Carbon ion therapy to debut in Europe.

fter 14 years of construction, the Large Hadron Collider, the world’s largest particle accelerator, fired its first beam of protons in September from its home at the European Organization for Nuclear Research (CERN) near Geneva. Now a spinoff technology for treating cancer is also nearing its European debut. The first European center to offer carbon ion therapy — a type of radiation treatment that uses charged particles instead of photons or x-rays — will open in early 2009 in Heidelberg, Germany. Like its cousin, proton therapy ( see JNCI 2008;100:1496-8), carbon ion therapy uses charged particles to deliver more precise, localized radiation to tumors with less exposure to surrounding tissues than x-rays (Therapy using particles — either protons or carbon ions — is called hadron therapy.) But unlike proton therapy, carbon ion therapy causes damage to cancer cells in a way that they cannot repair themselves. Among European researchers, interest in carbon ion therapy is increasing. The Heidelberg Ion Therapy facility, estimated to cost € 100 million, will treat cancer with proton and carbon ion therapy, and late next year, a second center offering similar treatments in Pavia, Italy, near Milan, will open as well. Five more European centers will be built in the next 3-5 years, and another 20 are planned in Europe over the next decade, according to Hirohiko Tsujii, M.D., Ph.D., a carbon ion therapy pioneer at Japan’s National Institute of Radiological Sciences. Plans for carbon ion therapy in the U.S., on the other hand, are extremely limited. There is more reticence about carbon ions among U.S. researchers because of the high cost — currently about three times the cost of a proton therapy center — and what U.S. investigators consider to be a lack of suffi cient evidence of its effi cacy. European Initiatives “There is a huge momentum in Europe for particle therapy,” said Manjit Dosanjh, Ph.D. , CERN’s sole biologist and the driving force behind ENLIGHT, a European network of medical physicists and radiation oncologists focusing on carbon ion therapy. Just as particle physics research gravitated to Europe about 15 years ago with the planning and building of CERN’s Large Hadron Collider, Europe is leading the initiative for carbon ion therapy. Encouraged by promising preliminary data, other European centers are planning to test and offer carbon ion and proton therapy, in Lyon, France; Uppsala, Sweden; Marburg and Kiel in Germany, and Wiener Neustadt, near Vienna, Austria. In addition to funding ENLIGHT, the EU is supporting particle therapy by recently naming it as one of six areas deemed a scientifi c research priority, said Piero Fossati, M.D., of Milan’s National Center for Oncological Hadron Therapy (CNAO), which is building the Pavia facility. The EU is funding a 4-year, € 5.6 million project, coordinated by Dosanjh, to train 25 researchers and post-docs in hadron therapy.