Accelerator technologies for proton and ion beam therapy

Over the past 75 years, proton beam therapy has emerged as a promising modality for cancer treatment, boasting precise targeting and reduced collateral damage to healthy tissue. Here we discuss the evolution of accelerator technology in proton therapy, examining advancements in cyclotron, synchrotron and linear accelerator technology, and their implications for modern treatment delivery. Additionally, we explore advances in delivering accelerated carbon or helium ions for therapeutic treatments. We also discuss the integration of advanced imaging modalities, such as multienergy X-ray, magnetic resonance imaging and ion-based imaging, for real-time monitoring and adaptive radiotherapy. These advancements position particle therapy to offer personalized and effective cancer treatment strategies, heralding improved patient outcomes. Proton and heavy-ion beam therapies are promising approaches for cancer treatment. This Review discusses the accelerator technologies that enable these therapies.