Intracranial Stereotactic Radiation Therapy With Charged Particle Beams: An Opportunity to Regain the Momentum

  • Frederik Vernimmen
    Reprint requests to: Frederik Vernimmen, MD, Department of Radiation Oncology, Cork University Hospital, Wilton, Cork, Ireland. Tel: (+353) 21-49234530
    Department of Radiation Oncology, Cork University Hospital, Wilton, Cork, Ireland
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      The first charged particle treatment was done with protons at Berkeley in 1954. Clinical use was initially provided at physics research laboratories like those at Berkeley, Los Alamos, TRIUMF (Vancouver), PSI (Switzerland), the Harvard Cyclotron Laboratories (Boston), and iThemba LABS (Cape Town). A variety of charged particles such as helium ions, neon ions, protons, and negative Pi-mesons were used. The medical use of particle beams at these facilities had limitations in terms of patient logistics and beam time availability, but they generated the first series of publications on intracranial stereotactic use. Over time, the spectrum of charged particles has diminished with the disappearance of helium ions, neon ions, and negative Pi-mesons from the scene, and only protons and carbon ions are presently in use. Nowadays particle therapy is provided in dedicated hospital-based facilities, and the number of such facilities is growing, with the majority using protons. Owing to high investment costs, patients' preference, and referral patterns, the therapy programs in these facilities emphasize treating malignancies, with a few centers offering radiosurgery for benign intracranial pathologic conditions.
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