What is particle radiation therapy

About treatment that consists of heavy particle radiation and proton radiation

Damage to DNA of genes could give rise to abnormal cell division, metamorphosis, tissue destruction and extinction as well as other consequences.
A small amount of radiation is strong enough to cut DNA and facilitate variation. Owing to reparability, the original DNA can be restored.
Intensive radiation kills not only cancer cells but also normal ones.
If likely to merely target the cancer focus with intensive radiation, the influence caused to normal cells can be reduced while making cancer cells disappear.

Radioactive ray therapy intends to rely upon certain radioactive rays to hinder cancer cells from proliferating and ultimately exterminate cancer focuses. With a view to effectively killing cancer cells and maintaining the functionality of normal cells, it is compelled to tune the amount, division and scope of radiation. Heavy ion ray therapy purports to avoid normal cells from being harmed by radiation through precise location measurement.

When radiated with X-rays, γ-rays or electron rays from the outside of the body, the deeper the cancer focus is situated, the less the amount of radiation becomes. From this perspective, radiation from one direction could put more normal cells situated shallower than the cancer focus at risk. Therefore, radiation technology marked by multi-direction, low dosage and adjacent normal cell protection, for example, intensity-modulated radiation therapy and tomotherapy etc. has been developed.

On the other hand, by means of accelerator-based energy regulation, particle rays are enabled to terminate energy release at the end of the journey, thus merely wiping out cancer cells instead of normal cells.

In particle ray therapy, accelerators such as rotary accelerator and synchrotron speed up protons and carbon ions to around 60%~80% of the speed of light to radiate target cancer focuses.

With extremely-concentrated rays, such a therapy is capable of aiming radiation at cancer lesions on the level of millimeters and accordingly, substitutes operations.

Attributed to rapid growth, the center of cancer cells is in a condition characterized by insufficient bloodstream and oxygen. Radioactive rays such as X-rays andγ-rays are less competent than heavy ion rays in killing cancer cells.

～Features～

1. No pain
2. Minimized damage to the function of internal organs and body shape as well
3. Do not disfigure outer appearance and looks, and leave no scars behind
4. Even suitable for the elderly
5. Tiny side-effect
6. Could be cured for good if treated in the early stage
7. Cancer located in deep that is out of reach of common X ray
8. Short recovery time length
9. Limited treatment scope
10. Cancer that cannot be treated by means of particle radiation therapy

《Examples of treatment conditions》

1)The focus (cancer) is contained in a certain area rather than overwhelmingly existed.
2)The part to be treated has not yet been treated with radiation therapy
3)Absence of other cancer focuses that are currently being treated, in the state of recurrence and have not fully recovered

Japan: Heavy ion ray therapy is a practically-proved treatment technology developed by the National Institute of Radiological Sciences (NIRS), which, primarily used treatment equipment produced by Mitsubishi Electric, Hitachi, Sumitomo Heavy Industries, Ltd. and Toshiba as well as other Japanese manufacturers, has successfully cured more than 7,500 patients from 1994 to August, 2013.; Up to 2015, with 14 particle ray cancer treatment centers (4 heavy ion ray cancer treatment centers and 10 proton ray cancer treatment centers) scattered around the country, Japan has owned the most cancer treatment centers in quantity throughout the world.; Especially in the field of heavy ion ray cancer treatment, NIRS is regarded as the best cancer treatment facility that has managed to sit on top of the world in terms of patient number and treatment achievements.

USA: In 1850s, the United States of America (USA) first started to put into practice particle ray therapy. Loma Linda University and Massachusetts General Hospital formally deployed rotating gantries to perform proton ray therapy respectively in 1991 and 2001. MD Anderson Hospital opened its proton ray treatment center in 2006 when many other proton ray treatment centers, including those based in Florida, began to operate. Represented by Mayo Clinic with its proton ray treatment center currently being structured, American medical institutions are now discussing the topic of heavy ion ray treatment center construction.

Germany: In 1997 (Heisei 5), the Heavy Ion Scientific Research Institute (GSI) at the Darmstadt University of Technology that adopted a nucleus-experiment-related heavy-ion synchrotron (not only for medical application), worked together with the German Cancer Research Center (DKFZ) to engage in heavy ion (carbon ion) ray therapy whose major characteristic consists in point beam scanning. In 2009, the Heidelberg University inherited their research outcomes and initiated its Carbon Ion · Proton Ray Treatment Center (HIT).

China: Headquartered in Shandong, China, the Wanjie Hospital launched its Proton Ray Treatment Center in 2004. Teamed up with German GSI, the Lanzhou Institute of Modern Physics as well as the Institute of Physical and Chemical Research integrated therapeutic beams into their Heavy Ion Research Institute (HIRFL) that has operated since 2006. At the same time, a new Heavy Ion Ray Treatment Center is currently being constructed.; Imported the third piece of proton ray and heavy ion ray treatment equipment around the globe manufactured by Siemens, the Shanghai Proton Ray & Heavy Ion Ray Hospital and the Proton Ray & Heavy Ion Ray Center of Fudan University Shanghai Cancer Center opened to the public in August.

Italy: Founded by various university hospitals, the CNAO Consortium (Italian Heavy Ion Treatment Center) cooperated with international organizations such as the European Organization for Nuclear Research (CERN), to jointly build a Carbon Ion · Proton Ray Treatment Center, and has implemented proton ray therapy and carbon ion radioactive ray therapy since 2011 and 2012 respectively.

Austria: A medical-exclusive heavy ion accelerator is being currently fabricated in Wiener Neustadt which is located in the suburban of Vienna, and expected to put into use in 2015.

Swiss: Started to perform proton ray therapy in 1984, the Paul Scherrer Institute (PSI) involved in research and development of spot-scanning proton ray intensity modulated radiation therapy in an attempt to improve the concentration of ray quantity, and replaced its therapeutic proton ray accelerator with a superconductive rotary accelerator.

France: In France, proton ray therapy is available in Orsay, Nice and other areas. The ETOILE proposal (referred to a plan for carbon ion ray treatment center construction) is being currently rolled out in Lyon by the Claude Bernard University Lyon 1 and other organizations, and meanwhile, the interested parties are also heatedly debating on the topics related to construction.

Korea: The Korea National Cancer Center (KNCC) kicked off its Proton Ray Treatment Center in 2007. Nowadays, the Korea Atomic Energy Medical College is planning with the government of Busan to mutually build a Heavy Ion Ray Treatment Center.

Russia: Started to get involved in proton ray therapy in 1960s, Russia has discussed to set up a Heavy Ion Ray Treatment Center over recent years.

Global market share

Producer (headquartered countries)	Market share (%)
(Japan) Mitsubishi Electric	10
(Japan) Hitachi	7
(Japan) Sumitomo Heavy Industries, Ltd.	5
(Japan) Toshiba	1
(Belgium) IBA	24
(USA) VALIAN	4
(USA) MEVION	3
(Germany) SIEMENS	3
Others	2

Comparison of particle ray therapy expenses

In the United States, normal particle ray therapy would cost patients approximately 120,000~150,000 US dollars that equals to around RMB 900,000, and in Japan, below 3,000,000 Japanese yen that around RMB 180,000, and in Germany, 50,000~60,000 Euros that around RMB 400,000. In short, Japan is at the bottom, Germany in the middle and the United States on top whose particle ray therapy expenses are 2~3 times that of Germany.

Let’s go back to home country, i.e. China. The Proton Ray & Heavy Ion Ray Center of Fudan University Shanghai Cancer Center has operated since May, 2015. Though lack of detailed quotation, the treatment cost would range between RMB 200,000 and 300,000 and must be paid by patients themselves as not covered by medical insurance.

[Expanded content]

To judge from what’s mentioned above, Chinese cancer patients urgently demand particle ray therapy from Japan due to the fact that comparing with other countries with advanced cancer treatment technology, Japan in which there are companies like Ono Pharmaceutical Co., Ltd. that is capable of producing Nivolumab, a PD-1 inhibitor, is rather competitive in terms of treatment cost.