-92">[92]</a> NRG Oncology<a href="#cite_note-93">[93]</a><a href="#cite_note-94">[94]</a></li> <li>Hepatocellular carcinoma (liver)—by NRG Oncology,<a href="#cite_note-95">[95]</a> Chang Gung Memorial Hospital,<a href="#cite_note-96">[96]</a> Loma Linda University <a href="#cite_note-97">[97]</a></li> <li>Lung cancer—by Radiation Therapy Oncology Group (RTOG),<a href="#cite_note-98">[98]</a> Proton Collaborative Group (PCG),<a href="#cite_note-99">[99]</a> Mayo Clinic<a href="#cite_note-100">[100]</a></li> <li>Esophageal cancer—by NRG Oncology,<a href="#cite_note-101">[101]</a> Abramson Cancer Center, University of Pennsylvania<a href="#cite_note-102">[102]</a></li> <li>Breast cancer—by University of Pennsylvania,<a href="#cite_note-103">[103]</a> Proton Collaborative Group (PCG)<a href="#cite_note-104">[104]</a></li> <li>Pancreatic cancer—by University of Maryland,<a href="#cite_note-105">[105]</a> Proton Collaborative Group (PCG)<a href="#cite_note-106">[106]</a></li></ul> <div class="mw-heading mw-heading3"><h3 id="X-ray_radiotherapy">X-ray radiotherapy</h3>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=20" title="Edit section: X-ray radiotherapy">edit</a>]</div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Comparison_of_dose_distributions_between_IMPT_(right)_and_IMRT_(left).jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e3/Comparison_of_dose_distributions_between_IMPT_%28right%29_and_IMRT_%28left%29.jpg/220px-Comparison_of_dose_distributions_between_IMPT_%28right%29_and_IMRT_%28left%29.jpg" decoding="async" width="220" height="224" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e3/Comparison_of_dose_distributions_between_IMPT_%28right%29_and_IMRT_%28left%29.jpg/330px-Comparison_of_dose_distributions_between_IMPT_%28right%29_and_IMRT_%28left%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e3/Comparison_of_dose_distributions_between_IMPT_%28right%29_and_IMRT_%28left%29.jpg/440px-Comparison_of_dose_distributions_between_IMPT_%28right%29_and_IMRT_%28left%29.jpg 2x" data-file-width="1200" data-file-height="1222" /></a><figcaption>Irradiation of <a href="/wiki/Nasopharyngeal_carcinoma" title="Nasopharyngeal carcinoma">nasopharyngeal carcinoma</a> by photon (X-ray) therapy (left) and proton therapy (right)</figcaption></figure> The figure at the right of the page shows how beams of X-rays (<a href="/wiki/IMRT" class="mw-redirect" title="IMRT">IMRT</a>; left frame) and beams of protons (right frame), of different energies, penetrate human tissue. A tumor with a sizable thickness is covered by the IMRT spread out Bragg peak (SOBP) shown as the red lined distribution in the figure. The SOBP is an overlap of several pristine Bragg peaks (blue lines) at staggered depths. Megavoltage X-ray therapy has less "skin sparing potential" than proton therapy: X-ray radiation at the skin, and at very small depths, is lower than for proton therapy. One study estimates that passively scattered proton fields have a slightly higher entrance dose at the skin (≈75%) compared to therapeutic megavoltage (MeV) photon beams (≈60%).<a href="#cite_note-SOBP-3">[3]</a> X-ray radiation dose falls off gradually, needlessly harming tissue deeper in the body and damaging the skin and surface tissue opposite the beam entrance. The differences between the two methods depends on: <ul><li>Width of the SOBP</li> <li>Depth of the tumor</li> <li>Number of beams that treat the tumor</li></ul> The X-ray advantage of less harm to skin at the entrance is partially counteracted by harm to skin at exit point. Since X-ray treatments are usually done with multiple exposures from opposite sides, each section of skin is exposed to both entering and exiting X-rays. In proton therapy, skin exposure at the entrance point is higher, but tissues on the opposite side of the body to the tumor get no radiation. Thus, X-ray therapy causes slightly less damage to skin and surface tissues, and proton therapy causes less damage to deeper tissues in front of and beyond the target.<a href="#cite_note-zap-5">[5]</a> An important consideration in comparing these treatments is whether the equipment delivers protons via the scattering method (historically, the most common) or a spot scanning method. Spot scanning can adjust the width of the SOBP on a spot-by-spot basis, which reduces the volume of normal (healthy) tissue inside the high dose region. Also, spot scanning allows for intensity modulated proton therapy (IMPT), which determines individual spot intensities using an optimization algorithm that lets the user balance the competing goals of irradiating tumors while sparing normal tissue. Spot scanning availability depends on the machine and the institution. Spot scanning is more commonly known as <a href="/wiki/Pencil-beam_scanning" title="Pencil-beam scanning">pencil-beam scanning</a> and is available on <a href="/wiki/Ion_Beam_Applications" title="Ion Beam Applications">IBA</a>, Hitachi, <a rel="nofollow" class="external text" href="https://www.mevion.com/">Mevion</a> (known as HYPERSCAN<a href="#cite_note-107">[107]</a> which became US FDA approved in 2017) and Varian. <div class="mw-heading mw-heading3"><h3 id="Surgery">Surgery</h3>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=21" title="Edit section: Surgery">edit</a>]</div> Physicians base the decision to use surgery or proton therapy (or any radiation therapy) on tumor type, stage, and location. Sometimes surgery is superior (such as cutaneous <a href="/wiki/Melanoma" title="Melanoma">melanoma</a>), sometimes radiation is superior (such as skull base <a href="/wiki/Chondrosarcoma" title="Chondrosarcoma">chondrosarcoma</a>), and sometimes are comparable (for example, <a href="/wiki/Prostate_cancer" title="Prostate cancer">prostate cancer</a>). Sometimes, they are used together (e.g., rectal cancer or early stage breast cancer). The benefit of external beam proton radiation is in the <a href="/wiki/Dosimetry" title="Dosimetry">dosimetric</a> difference from external beam X-ray radiation and <a href="/wiki/Brachytherapy" title="Brachytherapy">brachytherapy</a> in cases where use of radiation therapy is already indicated, rather than as a direct competition with surgery.<a href="#cite_note-ReferenceA-31">[31]</a> In prostate cancer, the most common indication for proton beam therapy, no clinical study directly comparing proton therapy to surgery, brachytherapy, or other treatments has shown any clinical benefit for proton beam therapy. Indeed, the largest study to date showed that IMRT compared with proton therapy was associated with less gastrointestinal <a href="/wiki/Morbidity" class="mw-redirect" title="Morbidity">morbidity</a>.<a href="#cite_note-108">[108]</a> <div class="mw-heading mw-heading2"><h2 id="Side_effects_and_risks">Side effects and risks</h2>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=22" title="Edit section: Side effects and risks">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">Main articles: <a href="/wiki/Radiation_therapy#Side_effects" title="Radiation therapy">Radiation therapy § Side effects</a>, and <a href="/wiki/Adverse_effect" title="Adverse effect">Adverse effect</a></div> Proton therapy is a type of external beam radiotherapy, and shares risks and <a href="/wiki/Side_effects" class="mw-redirect" title="Side effects">side effects</a> of other forms of radiation therapy. The dose outside of the treatment region can be significantly less for deep-tissue tumors than X-ray therapy, because proton therapy takes full advantage of the Bragg peak. Proton therapy has been in use for over 40 years, and is a mature technology. As with all medical knowledge, understanding of the interaction of radiations with tumor and normal tissue is still imperfect.<a href="#cite_note-costandconcern-109">[109]</a> <div class="mw-heading mw-heading2"><h2 id="Costs">Costs</h2>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=23" title="Edit section: Costs">edit</a>]</div> Historically, proton therapy has been expensive. An analysis published in 2003 found that the cost of proton therapy is ≈2.4 times that of X-ray therapies.<a href="#cite_note-GJ_relative_costs-110">[110]</a> Newer, less expensive, and dozens more proton treatment centers are driving costs down and they offer more accurate three-dimensional targeting. Higher proton dosage over fewer treatments sessions (1/3 fewer or less) is also driving costs down.<a href="#cite_note-Bassett-111">[111]</a><a href="#cite_note-God_particle-112">[112]</a> Thus the cost is expected to reduce as better proton technology becomes more widely available. An analysis published in 2005 determined that the cost of proton therapy is not unrealistic and should not be the reason for denying patients access to the technology.<a href="#cite_note-113">[113]</a> In some clinical situations, proton beam therapy is clearly superior to the alternatives.<a href="#cite_note-Advantages2004-114">[114]</a><a href="#cite_note-115">[115]</a> A study in 2007 expressed concerns about the effectiveness of proton therapy for prostate cancer,<a href="#cite_note-116">[116]</a> but with the advent of new developments in the technology, such as improved scanning techniques and more precise dose delivery ('<a href="/wiki/Pencil_beam_scanning" class="mw-redirect" title="Pencil beam scanning">pencil beam scanning</a>'), this situation may change considerably.<a href="#cite_note-117">[117]</a> Amitabh Chandra, a health economist at Harvard University, said, "Proton-beam therapy is like the <a href="/wiki/Death_Star" title="Death Star">Death Star</a> of American medical technology... It's a metaphor for all the problems we have in American medicine."<a href="#cite_note-118">[118]</a> Proton therapy is cost-effective for some types of cancer, but not all.<a href="#cite_note-auto-119">[119]</a><a href="#cite_note-120">[120]</a> In particular, some other treatments offer better overall value for treatment of prostate cancer.<a href="#cite_note-auto-119">[119]</a> As of 2018, the cost of a single-room particle therapy system is US$40 million, with multi-room systems costing up to US$200 million.<a href="#cite_note-121">[121]</a><a href="#cite_note-122">[122]</a> <div class="mw-heading mw-heading2"><h2 id="Treatment_centers">Treatment centers</h2>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=24" title="Edit section: Treatment centers">edit</a>]</div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Orsay_proton_therapy_dsc04460.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a3/Orsay_proton_therapy_dsc04460.jpg/220px-Orsay_proton_therapy_dsc04460.jpg" decoding="async" width="220" height="165" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a3/Orsay_proton_therapy_dsc04460.jpg/330px-Orsay_proton_therapy_dsc04460.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a3/Orsay_proton_therapy_dsc04460.jpg/440px-Orsay_proton_therapy_dsc04460.jpg 2x" data-file-width="2592" data-file-height="1944" /></a><figcaption>Control panel of the <a href="/wiki/Synchrocyclotron" title="Synchrocyclotron">synchrocyclotron</a> at the <a href="/wiki/Orsay" title="Orsay">Orsay</a> proton therapy center, France</figcaption></figure> As of August 2020, there are over 89 particle therapy facilities worldwide,<a href="#cite_note-123">[123]</a> with at least 41 others under construction.<a href="#cite_note-124">[124]</a> As of August 2020, there are 34 operational proton therapy centers in the United States. As of the end of 2015 more than 154,203 patients had been treated worldwide.<a href="#cite_note-125">[125]</a> One hindrance to universal use of the proton in cancer treatment is the size and cost of the cyclotron or <a href="/wiki/Synchrotron" title="Synchrotron">synchrotron</a> equipment necessary. Several industrial teams are working on development of comparatively small accelerator systems to deliver the proton therapy to patients.<a href="#cite_note-Matthews-126">[126]</a> Among the technologies being investigated are <a href="/wiki/Superconducting" class="mw-redirect" title="Superconducting">superconducting</a> <a href="/wiki/Synchrocyclotron" title="Synchrocyclotron">synchrocyclotrons</a> (also known as FM Cyclotrons), ultra-compact synchrotrons, <a href="/wiki/Dielectric_wall_accelerator" title="Dielectric wall accelerator">dielectric wall accelerators</a>,<a href="#cite_note-Matthews-126">[126]</a> and <a href="/wiki/Linear_particle_accelerator" title="Linear particle accelerator">linear particle accelerators</a>.<a href="#cite_note-God_particle-112">[112]</a> <div class="mw-heading mw-heading3"><h3 id="United_States">United States</h3>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=25" title="Edit section: United States">edit</a>]</div> Proton treatment centers in the United States as of 2024<a class="external text" href="https://en.wikipedia.org/w/index.php?title=Proton_therapy&action=edit">[update]</a> (in chronological order of first treatment date) include:<a href="#cite_note-ptcog.ch-24">[24]</a><a href="#cite_note-127">[127]</a> <table class="wikitable"> <tbody><tr> <th>Institution </th> <th width="130">Location </th> <th>Year of first treatment </th> <th>Comments </th></tr> <tr> <td><a href="/wiki/Loma_Linda_University_Medical_Center" title="Loma Linda University Medical Center">Loma Linda University Medical Center</a><a href="#cite_note-128">[128]</a> </td> <td>Loma Linda, CA </td> <td>1990 </td> <td>First hospital-based facility in USA; uses Spread Out Bragg's Peak (SOBP) </td></tr> <tr> <td><a href="/wiki/University_of_California,_Davis#Research_centers_and_laboratories" title="University of California, Davis">Crocker Nuclear Laboratory</a><a href="#cite_note-129">[129]</a> </td> <td>Davis, CA </td> <td>1994 </td> <td>Ocular treatments only (low energy accelerator); at <a href="/wiki/University_of_California,_Davis" title="University of California, Davis">University of California, Davis</a> </td></tr> <tr> <td>Francis H. Burr Proton Center </td> <td>Boston, MA </td> <td>2001 </td> <td>At <a href="/wiki/Massachusetts_General_Hospital" title="Massachusetts General Hospital">Massachusetts General Hospital</a> and formerly known as NPTC; continuation of <a href="/wiki/Harvard_Cyclotron_Laboratory" title="Harvard Cyclotron Laboratory">Harvard Cyclotron Laboratory</a>/MGH treatment program that began in 1961; Manufactured by <a href="/wiki/Ion_Beam_Applications" title="Ion Beam Applications">Ion Beam Applications</a><a href="#cite_note-iba-worldwide.com-130">[130]</a> </td></tr> <tr> <td><a href="/wiki/UF_Health_Jacksonville" title="UF Health Jacksonville">University of Florida Health</a> Proton Therapy Institute-Jacksonville<a href="#cite_note-131">[131]</a> </td> <td>Jacksonville, FL </td> <td rowspan="2">2006 </td> <td><a href="/w/index.php?title=The_UF_Health_Proton_Therapy_Institute&action=edit&redlink=1" class="new" title="The UF Health Proton Therapy Institute (page does not exist)">The UF Health Proton Therapy Institute</a><a href="#cite_note-132">[132]</a> is a part of a non-profit academic medical research facility affiliated with the <a href="/wiki/University_of_Florida_College_of_Medicine-Jacksonville" title="University of Florida College of Medicine-Jacksonville">University of Florida College of Medicine-Jacksonville</a>. It is the first treatment center in the Southeast U.S. to offer proton therapy. Manufactured by <a href="/wiki/Ion_Beam_Applications" title="Ion Beam Applications">Ion Beam Applications</a><a href="#cite_note-iba-worldwide.com-130">[130]</a> </td></tr> <tr> <td>University of Texas <a href="/wiki/MD_Anderson_Cancer_Center" title="MD Anderson Cancer Center">MD Anderson Cancer Center</a><a href="#cite_note-133">[133]</a> </td> <td>Houston, TX </td> <td> </td></tr> <tr> <td>Oklahoma Proton Center<a href="#cite_note-134">[134]</a> </td> <td>Oklahoma City, OK </td> <td>2009 </td> <td>4 treatment rooms, Proteus PLUS system manufactured by <a href="/wiki/Ion_Beam_Applications" title="Ion Beam Applications">Ion Beam Applications</a><a href="#cite_note-iba-worldwide.com-130">[130]</a> </td></tr> <tr> <td>Northwestern Medicine Chicago Proton Center<a href="#cite_note-135">[135]</a> </td> <td>Warrenville, IL </td> <td rowspan="3">2010 </td> <td>4 treatment rooms, Proteus PLUS system manufactured by <a href="/wiki/Ion_Beam_Applications" title="Ion Beam Applications">Ion Beam Applications</a><a href="#cite_note-iba-worldwide.com-130">[130]</a> </td></tr> <tr> <td><a href="/wiki/Perelman_Center_for_Advanced_Medicine" title="Perelman Center for Advanced Medicine">Roberts Proton Therapy Center</a><a href="#cite_note-136">[136]</a> </td> <td>Philadelphia, PA </td> <td>The largest proton therapy center in the world, the <a href="/wiki/Roberts_Proton_Therapy_Center" class="mw-redirect" title="Roberts Proton Therapy Center">Roberts Proton Therapy Center</a>,<a href="#cite_note-137">[137]</a> which is a part of <a href="/w/index.php?title=Penn%27s_Abramson_Cancer_Center&action=edit&redlink=1" class="new" title="Penn's Abramson Cancer Center (page does not exist)">Penn's Abramson Cancer Center</a>,<a href="#cite_note-138">[138]</a> <a href="/wiki/University_of_Pennsylvania_Health_System" title="University of Pennsylvania Health System">University of Pennsylvania Health System</a>; 5 treatment rooms, Proteus PLUS system manufactured by <a href="/wiki/Ion_Beam_Applications" title="Ion Beam Applications">Ion Beam Applications</a><a href="#cite_note-iba-worldwide.com-130">[130]</a> </td></tr> <tr> <td><a href="/wiki/Hampton_University" title="Hampton University">Hampton University</a> Proton Therapy Institute </td> <td>Hampton, VA </td> <td>5 treatment rooms, Proteus PLUS system manufactured by <a href="/wiki/Ion_Beam_Applications" title="Ion Beam Applications">Ion Beam Applications</a><a href="#cite_note-iba-worldwide.com-130">[130]</a> </td></tr> <tr> <td>ProCure Proton Therapy Center<a href="#cite_note-139">[139]</a> </td> <td>Somerset, NJ </td> <td>2012 </td> <td>4 treatment rooms, Proteus PLUS system manufactured by <a href="/wiki/Ion_Beam_Applications" title="Ion Beam Applications">Ion Beam Applications</a><a href="#cite_note-iba-worldwide.com-130">[130]</a> </td></tr> <tr> <td>SCCA Proton Therapy Center </td> <td>Seattle, WA </td> <td rowspan="2">2013 </td> <td>At <a href="/wiki/Seattle_Cancer_Care_Alliance" title="Seattle Cancer Care Alliance">Seattle Cancer Care Alliance</a>; part of <a href="/wiki/Fred_Hutchinson_Cancer_Research_Center" class="mw-redirect" title="Fred Hutchinson Cancer Research Center">Fred Hutchinson Cancer Research Center</a>; 4 treatment rooms, Proteus PLUS system manufactured by <a href="/wiki/Ion_Beam_Applications" title="Ion Beam Applications">Ion Beam Applications</a><a href="#cite_note-iba-worldwide.com-130">[130]</a> </td></tr> <tr> <td><a href="/wiki/Siteman_Cancer_Center" class="mw-redirect" title="Siteman Cancer Center">Siteman Cancer Center</a><a href="#cite_note-Bassett-111">[111]</a> </td> <td>St. Louis, MO </td> <td>First of the new single suite, ultra-compact, superconducting synchrocyclotron,<a href="#cite_note-140">[140]</a> lower cost facilities to treat a patient using the Mevion Medical System's S250.<a href="#cite_note-141">[141]</a> </td></tr> <tr> <td>Provision Proton Therapy Center<a href="#cite_note-142">[142]</a> </td> <td>Knoxville, TN </td> <td rowspan="2">2014 </td> <td>3 treatment rooms, Proteus PLUS system manufactured by <a href="/wiki/Ion_Beam_Applications" title="Ion Beam Applications">Ion Beam Applications</a><a href="#cite_note-iba-worldwide.com-130">[130]</a> </td></tr> <tr> <td>California Protons Cancer Therapy Center<a href="#cite_note-143">[143]</a><a href="#cite_note-144">[144]</a> </td> <td>San Diego, CA </td> <td>5 treatment rooms, manufactured by <a href="/wiki/Varian_Medical_Systems" title="Varian Medical Systems">Varian Medical Systems</a><a href="#cite_note-145">[145]</a> </td></tr> <tr> <td>Ackerman Cancer Center </td> <td>Jacksonville, FL </td> <td rowspan="5">2015 </td> <td><a href="/w/index.php?title=Ackerman_Cancer_Center&action=edit&redlink=1" class="new" title="Ackerman Cancer Center (page does not exist)">Ackerman Cancer Center</a><a href="#cite_note-146">[146]</a> is the world's first private, physician-owned practice to provide proton therapy, in addition to conventional radiation therapy and on-site diagnostic services. </td></tr> <tr> <td><a href="/wiki/The_Laurie_Proton_Therapy_Center" class="mw-redirect" title="The Laurie Proton Therapy Center">The Laurie Proton Therapy Center</a> </td> <td>New Brunswick, NJ </td> <td><a href="/wiki/The_Laurie_Proton_Therapy_Center" class="mw-redirect" title="The Laurie Proton Therapy Center">The Laurie Proton Therapy Center</a>,<a href="#cite_note-147">[147]</a> part of <a href="/wiki/Robert_Wood_Johnson_University_Hospital" title="Robert Wood Johnson University Hospital">Robert Wood Johnson University Hospital</a>, is home to the world's third MEVION S250 Proton Therapy System. </td></tr> <tr> <td>Texas Center for Proton Therapy </td> <td>Dallas Fort Worth, TX </td> <td>A collaboration by "Texas Oncology and The US Oncology Network, supported by McKesson Specialty Health, and Baylor Health Enterprises"; three pencil beam rooms and cone beam CT imaging.<a href="#cite_note-148">[148]</a> 3 treatment rooms, Proteus PLUS system manufactured by <a href="/wiki/Ion_Beam_Applications" title="Ion Beam Applications">Ion Beam Applications</a><a href="#cite_note-iba-worldwide.com-130">[130]</a> </td></tr> <tr> <td><a href="/wiki/Mayo_Clinic" title="Mayo Clinic">Mayo Clinic</a> Jacobson Building </td> <td>Rochester, MN </td> <td>4 treatment rooms.<a href="#cite_note-149">[149]</a> Manufactured by <a href="/wiki/Hitachi" title="Hitachi">Hitachi</a>.<a href="#cite_note-150">[150]</a> </td></tr> <tr> <td>St. Jude Red Frog Events Proton Therapy Center<a href="#cite_note-151">[151]</a> </td> <td>Memphis, TN </td> <td>3 treatment rooms </td></tr> <tr> <td><a href="/wiki/Mayo_Clinic" title="Mayo Clinic">Mayo Clinic</a> Cancer Center </td> <td>Phoenix, AZ </td> <td rowspan="5">2016 </td> <td>4 treatment rooms.<a href="#cite_note-152">[152]</a> Manufactured by <a href="/wiki/Hitachi" title="Hitachi">Hitachi</a>.<a href="#cite_note-153">[153]</a> </td></tr> <tr> <td>The Marjorie and Leonard Williams Center for Proton Therapy </td> <td>Orlando, FL </td> <td><a href="#cite_note-154">[154]</a> </td></tr> <tr> <td>Cancer and Blood Diseases Institute </td> <td><a href="/wiki/Liberty_Township,_Butler_County,_Ohio" title="Liberty Township, Butler County, Ohio">Liberty Township</a>, OH </td> <td>Collaboration of University of Cincinnati Cancer Institute and Cincinnati Children's Hospital Medical Center,<a href="#cite_note-155">[155]</a><a href="#cite_note-156">[156]</a> manufactured by <a href="/wiki/Varian_Medical_Systems" title="Varian Medical Systems">Varian Medical Systems</a> </td></tr> <tr> <td>Maryland Proton Treatment Center<a href="#cite_note-157">[157]</a> </td> <td>Baltimore, MD </td> <td>5 treatment rooms, affiliated with the <a href="/wiki/University_of_Maryland_Greenebaum_Comprehensive_Cancer_Center" class="mw-redirect" title="University of Maryland Greenebaum Comprehensive Cancer Center">University of Maryland Greenebaum Comprehensive Cancer Center</a>,<a href="#cite_note-158">[158]</a> manufactured by <a href="/wiki/Varian_Medical_Systems" title="Varian Medical Systems">Varian Medical Systems</a>. </td></tr> <tr> <td>Proton Therapy Center<a href="#cite_note-159">[159]</a> at <a href="/wiki/University_Hospitals_of_Cleveland" class="mw-redirect" title="University Hospitals of Cleveland">University Hospitals</a> Seidman Cancer Center </td> <td>Cleveland, OH </td> <td>Only proton therapy center in Northern Ohio. One treatment room with the Mevion S250 Proton Therapy System. Part of the NCI-designated Case Comprehensive Cancer Center, <a href="/wiki/University_Hospitals_of_Cleveland" class="mw-redirect" title="University Hospitals of Cleveland">University Hospitals</a> Seidman Cancer Center is one of the nation's leading freestanding cancer hospitals. </td></tr> <tr> <td>Miami Cancer Institute </td> <td>Miami, FL </td> <td rowspan="2">2017 </td> <td>3 treatment rooms, all using pencil-beam scanning<a href="#cite_note-160">[160]</a> Manufactured by <a href="/wiki/Ion_Beam_Applications" title="Ion Beam Applications">Ion Beam Applications</a><a href="#cite_note-iba-worldwide.com-130">[130]</a> </td></tr> <tr> <td>Beaumont Proton Therapy Center<a href="#cite_note-161">[161]</a> </td> <td>Royal Oak, MI </td> <td>Single treatment room, Proteus ONE system manufactured by <a href="/wiki/Ion_Beam_Applications" title="Ion Beam Applications">Ion Beam Applications</a><a href="#cite_note-iba-worldwide.com-130">[130]</a> </td></tr> <tr> <td>Emory Proton Therapy Center<a href="#cite_note-162">[162]</a> </td> <td>Atlanta, GA </td> <td rowspan="3">2018 </td> <td>Five treatment rooms, ProBeam Superconducting Cyclotron<a href="#cite_note-163">[163]</a> manufactured by <a href="/wiki/Varian_Medical_Systems" title="Varian Medical Systems">Varian Medical Systems</a> </td></tr> <tr> <td>Provision CARES Proton Therapy Center<a href="#cite_note-164">[164]</a> </td> <td>Nashville, TN </td> <td>Three treatment rooms, Two Gantries and One Fixed Beam, All Pencil Beam Scanning, manufactured by ProNova Solutions, LLC </td></tr> <tr> <td>McLaren Proton Therapy Center<a href="#cite_note-165">[165]</a> </td> <td>Flint, MI </td> <td>The McLaren Proton Therapy System uses the industry's highest energy 330 MeV proton synchrotron to accelerate and deliver proton beam to two treatment rooms, with an opportunity to extend into a planned third room. Both operating treatment rooms are equipped with proton pencil beam scanning, cone beam computed tomography for image guidance, patient positioning system with 6-degrees of freedom that coupled with 180-degree partial gantry allows for complete flexibility of treatment angles. </td></tr> <tr> <td>New York Proton Center<a href="#cite_note-166">[166]</a> </td> <td>New York, NY </td> <td rowspan="3">2019 </td> <td>A partnership between <a href="/wiki/Memorial_Sloan_Kettering" class="mw-redirect" title="Memorial Sloan Kettering">Memorial Sloan Kettering</a>, <a href="/wiki/Montefiore_Medical_Center" class="mw-redirect" title="Montefiore Medical Center">Montefiore Health</a>, and <a href="/wiki/Mount_Sinai_Health_System" title="Mount Sinai Health System">Mount Sinai Health System</a>. 4 treatment rooms, manufactured by <a href="/wiki/Varian_Medical_Systems" title="Varian Medical Systems">Varian Medical Systems</a> </td></tr> <tr> <td>Johns Hopkins Proton Therapy Center </td> <td>Washington, DC </td> <td>3 treatment rooms and 1 research gantry. Manufactured by Hitachi. </td></tr> <tr> <td>South Florida Proton Therapy Institute<a href="#cite_note-167">[167]</a> </td> <td>Delray Beach, FL </td> <td>One treatment room, manufactured by <a href="/wiki/Varian_Medical_Systems" title="Varian Medical Systems">Varian Medical Systems</a> </td></tr> <tr> <td>UAB Proton Therapy Center<a href="#cite_note-168">[168]</a> </td> <td>Birmingham, AL </td> <td rowspan="3">2020 </td> <td>One treatment room, manufactured by <a href="/wiki/Varian_Medical_Systems" title="Varian Medical Systems">Varian Medical Systems</a> </td></tr> <tr> <td>Dwoskin PTC - University of Miami<a href="#cite_note-169">[169]</a> </td> <td>Miami, FL </td> <td>One treatment room, manufactured by <a href="/wiki/Varian_Medical_Systems" title="Varian Medical Systems">Varian Medical Systems</a> </td></tr> <tr> <td>The Inova Mather Proton Therapy Center<a href="#cite_note-170">[170]</a> </td> <td>Fairfax, VA </td> <td>Two treatment rooms, manufactured by <a href="/wiki/Ion_Beam_Applications" title="Ion Beam Applications">Ion Beam Applications</a> </td></tr> <tr> <td>The University of Kansas Cancer Center </td> <td>Kansas City, KS </td> <td rowspan="3">2022 </td> <td>Announced Feb 2019<a href="#cite_note-171">[171]</a> </td></tr> <tr> <td>Penn Medicine Lancaster General Health Ann B. Barshinger Cancer Institute<a href="#cite_note-172">[172]</a> </td> <td>Lancaster, PA </td> <td>One treatment room, manufactured by <a href="/wiki/Varian_Medical_Systems" title="Varian Medical Systems">Varian Medical Systems</a> </td></tr> <tr> <td>Penn Medicine <a href="/wiki/Virtua_Health" title="Virtua Health">Virtua Health</a><a href="#cite_note-173">[173]</a> </td> <td>Voorhees, NJ </td> <td>One treatment room, manufactured by <a href="/wiki/Varian_Medical_Systems" title="Varian Medical Systems">Varian Medical Systems</a> </td></tr> <tr> <td>Ohio State, Nationwide Children's Hospital<a href="#cite_note-174">[174]</a> </td> <td>Columbus, OH </td> <td rowspan="1">2023 </td> <td>Three treatment rooms, manufactured by <a href="/wiki/Varian_Medical_Systems" title="Varian Medical Systems">Varian Medical Systems</a> </td></tr> <tr> <td>Kansas City Proton Institute<a href="#cite_note-175">[175]</a> </td> <td>Overland Park, KS </td> <td>2023 </td> <td>One treatment room, multidisciplinary practice providing proton therapy, conventional radiation therapy and diagnostic services. </td></tr> <tr> <td><a href="/wiki/OSF_Healthcare" class="mw-redirect" title="OSF Healthcare">OSF Healthcare</a> </td> <td>Peoria, IL </td> <td>2024 </td> <td>One treatment room, manufactured by <a href="/wiki/Varian_Medical_Systems" title="Varian Medical Systems">Varian Medical Systems</a> </td></tr> <tr> <td><a href="/wiki/Froedtert_Hospital" title="Froedtert Hospital">Froedtert Hospital</a> </td> <td>Wauwatosa, WI </td> <td>2024 (Estimated) </td> <td>Announced May 2022<a href="#cite_note-176">[176]</a> </td></tr> <tr> <td><a href="/wiki/Mayo_Clinic_Florida" title="Mayo Clinic Florida">Mayo Clinic Florida</a> </td> <td>Jacksonville, FL </td> <td rowspan="1">2025 (Estimated) </td> <td>Announced June 2019<a href="#cite_note-177">[177]</a> </td></tr> <tr> <td><a href="/wiki/Stanford_University_Medical_Center" title="Stanford University Medical Center">Stanford University Medical Center</a> </td> <td>Stanford, CA </td> <td>2025 (Estimated) </td> <td>One treatment room, manufactured by Mevion Medical Systems. Announced April 2024.<a href="#cite_note-178">[178]</a> </td></tr></tbody></table> The <a href="/wiki/Indiana_University_Health_Proton_Therapy_Center" title="Indiana University Health Proton Therapy Center">Indiana University Health Proton Therapy Center</a> in Bloomington, Indiana opened in 2004 and ceased operations in 2014. <div class="mw-heading mw-heading3"><h3 id="Outside_the_US">Outside the US</h3>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=26" title="Edit section: Outside the US">edit</a>]</div> <table class="wikitable"> <caption>Proton therapy Centres (partial list)<a href="#cite_note-ptcog.ch-24">[24]</a> </caption> <tbody><tr> <th>Institution </th> <th>Maximum energy (MeV) </th> <th>Year of first treatment </th> <th>Location </th></tr> <tr> <td><a href="/wiki/Paul_Scherrer_Institute" title="Paul Scherrer Institute">Paul Scherrer Institute</a> </td> <td>250 </td> <td>1984 </td> <td><a href="/wiki/Villigen" title="Villigen">Villigen</a>, Switzerland </td></tr> <tr> <td><a href="/wiki/Clatterbridge_Cancer_Centre_NHS_Foundation_Trust" title="Clatterbridge Cancer Centre NHS Foundation Trust">Clatterbridge Cancer Centre NHS Foundation Trust</a>, low-energy for ocular<a href="#cite_note-179">[179]</a> </td> <td>62 </td> <td>1989 </td> <td><a href="/wiki/Liverpool" title="Liverpool">Liverpool</a>, United Kingdom </td></tr> <tr> <td><a href="/wiki/Curie_Institute_(Paris)#Hospital" title="Curie Institute (Paris)">Centre de protonthérapie de l'Institut Curie</a> </td> <td>235 </td> <td>1991 </td> <td><a href="/wiki/Orsay" title="Orsay">Orsay</a>, France </td></tr> <tr> <td>Centre Antoine Lacassagne </td> <td>63 </td> <td>1991 </td> <td><a href="/wiki/Nice" title="Nice">Nice</a>, France </td></tr> <tr> <td>Research Center for Charged Particle Therapy </td> <td>350–400 </td> <td>1994 </td> <td><a href="/wiki/Chiba,_Chiba" class="mw-redirect" title="Chiba, Chiba">Chiba</a>, Japan </td></tr> <tr> <td><a href="/wiki/TRIUMF" title="TRIUMF">TRIUMF</a><a href="#cite_note-180">[180]</a> </td> <td>74 </td> <td>1995 </td> <td><a href="/wiki/Vancouver" title="Vancouver">Vancouver</a>, Canada </td></tr> <tr> <td><a href="/wiki/Helmholtz-Zentrum_Berlin" title="Helmholtz-Zentrum Berlin">Helmholtz-Zentrum Berlin</a> </td> <td>72 </td> <td>1998 </td> <td><a href="/wiki/Berlin" title="Berlin">Berlin</a>, Germany </td></tr> <tr> <td>Proton Medical Research Center University of Tsukuba </td> <td>250 </td> <td>2001 </td> <td><a href="/wiki/Tsukuba" title="Tsukuba">Tsukuba</a>, Japan </td></tr> <tr> <td>Centro di adroterapia oculare </td> <td>60 </td> <td>2002 </td> <td><a href="/wiki/Catania" title="Catania">Catania</a>, Italy </td></tr> <tr> <td>Wanjie Proton Therapy Center </td> <td>230 </td> <td>2004 </td> <td><a href="/wiki/Zibo" title="Zibo">Zibo</a>, China </td></tr> <tr> <td>Proton Therapy Center, Korea National Cancer Center </td> <td>230 </td> <td>2007 </td> <td><a href="/wiki/Seoul" title="Seoul">Seoul</a>, Korea </td></tr> <tr> <td>Heidelberg Ion-Beam Therapy Center (<a href="/w/index.php?title=Heidelberger_Ionenstrahl-Therapiezentrum&action=edit&redlink=1" class="new" title="Heidelberger Ionenstrahl-Therapiezentrum (page does not exist)">HIT</a> [<a href="https://de.wikipedia.org/wiki/Heidelberger_Ionenstrahl-Therapiezentrum" class="extiw" title="de:Heidelberger Ionenstrahl-Therapiezentrum">de</a>]) </td> <td>230 </td> <td>2009 </td> <td><a href="/wiki/Heidelberg" title="Heidelberg">Heidelberg</a>, Germany </td></tr> <tr> <td>Medipolis Proton Therapy and Research Center<a href="#cite_note-181">[181]</a> </td> <td>235 </td> <td>2011 </td> <td><a href="/wiki/Kagoshima" title="Kagoshima">Kagoshima</a>, Japan </td></tr> <tr> <td><a href="/wiki/Institute_of_Nuclear_Physics_of_the_Polish_Academy_of_Sciences" title="Institute of Nuclear Physics of the Polish Academy of Sciences">Instytut Fizyki Jądrowej</a> </td> <td>230 </td> <td>2011 </td> <td><a href="/wiki/Krak%C3%B3w" title="Kraków">Kraków</a>, Poland </td></tr> <tr> <td>Centro Nazionale di Adroterapia Oncologica </td> <td>250 </td> <td>2011 </td> <td><a href="/wiki/Pavia" title="Pavia">Pavia</a>, Italy </td></tr> <tr> <td><a href="/w/index.php?title=Protonov%C3%A9_centrum_v_Praze&action=edit&redlink=1" class="new" title="Protonové centrum v Praze (page does not exist)">Protonové centrum v Praze</a> [<a href="https://cs.wikipedia.org/wiki/Protonov%C3%A9_centrum_v_Praze" class="extiw" title="cz:Protonové centrum v Praze">cz</a>]<a href="#cite_note-182">[182]</a> </td> <td>230 </td> <td>2012 </td> <td><a href="/wiki/Prague" title="Prague">Prague</a>, Czech Republic </td></tr> <tr> <td><a href="/w/index.php?title=Westdeutsches_Protonentherapiezentrum_Essen&action=edit&redlink=1" class="new" title="Westdeutsches Protonentherapiezentrum Essen (page does not exist)">Westdeutsches Protonentherapiezentrum Essen</a> [<a href="https://de.wikipedia.org/wiki/Westdeutsches_Protonentherapiezentrum_Essen" class="extiw" title="de:Westdeutsches Protonentherapiezentrum Essen">de</a>] </td> <td>230 </td> <td>2013 </td> <td><a href="/wiki/Essen" title="Essen">Essen</a>, Germany </td></tr> <tr> <td>PTC <a href="/w/index.php?title=Uniklinikum_Dresden&action=edit&redlink=1" class="new" title="Uniklinikum Dresden (page does not exist)">Uniklinikum Dresden</a> [<a href="https://de.wikipedia.org/wiki/Universit%C3%A4tsklinikum_Carl_Gustav_Carus_Dresden" class="extiw" title="de:Universitätsklinikum Carl Gustav Carus Dresden">de</a>] </td> <td>230 </td> <td>2014 </td> <td><a href="/wiki/Dresden" title="Dresden">Dresden</a>, Germany </td></tr> <tr> <td>Centro di Protonterapia, APSS Trento<a href="#cite_note-183">[183]</a> </td> <td>230 </td> <td>2014 </td> <td><a href="/wiki/Trento" title="Trento">Trento</a>, Italy </td></tr> <tr> <td>Shanghai Proton and Heavy Ion Center </td> <td>230 </td> <td>2014 </td> <td><a href="/wiki/Shanghai" title="Shanghai">Shanghai</a>, China </td></tr> <tr> <td><a href="/w/index.php?title=Centrum_Cyklotronowe_Bronowice&action=edit&redlink=1" class="new" title="Centrum Cyklotronowe Bronowice (page does not exist)">Centrum Cyklotronowe Bronowice</a> [<a href="https://pl.wikipedia.org/wiki/Narodowe_Centrum_Radioterapii_Hadronowej" class="extiw" title="pl:Narodowe Centrum Radioterapii Hadronowej">pl</a>] </td> <td>230 </td> <td>2015 </td> <td><a href="/wiki/Krak%C3%B3w" title="Kraków">Kraków</a>, Poland </td></tr> <tr> <td>Samsung Medical Center Proton Therapy Center </td> <td>230 </td> <td>2015 </td> <td><a href="/wiki/Seoul" title="Seoul">Seoul</a>, Korea </td></tr> <tr> <td>Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital </td> <td>230 </td> <td>2015 </td> <td><a href="/wiki/Taipei" title="Taipei">Taipei</a>, Taiwan </td></tr> <tr> <td>Yung-Ching Proton Center, Kaohsiung Chang Gung Memorial Hospital<a href="#cite_note-184">[184]</a> </td> <td>230 </td> <td>2018 </td> <td><a href="/wiki/Kaohsiung" title="Kaohsiung">Kaohsiung</a>, Taiwan </td></tr> <tr> <td><a href="/w/index.php?title=Skandionkliniken&action=edit&redlink=1" class="new" title="Skandionkliniken (page does not exist)">Skandionkliniken</a> [<a href="https://sv.wikipedia.org/wiki/Skandionkliniken" class="extiw" title="sv:Skandionkliniken">sv</a>]<a href="#cite_note-185">[185]</a> </td> <td>230 </td> <td>2015 </td> <td><a href="/wiki/Uppsala" title="Uppsala">Uppsala</a>, Sweden </td></tr> <tr> <td><a href="/w/index.php?title=A._Tsyb_Medical_Radiological_Research_Centre&action=edit&redlink=1" class="new" title="A. Tsyb Medical Radiological Research Centre (page does not exist)">A. Tsyb Medical Radiological Research Centre</a> [<a href="https://ru.wikipedia.org/wiki/%D0%9C%D0%B5%D0%B4%D0%B8%D1%86%D0%B8%D0%BD%D1%81%D0%BA%D0%B8%D0%B9_%D1%80%D0%B0%D0%B4%D0%B8%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B9_%D0%BD%D0%B0%D1%83%D1%87%D0%BD%D1%8B%D0%B9_%D1%86%D0%B5%D0%BD%D1%82%D1%80" class="extiw" title="ru:Медицинский радиологический научный центр">ru</a>] </td> <td>250 </td> <td>2016 </td> <td><a href="/wiki/Obninsk" title="Obninsk">Obninsk</a>, Russia </td></tr> <tr> <td><a href="/wiki/MedAustron" title="MedAustron">MedAustron</a> </td> <td>250 </td> <td>2016 </td> <td><a href="/wiki/Wiener_Neustadt" title="Wiener Neustadt">Wiener Neustadt</a>, Austria </td></tr> <tr> <td>Clinical Proton Therapy Center Dr. Berezin Medical Institute<a href="#cite_note-186">[186]</a> </td> <td>250 </td> <td>2017 </td> <td><a href="/wiki/Saint-Petersburg" class="mw-redirect" title="Saint-Petersburg">Saint-Petersburg</a>, Russia </td></tr> <tr> <td>Holland Proton Therapy Center<a href="#cite_note-187">[187]</a> </td> <td>250 </td> <td>2018 </td> <td><a href="/wiki/Delft" title="Delft">Delft</a>, Netherlands </td></tr> <tr> <td>UMC Groningen Protonen Therapie Centrum<a href="#cite_note-188">[188]</a> </td> <td>230 </td> <td>2018 </td> <td><a href="/wiki/Groningen" title="Groningen">Groningen</a>, Netherlands </td></tr> <tr> <td><a href="/wiki/Christie_Hospital" class="mw-redirect" title="Christie Hospital">The Christie</a><a href="#cite_note-189">[189]</a> </td> <td>250 </td> <td>2018 </td> <td><a href="/wiki/Manchester" title="Manchester">Manchester</a>, United Kingdom </td></tr> <tr> <td>Danish Centre for Particle Therapy<a href="#cite_note-190">[190]</a> </td> <td>250 </td> <td>2019 </td> <td><a href="/wiki/Aarhus" title="Aarhus">Aarhus</a>, Denmark </td></tr> <tr> <td><a href="/w/index.php?title=Apollo_Proton_Cancer_Centre&action=edit&redlink=1" class="new" title="Apollo Proton Cancer Centre (page does not exist)">Apollo Proton Cancer Centre</a><a href="#cite_note-191">[191]</a> </td> <td>230 </td> <td>2019 </td> <td><a href="/wiki/Chennai" title="Chennai">Chennai</a>, India </td></tr> <tr> <td><a href="/wiki/Maastricht_UMC%2B#Miscellaneous" title="Maastricht UMC+">MAASTRO Clinic</a> Proton Therapy<a href="#cite_note-192">[192]</a> </td> <td>230 </td> <td>2019 </td> <td><a href="/wiki/Maastricht" title="Maastricht">Maastricht</a>, Netherlands </td></tr> <tr> <td><a href="/w/index.php?title=Cl%C3%ADnica_Universidad_de_Navarra&action=edit&redlink=1" class="new" title="Clínica Universidad de Navarra (page does not exist)">Clínica Universidad de Navarra</a> [<a href="https://es.wikipedia.org/wiki/Cl%C3%ADnica_Universidad_de_Navarra#Historia" class="extiw" title="es:Clínica Universidad de Navarra">es</a>] </td> <td>230 </td> <td>2019 </td> <td><a href="/wiki/Madrid" title="Madrid">Madrid</a>, Spain </td></tr> <tr> <td>Centro de Protonterapia de Quirónsalud<a href="#cite_note-193">[193]</a> </td> <td>230 </td> <td>2019 </td> <td><a href="/wiki/Madrid" title="Madrid">Madrid</a>, Spain </td></tr> <tr> <td>King Chulalongkorn Memorial Hospital <a href="#cite_note-194">[194]</a> </td> <td>250 </td> <td>2021 </td> <td><a href="/wiki/Bangkok" title="Bangkok">Bangkok</a>, Thailand </td></tr> <tr> <td>University College London Hospitals<a href="#cite_note-195">[195]</a> </td> <td>250 </td> <td>2021 </td> <td><a href="/wiki/London" title="London">London</a>, United Kingdom </td></tr> <tr> <td>Hefei Ion Medical Center<a href="#cite_note-196">[196]</a> </td> <td>250 </td> <td>2022 </td> <td><a href="/wiki/Hefei" title="Hefei">Hefei</a>, China </td></tr> <tr> <td>Proton Clinical Research Center of the Shandong Cancer Hospital </td> <td>250 </td> <td>2022 </td> <td><a href="/wiki/Jinan" title="Jinan">Jinan</a>, China </td></tr> <tr> <td>Gleneagles Hospital Singapore<a href="#cite_note-197">[197]</a> </td> <td> </td> <td>2023 </td> <td><a href="/wiki/Singapore" title="Singapore">Singapore</a> </td></tr> <tr> <td>Singapore Institute of Advanced Medicine Holdings - Proton Therapy SG<a href="#cite_note-198">[198]</a> </td> <td>250 </td> <td>2023 </td> <td><a href="/wiki/Singapore" title="Singapore">Singapore</a> </td></tr> <tr> <td>Mount Elizabeth Proton Therapy Centre<a href="#cite_note-199">[199]</a> </td> <td>230 </td> <td>2023 </td> <td><a href="/wiki/Singapore" title="Singapore">Singapore</a> </td></tr> <tr> <td><a href="/wiki/National_Cancer_Centre_Singapore" class="mw-redirect" title="National Cancer Centre Singapore">National Cancer Centre Singapore</a> - Goh Cheng Liang Proton Therapy Centre<a href="#cite_note-200">[200]</a> </td> <td> </td> <td>2023 </td> <td><a href="/wiki/Singapore" title="Singapore">Singapore</a> </td></tr> <tr> <td>Parkway Cancer Centre<a href="#cite_note-201">[201]</a> </td> <td> </td> <td>2023 </td> <td><a href="/wiki/Singapore" title="Singapore">Singapore</a> </td></tr> <tr> <td><a href="/wiki/Hong_Kong_Sanatorium_%26_Hospital" title="Hong Kong Sanatorium & Hospital">Hong Kong Sanatorium & Hospital</a> - HKSH Proton Therapy Centre<a href="#cite_note-202">[202]</a><a href="#cite_note-203">[203]</a><a href="#cite_note-204">[204]</a> </td> <td> </td> <td>2023 </td> <td><a href="/wiki/Hong_Kong" title="Hong Kong">Hong Kong</a>, China </td></tr> <tr> <td>Central Japan International Medical Center <a href="#cite_note-205">[205]</a> </td> <td>230 </td> <td>2024 </td> <td><a href="/wiki/Minokamo" class="mw-redirect" title="Minokamo">Minokamo</a>, Japan </td></tr> <tr> <td>Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Center<a href="#cite_note-206">[206]</a> </td> <td> </td> <td>2024 </td> <td><a href="/wiki/Shenzhen" title="Shenzhen">Shenzhen</a>, China </td></tr> <tr> <td><a href="/wiki/Oslo_University_Hospital,_Radiumhospitalet" title="Oslo University Hospital, Radiumhospitalet">Oslo University Hospital, Radiumhospitalet</a><a href="#cite_note-207">[207]</a> </td> <td> </td> <td>2025 </td> <td><a href="/wiki/Oslo" title="Oslo">Oslo</a>, Norway </td></tr> <tr> <td><a href="/wiki/Haukeland_University_Hospital" title="Haukeland University Hospital">Haukeland University Hospital</a><a href="#cite_note-208">[208]</a> </td> <td> </td> <td>2025 </td> <td><a href="/wiki/Bergen" title="Bergen">Bergen</a>, Norway </td></tr> <tr> <td>Heyou International Hospital<a href="#cite_note-209">[209]</a> </td> <td> </td> <td>2026<a href="#cite_note-210">[210]</a> </td> <td><a href="/wiki/Foshan" title="Foshan">Foshan</a>, China </td></tr></tbody></table> <div class="mw-heading mw-heading4"><h4 id="Australia">Australia</h4>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=27" title="Edit section: Australia">edit</a>]</div> In July 2020, construction began for "SAHMRI 2", the second building for the <a href="/wiki/South_Australian_Health_and_Medical_Research_Institute" title="South Australian Health and Medical Research Institute">South Australian Health and Medical Research Institute</a>. The building should house the <a href="/wiki/Australian_Bragg_Centre_for_Proton_Therapy_%26_Research" class="mw-redirect" title="Australian Bragg Centre for Proton Therapy & Research">Australian Bragg Centre for Proton Therapy & Research</a>, a A$500+ million addition to the largest health and biomedical precinct in the <a href="/wiki/Southern_Hemisphere" title="Southern Hemisphere">Southern Hemisphere</a>, <a href="/wiki/Adelaide" title="Adelaide">Adelaide</a>'s BioMed City. The proton therapy unit was to be supplied by ProTom International, an American supplier of the therapy equipment. The facility was expected to be completed in late 2023, with its first patients treated in 2025.<a href="#cite_note-indaily2020-211">[211]</a> Early 2024 the South Australian government expressed concerns about the delivery of the project and later in the year the agreement with ProTom International was terminated. <a href="#cite_note-indaily2024-212">[212]</a> <a href="#cite_note-9news2024-213">[213]</a> <div class="mw-heading mw-heading4"><h4 id="India">India</h4>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=28" title="Edit section: India">edit</a>]</div> Apollo Proton Cancer Centre (APCC) in Chennai, Tamil Nadu, a unit under <a href="/wiki/Apollo_Hospitals" title="Apollo Hospitals">Apollo Hospitals</a>, is a Cancer specialty hospital.<a href="#cite_note-214">[214]</a> APCC is the only cancer hospital in India with <a href="/wiki/Joint_Commission_International" class="mw-redirect" title="Joint Commission International">Joint Commission International</a> accreditation.<a href="#cite_note-215">[215]</a> <div class="mw-heading mw-heading4"><h4 id="Israel">Israel</h4>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=29" title="Edit section: Israel">edit</a>]</div> In January 2020, it was announced that a proton therapy center would be built in Ichilov Hospital, at the <a href="/wiki/Tel_Aviv_Sourasky_Medical_Center" title="Tel Aviv Sourasky Medical Center">Tel Aviv Sourasky Medical Center</a>. The project's construction was fully funded by donations. It will have two treatment rooms.<a href="#cite_note-216">[216]</a> According to a newspaper report in 2023, it should be ready in three to four years. The report also mentions that "Proton therapy for cancer treatment has arrived in Israel and the Middle East with a clinical trial underway that sees <a href="/wiki/Hadassah_Medical_Center" title="Hadassah Medical Center">Hadassah Medical Center</a> partnering with P-Cure, an Israeli company that has developed a unique system designed to fit into existing hospital settings".<a href="#cite_note-217">[217]</a> <div class="mw-heading mw-heading4"><h4 id="Spain">Spain</h4>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=30" title="Edit section: Spain">edit</a>]</div> In October 2021, the <a href="/wiki/Amancio_Ortega_Foundation" title="Amancio Ortega Foundation">Amancio Ortega Foundation</a> arranged with the Spanish government and several autonomous communities to donate 280 million euros to install ten proton accelerators in the public health system.<a href="#cite_note-218">[218]</a> <div class="mw-heading mw-heading4"><h4 id="United_Kingdom">United Kingdom</h4>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=31" title="Edit section: United Kingdom">edit</a>]</div> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Prince_Charles_and_Dr._Yen-Ching_Chang_at_UCLH.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/13/Prince_Charles_and_Dr._Yen-Ching_Chang_at_UCLH.jpg/220px-Prince_Charles_and_Dr._Yen-Ching_Chang_at_UCLH.jpg" decoding="async" width="220" height="149" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/13/Prince_Charles_and_Dr._Yen-Ching_Chang_at_UCLH.jpg/330px-Prince_Charles_and_Dr._Yen-Ching_Chang_at_UCLH.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/13/Prince_Charles_and_Dr._Yen-Ching_Chang_at_UCLH.jpg/440px-Prince_Charles_and_Dr._Yen-Ching_Chang_at_UCLH.jpg 2x" data-file-width="973" data-file-height="660" /></a><figcaption><a href="/wiki/Prince_Charles" class="mw-redirect" title="Prince Charles">Prince Charles</a> and Dr. Yen-Ching Chang at the <a href="/wiki/University_College_London_Hospitals_NHS_Foundation_Trust" title="University College London Hospitals NHS Foundation Trust">University College London Hospitals NHS Foundation Trust</a> proton centre opening ceremony</figcaption></figure> In 2013 the British government announced that £250 million had been budgeted to establish two centers for advanced radiotherapy: <a href="/wiki/The_Christie_NHS_Foundation_Trust" class="mw-redirect" title="The Christie NHS Foundation Trust">The Christie NHS Foundation Trust</a> (the <a href="/wiki/Christie_Hospital" class="mw-redirect" title="Christie Hospital">Christie Hospital</a>) in <a href="/wiki/Manchester" title="Manchester">Manchester</a>, which opened in 2018; and <a href="/wiki/University_College_London_Hospitals_NHS_Foundation_Trust" title="University College London Hospitals NHS Foundation Trust">University College London Hospitals NHS Foundation Trust</a>, which opened in 2021. These offer high-energy proton therapy, and other types of advanced radiotherapy, including <a href="/wiki/Intensity-modulated_radiotherapy" class="mw-redirect" title="Intensity-modulated radiotherapy">intensity-modulated radiotherapy</a> (IMRT) <a href="/wiki/Liverpool" title="Liverpool">and</a> <a href="/wiki/Image-guided_radiation_therapy" title="Image-guided radiation therapy">image-guided radiotherapy</a> (IGRT).<a href="#cite_note-219">[219]</a> In 2014, only low-energy proton therapy was available in the UK, at <a href="/wiki/Clatterbridge_Cancer_Centre_NHS_Foundation_Trust" title="Clatterbridge Cancer Centre NHS Foundation Trust">Clatterbridge Cancer Centre NHS Foundation Trust</a> in <a href="/wiki/Merseyside" title="Merseyside">Merseyside</a>. But <a href="/wiki/NHS_England" title="NHS England">NHS England</a> has paid to have suitable cases treated abroad, mostly in the US. Such cases rose from 18 in 2008 to 122 in 2013, 99 of whom were children. The cost to the National Health Service averaged ~£100,000 per case.<a href="#cite_note-220">[220]</a> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=32" title="Edit section: See also">edit</a>]</div> <ul><li><a href="/wiki/Particle_therapy" title="Particle therapy">Particle therapy</a></li> <li><a href="/wiki/Charged_particle_therapy" class="mw-redirect" title="Charged particle therapy">Charged particle therapy</a></li> <li><a href="/wiki/Hadron" title="Hadron">Hadron</a></li> <li><a href="/wiki/Microbeam" title="Microbeam">Microbeam</a></li> <li><a href="/wiki/Fast_neutron_therapy" title="Fast neutron therapy">Fast neutron therapy</a></li> <li><a href="/wiki/Boron_neutron_capture_therapy" class="mw-redirect" title="Boron neutron capture therapy">Boron neutron capture therapy</a></li> <li><a href="/wiki/Linear_energy_transfer" title="Linear energy transfer">Linear energy transfer</a></li> <li><a href="/wiki/Electromagnetic_radiation_and_health" title="Electromagnetic radiation and health">Electromagnetic radiation and health</a></li> <li><a href="/wiki/Dosimetry" title="Dosimetry">Dosimetry</a></li> <li><a href="/wiki/Ionizing_radiation" title="Ionizing radiation">Ionizing radiation</a></li> <li><a href="/wiki/List_of_oncology-related_terms" class="mw-redirect" title="List of oncology-related terms">List of oncology-related terms</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=33" title="Edit section: References">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist reflist-columns references-column-width reflist-columns-2"> <ol class="references"> <li id="cite_note-Yuan-1">^ <a href="#cite_ref-Yuan_1-0">a</a> <a href="#cite_ref-Yuan_1-1">b</a> <style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFTai-Ze_Yuan2019" 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Baptist Health South Florida. Archived from <a rel="nofollow" class="external text" href="https://baptisthealth.net/en/health-services/cancer-services/pages/cancer-care/treatments-and-services/proton-therapy.aspx">the original</a> on 2017-10-06.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Baptist+Health+South+Florida&rft.atitle=Proton+Therapy+at+Miami+Cancer+Institute&rft_id=https%3A%2F%2Fbaptisthealth.net%2Fen%2Fhealth-services%2Fcancer-services%2Fpages%2Fcancer-care%2Ftreatments-and-services%2Fproton-therapy.aspx&rfr_id=info%3Asid%2Fen.wikipedia.org%3AProton+therapy" class="Z3988"> </li> <li id="cite_note-161"><a href="#cite_ref-161">^</a> <a rel="nofollow" class="external text" href="https://www.beaumont.org/treatments/proton-therapy">Beaumont Proton Therapy Center</a> </li> <li id="cite_note-162"><a href="#cite_ref-162">^</a> <a rel="nofollow" class="external text" href="https://winshipcancer.emory.edu/patient-care/clinics-and-centers/proton-therapy-center.html">Emory Proton Therapy Center</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20180307150839/https://winshipcancer.emory.edu/patient-care/clinics-and-centers/proton-therapy-center.html">Archived</a> 2018-03-07 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a> </li> <li id="cite_note-163"><a href="#cite_ref-163">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20171014235603/https://winshipcancer.emory.edu/files/patient-care-files/emory-proton-therapy-center-fact-sheet.pdf">"Emory Proton Therapy Center Fact Sheet"</a> (PDF). winshipcancer.emory.edu. 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Retrieved 2021-12-06.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Hindu&rft.atitle=Apollo+Proton+Centre+gets+JCI+accreditation&rft.date=2020-07-04&rft.issn=0971-751X&rft_id=https%3A%2F%2Fwww.thehindu.com%2Fnews%2Fcities%2Fchennai%2Fapollo-proton-centre-gets-jci-accreditation%2Farticle31984873.ece&rfr_id=info%3Asid%2Fen.wikipedia.org%3AProton+therapy" class="Z3988"> </li> <li id="cite_note-216"><a href="#cite_ref-216">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFFilut2020" class="citation web cs1">Filut, Adrian (January 27, 2020). <a rel="nofollow" class="external text" href="https://www.calcalistech.com/ctech/articles/0,7340,L-3783170,00.html">"Israel to Establish National Center for Proton Radiation Cancer Therapy"</a>. CTECH - www.calcalistech.com.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=CTECH+-+www.calcalistech.com&rft.atitle=Israel+to+Establish+National+Center+for+Proton+Radiation+Cancer+Therapy&rft.date=2020-01-27&rft.aulast=Filut&rft.aufirst=Adrian&rft_id=https%3A%2F%2Fwww.calcalistech.com%2Fctech%2Farticles%2F0%2C7340%2CL-3783170%2C00.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3AProton+therapy" class="Z3988"> </li> <li id="cite_note-217"><a href="#cite_ref-217">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFGhert-Zand2022" class="citation web cs1">Ghert-Zand, Renee (27 June 2022). <a rel="nofollow" class="external text" href="https://www.hadassah.org/story/an-israel-first-hadassah-to-offer-proton-therapy-to-cancer-patients">"An Israel First: Hadassah to Offer Proton Therapy to Cancer Patients"</a>. hadassah. Retrieved 4 Oct 2023.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=hadassah&rft.atitle=An+Israel+First%3A+Hadassah+to+Offer+Proton+Therapy+to+Cancer+Patients&rft.date=2022-06-27&rft.aulast=Ghert-Zand&rft.aufirst=Renee&rft_id=https%3A%2F%2Fwww.hadassah.org%2Fstory%2Fan-israel-first-hadassah-to-offer-proton-therapy-to-cancer-patients&rfr_id=info%3Asid%2Fen.wikipedia.org%3AProton+therapy" class="Z3988"> </li> <li id="cite_note-218"><a href="#cite_ref-218">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.faortega.org/en/projects/programme-proton-therapy/">"Programme for the implementation of proton therapy in the Spanish public health system"</a>. Fundación Amancio Ortega.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Fundaci%C3%B3n+Amancio+Ortega&rft.atitle=Programme+for+the+implementation+of+proton+therapy+in+the+Spanish+public+health+system&rft_id=http%3A%2F%2Fwww.faortega.org%2Fen%2Fprojects%2Fprogramme-proton-therapy%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AProton+therapy" class="Z3988"> </li> <li id="cite_note-219"><a href="#cite_ref-219">^</a> <a rel="nofollow" class="external text" href="http://www.cancerresearchuk.org/about-us/cancer-news/news-report/manchester-and-london-proton-beam-therapy-units-confirmed">"Manchester and London proton beam therapy units confirmed"</a>, Press release, <a href="/wiki/Press_Association" class="mw-redirect" title="Press Association">Press Association</a>, <a href="/wiki/Cancer_Research_UK" title="Cancer Research UK">Cancer Research UK</a>, 1 August 2013 </li> <li id="cite_note-220"><a href="#cite_ref-220">^</a> <a rel="nofollow" class="external text" href="https://www.bbc.co.uk/news/uk-29002221">"Ashya King case: What is proton beam therapy?"</a> BBC news story with NHS England figures, 31 August 2014 </li> </ol></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=34" title="Edit section: Further reading">edit</a>]</div> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFGreco_C.Wolden_S.2007" class="citation journal cs1">Greco C.; Wolden S. (Apr 2007). <a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Fcncr.22542">"Current status of radiotherapy with proton and light ion beams"</a>. Cancer. 109 (7): 1227–1238. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Fcncr.22542">10.1002/cncr.22542</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17326046">17326046</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:36256866">36256866</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Cancer&rft.atitle=Current+status+of+radiotherapy+with+proton+and+light+ion+beams&rft.volume=109&rft.issue=7&rft.pages=%3Cspan+class%3D%22nowrap%22%3E1227-%3C%2Fspan%3E1238&rft.date=2007-04&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A36256866%23id-name%3DS2CID&rft_id=info%3Apmid%2F17326046&rft_id=info%3Adoi%2F10.1002%2Fcncr.22542&rft.au=Greco+C.&rft.au=Wolden+S.&rft_id=https%3A%2F%2Fdoi.org%2F10.1002%252Fcncr.22542&rfr_id=info%3Asid%2Fen.wikipedia.org%3AProton+therapy" class="Z3988"></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFKoehler1971" class="citation book cs1">Koehler, A.M. (1971). <a rel="nofollow" class="external text" href="https://s3.cern.ch/inspire-prod-files-e/ef51057c4e2afde2f296ca3cb16664b9">"Use of Protons for Radiotherapy"</a>. Proceedings Of The Symposium On Pion And Proton Radiography, Fermi National Accelerator Laboratory, Batavia, IL. pp. 63–68.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Use+of+Protons+for+Radiotherapy&rft.btitle=Proceedings+Of+The+Symposium+On+Pion+And+Proton+Radiography%2C+Fermi+National+Accelerator+Laboratory%2C+Batavia%2C+IL&rft.pages=%3Cspan+class%3D%22nowrap%22%3E63-%3C%2Fspan%3E68&rft.date=1971&rft.aulast=Koehler&rft.aufirst=A.M.&rft_id=https%3A%2F%2Fs3.cern.ch%2Finspire-prod-files-e%2Fef51057c4e2afde2f296ca3cb16664b9&rfr_id=info%3Asid%2Fen.wikipedia.org%3AProton+therapy" class="Z3988"></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFKoehlerPreston1972" class="citation journal cs1">Koehler, A. M.; Preston, W. M. (1972). "Protons in Radiation Therapy". Radiology. 104 (1). Radiological Society of North America (RSNA): 191–195. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1148%2F104.1.191">10.1148/104.1.191</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0033-8419">0033-8419</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/4624458">4624458</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Radiology&rft.atitle=Protons+in+Radiation+Therapy&rft.volume=104&rft.issue=1&rft.pages=%3Cspan+class%3D%22nowrap%22%3E191-%3C%2Fspan%3E195&rft.date=1972&rft.issn=0033-8419&rft_id=info%3Apmid%2F4624458&rft_id=info%3Adoi%2F10.1148%2F104.1.191&rft.aulast=Koehler&rft.aufirst=A.+M.&rft.au=Preston%2C+W.+M.&rfr_id=info%3Asid%2Fen.wikipedia.org%3AProton+therapy" class="Z3988"></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFKjelberg1977" class="citation book cs1">Kjelberg, R.N. (1977). "Bragg Peak Proton Radiosurgery for Arteriovenous Malformation of the Brain". First International Seminar on the use of Proton Beams in Radiation Therapy, Moscow.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Bragg+Peak+Proton+Radiosurgery+for+Arteriovenous+Malformation+of+the+Brain&rft.btitle=First+International+Seminar+on+the+use+of+Proton+Beams+in+Radiation+Therapy%2C+Moscow&rft.date=1977&rft.aulast=Kjelberg&rft.aufirst=R.N.&rfr_id=info%3Asid%2Fen.wikipedia.org%3AProton+therapy" class="Z3988"></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFAustin-SeymourMunzenriderLinggoodGoitein1990" class="citation journal cs1">Austin-Seymour, Mary; Munzenrider, John; et al. (1990). "Fractionated Proton Radiation Therapy of Cranial and Intracranial Tumors". American Journal of Clinical Oncology. 13 (4). Ovid Technologies (Wolters Kluwer Health): 327–330. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F00000421-199008000-00013">10.1097/00000421-199008000-00013</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0277-3732">0277-3732</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/2165739">2165739</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:26465153">26465153</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=American+Journal+of+Clinical+Oncology&rft.atitle=Fractionated+Proton+Radiation+Therapy+of+Cranial+and+Intracranial+Tumors&rft.volume=13&rft.issue=4&rft.pages=%3Cspan+class%3D%22nowrap%22%3E327-%3C%2Fspan%3E330&rft.date=1990&rft.issn=0277-3732&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A26465153%23id-name%3DS2CID&rft_id=info%3Apmid%2F2165739&rft_id=info%3Adoi%2F10.1097%2F00000421-199008000-00013&rft.aulast=Austin-Seymour&rft.aufirst=Mary&rft.au=Munzenrider%2C+John&rft.au=Linggood%2C+Rita&rft.au=Goitein%2C+Michael&rft.au=Verhey%2C+Lynn&rft.au=Urie%2C+Marcia&rft.au=Gentry%2C+Richard&rft.au=Birnbaum%2C+Steven&rft.au=Ruotolo%2C+Donna&rft.au=Crowell%2C+Candace&rft.au=McManus%2C+Patricia&rft.au=Skates%2C+Steven&rft.au=Koehler%2C+Andreas&rft.au=Suit%2C+Herman+D.&rfr_id=info%3Asid%2Fen.wikipedia.org%3AProton+therapy" class="Z3988"></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFHartfordZietman1999" class="citation book cs1">Hartford, Zietman, et al. (1999). "Proton Radiotherapy". In A. D'Amico, G.E. Hanks (eds.). Radiotherapeutic Management of Carcinoma of the Prostate. London, UK: Arnold Publishers. pp. 61–72.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Proton+Radiotherapy&rft.btitle=Radiotherapeutic+Management+of+Carcinoma+of+the+Prostate&rft.place=London%2C+UK&rft.pages=%3Cspan+class%3D%22nowrap%22%3E61-%3C%2Fspan%3E72&rft.pub=Arnold+Publishers&rft.date=1999&rft.au=Hartford&rft.au=Zietman&rfr_id=info%3Asid%2Fen.wikipedia.org%3AProton+therapy" class="Z3988"></li></ul> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2>[<a href="/w/index.php?title=Proton_therapy&action=edit&section=35" title="Edit section: External links">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid #aaa;font-size:88%;line-height:1.25em;background-color:var(--background-color-interactive-subtle,#f8f9fa);display:flow-root}.mw-parser-output .side-box-abovebelow,.mw-parser-output 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therapy</a>.</div></div> </div> <ul><li>The Intrepid <a rel="nofollow" class="external text" href="https://www.flipsnack.com/protonman/protonman_issue02.html">Proton-Man</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20210805153357/https://www.flipsnack.com/protonman/protonman_issue02.html">Archived</a> 2021-08-05 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a>, educational comic books by <a href="/wiki/Steve_Englehart" title="Steve Englehart">Steve Englehart</a> and Michael Jaszewski for pediatric patients</li> <li>2019 BBC Horizon <a rel="nofollow" class="external text" href="https://www.bitchute.com/video/FPUsUoOQFd3T/">documentary</a></li> <li>2019 Jove video by the University of Maryland School of Medicine explaining the treatment process: <a rel="nofollow" class="external text" href="https://www.jove.com/video/58372/proton-therapy-delivery-its-clinical-application-select-solid-tumor">Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies</a></li> <li>2019 <a rel="nofollow" class="external text" href="https://www.youtube.com/watch?v=GF7nDC8giK0">The NHS Proton Beam Therapy Programme</a></li> <li>Proton Therapy Collaborative Group <a rel="nofollow" class="external text" href="https://www.ptcog.ch/">PTCOG</a></li> <li><a rel="nofollow" class="external text" href="https://allianceforprotontherapy.org/">Alliance for Proton Therapy</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20190715163359/https://allianceforprotontherapy.org/">Archived</a> 2019-07-15 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a></li> <li><a rel="nofollow" class="external text" href="https://provisionhealthcare.com/about-us/our-cares-cancer-network/">CARES Cancer Network</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20201027062657/https://provisionhealthcare.com/about-us/our-cares-cancer-network/">Archived</a> 2020-10-27 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a></li> <li><a rel="nofollow" class="external text" href="https://www.proton-therapy.org/">National Association for Proton Therapy</a></li> <li><a href="/wiki/American_Society_for_Radiation_Oncology" title="American Society for Radiation Oncology">American Society for Radiation Oncology</a> Model Policy – <a rel="nofollow" class="external text" href="https://www.astro.org/uploadedFiles/_MAIN_SITE/Daily_Practice/Reimbursement/Model_Policies/Content_Pieces/ASTROPBTModelPolicy.pdf">Proton Beam Therapy</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20220611131919/https://www.astro.org/uploadedFiles/_MAIN_SITE/Daily_Practice/Reimbursement/Model_Policies/Content_Pieces/ASTROPBTModelPolicy.pdf">Archived</a> 2022-06-11 at the <a 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abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Radiation_oncology" title="Template:Radiation oncology"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Radiation_oncology" title="Template talk:Radiation oncology"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Radiation_oncology" title="Special:EditPage/Template:Radiation oncology"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Radiation_oncology260" style="font-size:114%;margin:0 4em"><a href="/wiki/Radiation_therapy" title="Radiation therapy">Radiation oncology</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align: center;"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;">Specific therapies</div></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0;background: none;"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;font-weight: normal;"><a href="/wiki/External_beam_radiotherapy" title="External beam radiotherapy">Teletherapy</a>1</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;font-weight: normal;">by <a href="/wiki/Photon" title="Photon">photon</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Superficial_X-rays" title="Superficial X-rays">Superficial X-rays</a></li> <li><a href="/wiki/Orthovoltage_X-rays" title="Orthovoltage X-rays">Orthovoltage X-rays</a></li> <li><a href="/wiki/Megavoltage_X-rays" title="Megavoltage X-rays">Megavoltage X-rays</a></li> <li><a href="/wiki/Radiosurgery" title="Radiosurgery">Radiosurgery</a> / <a href="/wiki/Stereotactic_radiation_therapy" title="Stereotactic radiation therapy">Stereotactic radiation therapy</a> <ul><li><a href="/wiki/Cyberknife_(device)" title="Cyberknife (device)">Cyberknife</a></li> <li><a href="/wiki/Gamma_Knife" class="mw-redirect" title="Gamma Knife">Gamma Knife</a></li></ul></li> <li><a href="/wiki/Cobalt_therapy" title="Cobalt therapy">Cobalt therapy</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;font-weight: normal;">by <a href="/wiki/Electron" title="Electron">electron</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Electron_therapy" title="Electron therapy">Electron therapy</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;font-weight: normal;">by <a href="/wiki/Hadron" title="Hadron">hadron</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Particle_therapy" title="Particle therapy">Particle therapy</a> <ul><li><a href="/wiki/Fast_neutron_therapy" title="Fast neutron therapy">fast neutron</a></li> <li><a href="/wiki/Neutron_capture_therapy_of_cancer" title="Neutron capture therapy of cancer">neutron-capture</a></li> <li><a class="mw-selflink selflink">proton</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;font-weight: normal;"><a href="/wiki/Brachytherapy" title="Brachytherapy">Brachytherapy</a>2</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Prostate_brachytherapy" title="Prostate brachytherapy">Prostate</a> <ul><li><a href="/wiki/Iodine-125" title="Iodine-125">125I</a></li> <li><a href="/wiki/Palladium-103" class="mw-redirect" title="Palladium-103">103Pd</a></li></ul></li> <li><a href="/wiki/Plaque_radiotherapy" title="Plaque radiotherapy">Plaque radiotherapy</a> (125I)</li> <li><a href="/wiki/Selective_internal_radiation_therapy" title="Selective internal radiation therapy">Selective internal radiation therapy</a> / <a href="/wiki/SIR-Spheres" title="SIR-Spheres">SIR-Spheres</a> / <a href="/wiki/TheraSphere" title="TheraSphere">TheraSphere</a> (<a href="/wiki/Yttrium-90" title="Yttrium-90">90Y</a>)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;font-weight: normal;"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0; line-height: 1.15em"><a href="/wiki/Unsealed_source_radiotherapy" class="mw-redirect" title="Unsealed source radiotherapy">Unsealed source radiotherapy</a>3 </div></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Iobenguane" title="Iobenguane">Iobenguane</a> (<a href="/wiki/Iodine-131" title="Iodine-131">131I</a>)</li> <li><a href="/wiki/Yttrium-90" title="Yttrium-90">90Y</a></li> <li><a href="/wiki/Samarium_(153Sm)_lexidronam" title="Samarium (153Sm) lexidronam">Lexidronam</a> (<a href="/wiki/Samarium-153" class="mw-redirect" title="Samarium-153">153Sm</a>)</li> <li><a href="/wiki/Strontium-89" title="Strontium-89">89Sr</a></li> <li><a href="/wiki/Radioimmunotherapy" title="Radioimmunotherapy">Radioimmunotherapy</a> <ul><li><a href="/wiki/Ibritumomab_tiuxetan" title="Ibritumomab tiuxetan">ibritumomab tiuxetan</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;font-weight: normal;">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Intraoperative_radiation_therapy" title="Intraoperative radiation therapy">Intraoperative radiation therapy</a> <ul><li><a href="/wiki/Intraoperative_electron_radiation_therapy" title="Intraoperative electron radiation therapy">electron</a></li> <li><a href="/wiki/TARGIT" class="mw-redirect" title="TARGIT">TARGIT</a></li></ul></li> <li><a href="/wiki/Tomotherapy" title="Tomotherapy">Tomotherapy</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align: center;">Conditions</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0;background: none;"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Radiation_burn" title="Radiation burn">Radiation burn</a></li> <li><a href="/wiki/Radiation_proctitis" title="Radiation proctitis">Radiation proctitis</a></li> <li><a href="/wiki/Radiation-induced_lung_injury" title="Radiation-induced lung injury">Radiation-induced lung injury</a></li> <li><a href="/wiki/Bystander_effect_(radiobiology)" title="Bystander effect (radiobiology)">Bystander effect</a></li> <li><a href="/wiki/Abscopal_effect" title="Abscopal effect">Abscopal effect</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align: center;"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;">Features and equipment</div></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0;background: none;;background: whitesmoke;"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/BEAMnrc" class="mw-redirect" title="BEAMnrc">BEAMnrc</a></li> <li><a href="/wiki/Bolus_(radiation_therapy)" title="Bolus (radiation therapy)">Bolus</a></li> <li><a href="/wiki/Bragg_peak" title="Bragg peak">Bragg peak</a></li> <li><a href="/wiki/D50_(radiotherapy)" title="D50 (radiotherapy)">D50</a></li> <li><a href="/wiki/Dose_profile" title="Dose profile">Dose profile</a></li> <li><a href="/wiki/Dose_verification_system" title="Dose verification system">Dose verification system</a></li> <li><a href="/wiki/Dose-volume_histogram" title="Dose-volume histogram">Dose-volume histogram</a></li> <li><a href="/wiki/Dosimetry" title="Dosimetry">Dosimetry</a></li> <li><a href="/wiki/Isocenter" title="Isocenter">Isocenter</a></li> <li><a href="/wiki/Mobetron" class="mw-redirect" title="Mobetron">Mobetron</a></li> <li><a href="/wiki/Monitor_unit" title="Monitor unit">Monitor unit</a></li> <li><a href="/wiki/Multileaf_collimator" title="Multileaf collimator">Multileaf collimator</a></li> <li><a href="/wiki/Nanoimpellers" title="Nanoimpellers">Nanoimpellers</a></li> <li><a href="/wiki/Neutron_generator" title="Neutron generator">Neutron generator</a></li> <li><a href="/wiki/Oxygen_enhancement_ratio" title="Oxygen enhancement ratio">Oxygen enhancement ratio</a></li> <li><a href="/wiki/Pencil_(optics)" title="Pencil (optics)">Pencil</a></li> <li><a href="/wiki/Pencil-beam_scanning" title="Pencil-beam scanning">Pencil-beam scanning</a></li> <li><a href="/wiki/Percentage_depth_dose_curve" title="Percentage depth dose curve">Percentage depth dose curve</a></li> <li><a href="/wiki/Radiation_oncologist" title="Radiation oncologist">Radiation oncologist</a></li> <li><a href="/wiki/Radiation_therapist" title="Radiation therapist">Radiation Therapist</a></li> <li><a href="/wiki/Radiation_treatment_planning" title="Radiation treatment planning">Radiation treatment planning</a></li> <li><a href="/wiki/Radiopharmacology" title="Radiopharmacology">Radiopharmacology</a></li> <li><a href="/wiki/Tissue-to-air_ratio" title="Tissue-to-air ratio">Tissue to Air Ratio (TAR)</a></li></ul> </div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0;background: none;"><div style="padding:0 0.25em"> <ul><li>1 Also known as external-beam radiotherapy.   </li> <li>2 Also known as sealed-source radiation therapy.   </li> <li>3 Also known as systemic <a href="/wiki/Radioisotope" class="mw-redirect" title="Radioisotope">radioisotope</a> therapy.</li></ul> </div></td></tr></tbody></table></div>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?useformat=desktop&type=1x1&usesul3=0" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" href="https://en.wikipedia.org/w/index.php?title=Proton_therapy&oldid=1280397747">https://en.wikipedia.org/w/index.php?title=Proton_therapy&oldid=1280397747</a>"</div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="/wiki/Help:Category" title="Help:Category">Categories</a>: <ul><li><a href="/wiki/Category:Medical_physics" title="Category:Medical physics">Medical 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