Research on Cancer Therapy with Carbon Beams - Development of Human - Friendly Cancer Therapy with Carbon

called the “Center”) was established in 1993 when NIRS completed construction of the HIMAC. Since then it has been carrying out clinical, biological and physics research using heavy ions generated from the HIMAC. After accumulating clinical experiences of carbon ion radiotherapy (C-ion RT) in various types of malignant tumors, the Center was successful in obtaining approval from the Ministry of Health, Welfare and Labor for “Highly Advanced Medical Technology” in 2003. In the meantime, C-ion RT has achieved for itself a solid place in general practice of cancer treatment. The HIMAC has been used by more than 700 researchers as a multi-user utilization facility for medical, biological and physics research, including more than 100 researchers from outside Japan. In 2011, when the third Mid-Term Plan of NIRS was initiated, the Center was reorganized to conduct research on heavy ion beams using carbon ions and development of more patient-friendly next generation heavy ion treatment system. This will eventually contribute to the improvement of cancer cures and quality of life of cancer victims. The Center is organized into four research programs, the Department of Physics(Director: Koji Noda)and Hospital (Director: Yutaka Ando) for this long-term aim. In the following, summaries are given on the progress of research and practice for fiscal year (FY) 2014: 1) Research program for carbon ion therapy and diagnostic imaging (Program Leader: Hiroshi Tsuji); 2) Medical physics research program for development of a novel irradiation system for charged particle therapy (PL: Toshiyuki Shirai); 3) Advanced radiation biology research program (PL: Takashi Imai); 4) Research program for the application of heavy ions in medical sciences (PL: Takeshi Murakami); and 5) Research Center Hospital for Charged Particle Therapy. Research program for carbon ion therapy and diagnostic imaging (PL: Hiroshi Tsuji) This program consists of the clinical trial research team, applied PET research team, applied MRI research team, and clinical database research team. According to the long-term objectives, research on developing advanced clinical therapy using carbon ion beam has been aggressively performed in FY 2014. The clinical trial team has had quite a large number of patients undergo C-ion RT and the team continued clinical trials in pancreas, esophagus, uterus, kidney, and breast cancers. A total of 794 patients were treated with C-ion RT in FY 2014. Prostate, lung, head and neck, bone and soft tissue, liver tumors, post-operative pelvic recurrence of rectal cancer, and pancreatic cancer are the seven leading tumor types in the trials. The treatment with scanning irradiation at the new treatment research facility was smoothly performed as well. In addition, the clinical trial aiming to verify safety and steadiness of the respiratory-gated scanning system in the treatment of mobile tumors was started. The outcomes of C-ion RT in tumors that were hard to cure with other modalities revealed quite high probability of local control, a survival benefit, and acceptable morbidity. In addition, clinical trials for establishment of hypofractionated C-ion RT in common cancers, such as lung cancer, liver cancer, and prostate cancer have also been successfully achieved. Recently, four operating carbon therapy facilities in Japan, NIRS, HIBMC (Hyogo), GHMC (Gunma), and HIMAT (Saga) organized a cooperative study group, named J-CROS (Japanese Carbon-ion Radiation Oncology Study Group) to collaborate on standardizing C-ion RT in various tumor entities. The database research team developed a database system that can store integrated information for patients treated at all the institutions of this study group, in collaboration with the clinical trial research team. Now, the group is preparing the data collection from the four member institutes for a retrospective analysis and making protocols for prospective clinical studies for major tumor sites. Medical physics research program for development of a novel irradiation system for charged particle therapy (PL: Toshiyuki Shirai) This program consists of the beam delivery system research team, treatment planning system research team, radiation effect research team, experimental therapy research team, and image guided radiotherapy research team. In FY 2014, we have carried out the clinical trial of the markerless fluoroscopic respiration gating system for liver and pancreas. We have also developed patient specific beam QA methods for the moving target scanning irradiation and improved the precision of the dose calculation for heterogeneous targets in treatment planning. Based on these results, we successfully started the clinical trial of the scanning irraResearch on Cancer Therapy with Carbon Beams -Development of Human-Friendly Cancer Therapy with Carbon Ion Beams-