08 Applications of Accelerators, Technology Transfer and Industrial Relations
U01 Medical Applications

Paper	Title	Page
THOAB03	Commissioning of the Ion Beam Gantry at HIT	2874
	M. Galonska, R. Cee, Th. Haberer, K. Höppner, A. Peters, S. Scheloske, T. Winkelmann HIT, Heidelberg, Germany
	The Heidelberg Ion Beam Therapy Facility (HIT) is the first dedicated proton and carbon cancer therapy facility in Europe. It uses a full 3D intensity controlled raster scanning dose delivering method. The ion energy ranges from ca. 50 to 430 MeV/u corresponding to ion penetration depths of 20 to 300 mm in water. The HIT facility comprises the only heavy ion gantry worldwide designed for the beam transport of beams demanding a magnetic rigidity from 1 to 6.6 Tm. The gantry rotation of 360° enables beam scanning patient treatment from arbitrary directions. The libraries of carbon and proton pencil beams at the gantry are now offered with the whole variety of ion beam properties, i.e. 255 energy steps, 4 beam foci, 360°, and 10 intensities (106-1010/spill). The beam has to be adjusted only for a fraction of possible combinations of energy, focus, and gantry angle. These are taken as base points for a calculation of an overall number of about 37,000 different set values per ion type, and one intensity step according to the data supply model. This paper gives an outline on the practical concepts and results of adjusting the required beam properties independent of the gantry angle.
	Slides THOAB03 [4.526 MB]
THPS066	Technical Overview of the SIEMENS Particle Therapy Accelerator	3577
	V. Lazarev, O. Chubarov, S. Emhofer, G. Franzini, S. Göller, B. Nagorny, A. Robin, H. Rohdjess, R. Rottenbach, A.C. Sauer, R. Schedler, T. Sieber, B. Steiner, J. Tacke, D.B. Thorn, T. Uhl, P. Urschütz, O. Wilhelmi Siemens Med, Erlangen, Germany M. Budde, J.S. Gretlund, H.B. Jeppesen, C.V. Nielsen, C.G. Pedersen, Ka.T. Therkildsen, S.V. Weber Siemens DK, Jyllinge, Denmark
	Siemens has developed an accelerator system for particle therapy. It consists of an injector (7 MeV/u protons and light ions) and a compact synchrotron able to accelerate proton beams up to 250 MeV and carbon ions up to 430 MeV/u. These beams are extracted slowly from the synchrotron and delivered to a number of beam ports. The first accelerator system has been built and commissioned up to the first two beam outlets. An overview of the achieved performance of the system is presented. *Particle therapy is a work in progress and requires country-specific regulatory approval prior to clinical use.
THPS067	The TOP-IMPLART Project	3580
	C. Ronsivalle, M.C. Carpanese, G. Messina, L. Picardi, S. Sandri ENEA C.R. Frascati, Frascati (Roma), Italy M. Benassi, L. Strigari IFO, Roma, Italy E. Cisbani, S.F. Frullani, V. Macellari ISS, Rome, Italy C. Marino ENEA Casaccia, Roma, Italy
	The TOP-IMPLART project, developed by ENEA, the Italian National Institute of Health (ISS) and Regina Elena National Cancer Institute-IFO-Rome is devoted to the realization of a proton therapy centre to be sited at IFO, based on a sequence of linear accelerators and designed with three treatment rooms: one with a 150 MeV beam for shallow tumors and two with a 230 MeV beam for deep tumors. The first part of the acronym remarks the heritage from the TOP Project developed in 1998-2005 by ISS and ENEA, whilst the second part (“Intensity Modulated Proton Linear Accelerator for RadioTherapy”) exploits the possibility to perform a highly conformational therapy based on spatial and intensity modulation of the beam. The segment up to 150 MeV, funded by the Italian “Regione Lazio” for 11M€ over four years, is under installation at ENEA-Frascati for its validation before the transfer to IFO. The low energy part is also used as a facility for radiobiology experiments in the framework of a satellite program foreseeing cells irradiation at 7 MeV with a vertical and horizontal beam and small animal irradiation with a 17.5 MeV horizontal beam. The status of the Project is presented.
THPS068	A Proton Therapy Test Facility: The Radiation Protection Design	3583
	S. Sandri, M.C. Carpanese, G. Ottaviano, L. Picardi, C. Poggi, C. Ronsivalle ENEA C.R. Frascati, Frascati (Roma), Italy
	A proton therapy test facility is planned to be sited in the Frascati ENEA Research Center, in Italy. A 30 m long, 3 m wide bunker has to be designed to host a proton linear accelerator with a low beam current, lower than 10 nA in average, and an energy up to 150 MeV. The accelerator will be part of the TOP-IMPLART project for deep tumors treatment. The design of the 150 MeV accelerator is under study and the radiation protection solutions are considered in this phase. The linear accelerator has some safety advantages if compared to cyclotrons and synchrotrons. It can be easily housed in the long, narrow tunnel. The main radiation losses during the acceleration process occur below 20 MeV, with a low neutron production. As a consequence the barriers needed should be substantially lighter than the one used for other types of machines. In the paper the simulation models and the calculation performed with Monte Carlo codes are described. The related results are presented together with those assessed by using published experimental data. Considerations about workers and population protection are issued in the conclusions.
THPS069	Particle Beam Characteristics Verification for Patient Treatment at CNAO	3586
	M. Donetti, M. Ciocca, M.A. Garella, A. Mirandola, S. Molinelli, M. Pullia, G. Vilches Freixas CNAO Foundation, Milan, Italy S. Giordanengo INFN-Torino, Torino, Italy M. Lavagno DE.TEC. TOR. S.r.l., Torino, Italy R. Sacchi Torino University, ., Torino, Italy
	At Centro Nazionale di Adroterapia Oncologica (CNAO) in Pavia, Italy, a synchrotron has been designed to treat tumor with protons and ions delivered with a full active delivery system. Several pencil beams with appropriate energy are steered in sequence to the right positions inside the tumor volume covering it totally. Several beam characteristics have to be deeply known in order to be able to deliver a safe patient treatment. CNAO is now able to send beam in the treatment room and the Dose Delivery system is in the commissioning phase. Dose Delivery system, composed by beam monitoring and scanning magnets, manages the treatment with high precision in real time. The dose delivery system functions and components will be presented. Beam characteristic are studied by means of several detectors and verification systems in the treatment room to guarantee the quality of the treatment. Quality is checked in terms of pencil beam characteristics and characteristic of the overall dose in the treatment fields. The detector used and the results of the measurements will be shown.
THPS070	Status Report of the CNAO Construction and Commissioning	3589
	M. Pullia CNAO Foundation, Milan, Italy
	The CNAO (National Center for Oncological Hadrontherapy) is the first Italian center for deep hadrontherapy. The main accelerator is a synchrotron, based on the PIMMS design, capable to accelerate carbon ions up to 400 MeV/u and protons up to 250 MeV. Four treatment lines, in three treatment rooms, are foreseen in a first stage. The CNAO facility, has been designed for a completely active beam delivery system, in which a pencil beam is scanned transversely and the extracted beam energy can be changed on a spill to spill basis. The commissioning of the synchrotron started in August 2010. At the beginning of 2011 the first Spread Out Bragg Peaks with proton beams in the energy range 120-170 MeV/u, matching the first foreseen treatments, have been measured. The commissioning of the machine with protons has now been completed and authorisation to treatment of patients has been obtained from the competent authorities. The commissioning with carbon ions is in progress.
THPS071	The HIMAC Beam-intensity Control System for Heavy-ion Scanning	3592
	K. Mizushima Chiba University, Graduate School of Science and Technology, Chiba, Japan T. Furukawa, Y. Iwata, K. Katagiri, K. Noda, S. Sato, T. Shirai NIRS, Chiba-shi, Japan E. Takeshita Gunma University, Heavy-Ion Medical Research Center, Maebashi-Gunma, Japan
	Raster scanning irradiation has been carried out at a HIMAC new treatment facility in NIRS. In order to reduce the difference between prescribed and delivered dose distribution, the accurate beam-intensity control with a low ripple and the fast beam-on/off switching are strongly required. For this purpose, we have developed a new beam-intensity control system using the RF-knockout slow extraction. To keep the beam rate constant, this system controls the transverse RF voltage with the feedback proportional-integral control. In addition, the beam-on/off response was improved by the fast quadrupole magnets and the implementation of the transverse beam preheating method. As a result of the system commissioning, it was verified that this system can modulate the beam-intensity with a low ripple and switch the beam-on/off with quick responses. We will report the result in detail.
THPS072	Commissioning of NIRS Fast Scanning System for Heavy-ion Therapy	3595
	T. Furukawa, T. Inaniwa, K. Katagiri, K. Mizushima, K. Noda, S. Sato, T. Shirai NIRS, Chiba-shi, Japan E. Takeshita Gunma University, Heavy-Ion Medical Research Center, Maebashi-Gunma, Japan
	The commissioning of NIRS fast scanning system was started in September 2010, when the first beam was successfully delivered from the HIMAC synchrotron to the new treatment room. After the fine tuning of the new transport line, the commissioning of the scanning system was carried out as following steps; 1) verification of the beam size, position and intensity stability; 2) verification of beam scanning performance and calibration; 3) verification of beam monitor performance; 4) dose measurement of pencil beams for the beam parameterization in the treatment planning system; and 5) verification of 3D dose conformation. As a result of the commissioning, we verified that the new scanning delivery system can produce an accurate 3D dose distribution for the target volume in combination with the planning software. We will report the commissioning results and the performance of the scanning system.
THPS073	Dosimetric Impact of Multiple Energy Operation in Carbon-ion Radiotherapy	3598
	T. Inaniwa, T. Furukawa, N. Kanematsu, S. Mori, K. Noda, S. Sato, T. Shirai NIRS, Chiba-shi, Japan
	In radiotherapy with a scanned carbon beam, its Bragg peak is placed within the target volume either by inserting the range shifter plates or by changing the beam energy extracted from the synchrotron. The former method (range shifter scanning: RS) is adopted in NIRS while the latter method (active energy scanning: ES) has been used in GSI and HIT. In NIRS, an intermediate method, a combination scanning (CS), is now under consideration where eleven beam energies having the ranges with 30 mm intervals are prepared and used in conjunction with the range shifter plates for slighter range shift. The disadvantages of the RS are the beam spread due to the multiple scattering within the range shifter plates and the production of fragment particles through the nuclear reactions within them. On the other hand, for the ES, severely time-consuming beam commissioning and the expensive devices are required. In this study, we compare these three methods from the viewpoint of dose distributions and the impacts for clinical cases will be discussed.
THPS074	Design of Superconducting Rotating-gantry for Heavy-ion Therapy	3601
	Y. Iwata, T. Furukawa, A. I. Itano, K. Mizushima, K. Noda, T. Shirai NIRS, Chiba-shi, Japan N. Amemiya KUEE, Kyoto, Japan T. Obana NIFS, Gifu, Japan T. Ogitsu KEK, Ibaraki, Japan T. Tosaka, I. Watanabe Toshiba, Tokyo, Japan M. Yoshimoto JAEA/J-PARC, Tokai-Mura, Naka-Gun, Ibaraki-Ken, Japan
	Tumor therapy using energetic carbon ions, as provided by the HIMAC, has been performed since June 1994, and more than 5000 patients were treated until now. With the successful clinical results, we constructed a new treatment facility. The new facility has three treatment rooms; two of them have both horizontal and vertical fixed-irradiation-ports, and the other has a rotating-gantry-port. For all the ports, a scanning-irradiation method is applied. The fixed-irradiation-ports were constructed and commissioned, and we are now designing the rotating gantry. This isocentric rotating-gantry can transport heavy ions having 430 MeV/u to the isocenter with irradiation angles of 0-360 degrees. For the magnets, combined-function superconducting-magnets will be employed. The use of the superconducting magnets allowed us to design the compact gantry; the length and radius of the gantry would be approximately 12m and 5m, which are comparable to those of the existing proton gantries. A part of the superconducting magnets will be constructed within this fiscal year. The design of the rotating gantry, including the beam optics as well as details of the superconducting magnets, will be presented.
THPS075	Recent Progress of New Cancer Therapy Facility at HIMAC	3604
	T. Shirai, T. Furukawa, T. Inaniwa, Y. Iwata, K. Katagiri, K. Mizushima, S. Sato, E. Takada, Y. Takei, E. Takeshita NIRS, Chiba-shi, Japan T. Fujimoto, T. Kadowaki, T. Miyoshi, Y. Sano AEC, Chiba, Japan
	Since 1994, the carbon beam treatment has been continued at Heavy Ion Medical Accelerator in Chiba (HIMAC). The total number of patients treated is more than 5,000 in 2010. Based on more than ten years of experience with HIMAC, we have developed new treatment equipments toward adaptive cancer therapy with heavy ion at New Particle Therapy Research Facility in NIRS.
THPS076	Sub-mm Therapeutic Carbon-Ion Irradiation Port in Gunma University	3607
	K. Torikai, T. Kanai, N.T. Nakano, H. Shimada, E. Takeshita, M. Tashiro, S. Yamada, K. Yusa Gunma University, Heavy-Ion Medical Research Center, Maebashi-Gunma, Japan K. Hanakawa, T. Honda, K. Yoshida Mitsubishi Electric Corporation, Kobe, Japan
	Funding: This Study was done by Grant-in-Aid for Scientific Research (KAKENHI). One of advantage of particle therapy is concentration of irradiation dose. In April 2011, we developed "in-body-focusing type" irradiation port for "Proof-of-Principle" . This sub-mm port produces 1mm(1σ) beam. we will explain this irradion port at the conference.
THPS077	Compact Superconducting Synchrocyclotrons at Magnetic Field Level of up to 10 T for Proton and Carbon Therapy	3610
	A.I. Papash MPI-K, Heidelberg, Germany G.A. Karamysheva JINR, Dubna, Moscow Region, Russia L.M. Onischenko JINR/DLNP, Dubna, Moscow region, Russia
	Based on brief analysis of accelerators widely used for proton-ion therapy and patient cure during last 20 years the feasibility and importance of compact superconducting synchrocyclotrons operating at magnetic field level up to 10 T is outlined. The main component of modern commercial facility for proton-ion therapy is an isochronous cyclotron with room temperature or superconducting coils accelerating protons up to 250 MeV as well as synchrotron accelerating carbon ions up to 400 MeV/A. Usually ions are delivered from accelerator into the treatment room by transport lines. Irradiation is done by system of pointed to the patient magnets, collimators, energy degraders which are attached to the rotating Gantry. To greatly reduce price of facility (almost in one order of magnitude) and to simplify operational conditions of hospital personal it is proposed to provide iso-centric rotation of compact superconducting synchrocyclotron around the patient. Main physical and technical parameters are described in the paper.
THPS078	Medical Applications of INR Proton Linac	3613
	S.V. Akulinichev, L.V. Kravchuk RAS/INR, Moscow, Russia
	The main parameters of INR proton linac are suitable for several medical applications. The isotope laboratory of INR is now producing Sr-82 for PET diagnostics in cardiology and the first proton therapy treatment room is now being tested. This treatment room was designed for the therapy of tumors of different sizes and localizations, the patient position can be either sitting or lying. The combination of scatterers and collimators makes the formed beam profile at the isocenter insensitive to the initial beam profile in the transport channel. During the linac run for medicine at the end of 2010 the proton beams with energies of 120-209 MeV have been shown to fulfilled the medical requirements. Due to high maximal intensity of the proton beam, the brachytherapy source activation and the neutron therapy can become other applications of the facility. It is possible to use the parasitic neutrons, arising at the isotope laboratory or at some installations of the experimental complex, for the activation of medical sources with ytterbium or other nuclides, for the neutron therapy and even for the boron or gadolinium neutron-capture therapy of radio-resistant tumors.
THPS079	Vacuum-insulation Tandem Accelerator for Boron Neutron Capture Therapy	3615
	S.Yu. Taskaev, V.I. Aleynik, A. Burdakov, A.A. Ivanov, A.S. Kuznetsov, A.N. Makarov, I.N. Sorokin BINP SB RAS, Novosibirsk, Russia
	Novel powerful electrostatic vacuum-insulation tandem accelerator had been proposed* and created at BINP. A 2 MeV 3 mA dc proton beam is obtained. Neutrons are generated by 7Li(p,n)7Be reaction in the near threshold mode**. Epithermal neutron flux is formed for the development of Boron Neutron Capture Therapy (BNCT) of malignant tumors. In this report results on proton beam obtaining, neutron flux generation and in vitro investigation are presented and discussed. This accelerator based neutron source looks like a prototype of compact inexpensive epithermal neutron source for the spread of BNCT. Plans on BNCT realization are declared. Also the facility is used for the development of nuclear resonance absorption technique for nitrogen detection, and for the investigation of neutronless fusion. First, 9.17-MeV gamma rays are generated by 13C(p,gamma)14N reaction at 1.76 MeV protons***. Second, we are ready to measure alfa particles energy spectrum of p+11B reaction. * Bayanov et al., NIM A 413 (1998) 397-426. ** Kuznetsov et al., Technical Physics Letters 35/8 (2009) 1-6. *** Kuznetsov et al., NIM A 606 (2009) 238-242.
THPS080	The New Bern Cyclotron Laboratory for Radioisotope Production and Research	3618
	S. Braccini, A. Ereditato LHEP, Bern, Switzerland P. Scampoli Naples University Federico II, Napoli, Italy K. von Bremen SWAN, Bern, Switzerland
	A new cyclotron laboratory for radioisotope production and multi-disciplinary research is under construction in Bern and will be operational by the end of 2011. A commercial IBA 18 MeV proton cyclotron, equipped with a specifically conceived 6 m long external beam line, ending in a separate bunker, will provide beams for routine 18-F production as well as for novel detector, radiation biophysics, radioprotection, radiochemistry and radiopharmacy developments. The accelerator is embedded into a complex building which hosts two physics laboratories, four GMP radiochemistry and radiopharmacy laboratories, offices and two floors for patient treatment and clinical research activities. This project is the result of a successful collaboration among the University Hospital in Bern (Inselspital), the University of Bern and private investors, aiming at the constitution of a combined medical and research center able to provide the most cutting-edge technologies in medical imaging and cancer radiation therapy. For this purpose, the establishment of a proton therapy center on the campus of Inselspital is in the phase of advanced study.
THPS081	Design Choices of the MedAustron Nozzles and Proton Gantry based on Modeling of Particle Scattering	3621
	M. Palm CERN, Geneva, Switzerland M. Benedikt, A. Fabich EBG MedAustron, Wr. Neustadt, Austria M. Palm ATI, Wien, Austria
	MedAustron, the Austrian hadron therapy center is currently under construction. Irradiations will be performed using active scanning with a proton or carbon ion pencil beam which is subject to scattering in vacuum windows, beam monitors and air gap. For applications where sharp lateral beam penumbras are required in order to spare critical organs from unwanted dose, scattering should be minimal. A semi-empirical scattering model has been established to evaluate beam size growth at the patient due to upstream scattering. Major design choices for proton gantry and nozzle based on the scattering calculations are presented.
THPS082	Dose-homogeneity Driven Beam Delivery System Performance Requirements for MedAustron	3624
	M. Palm, F. Moser CERN, Geneva, Switzerland M. Benedikt, A. Fabich EBG MedAustron, Wr. Neustadt, Austria M. Palm ATI, Wien, Austria
	MedAustron, the Austrian hadron therapy center is currently under construction. Irradiation will be performed using active scanning with proton or carbon ion pencil beams. Major beam delivery system contributors to dose heterogeneities during active scanning are evaluated: beam position, beam size and spot weight errors. Their individual and combined effect on the dose distribution is quantified, using semi-analytical models of lateral beam spread in the nozzle and target and depth-dose curves for protons and carbon ions. Deduced requirements on critical parts of the beam delivery system are presented. Preventive and active methods to suppress the impact of beam delivery inaccuracies are proposed.
THPS083	Two-channel Mode of Mo-99 Production at an Electron Accelerator	3627
	V.L. Uvarov, A.N. Dovbnya, V.V. Mytrochenko, V.I. Nikiforov, S.A. Perezhogin, V.A. Shevchenko, B.I. Shramenko, A.Eh. Tenishev, A.V. Torgovkin NSC/KIPT, Kharkov, Ukraine
	High-energy bremsstrahlung is the main source of isotopic target activation at an electron accelerator. The photoneutrons concurrently generated are generally considered as a background radiation. At the same time, the natural materials entering into photonuclear targets sometimes comprise a mixture of stable isotopes, the atomic-number difference of which equals 2. Thus, if the desired isotope has an intermediate mass, then at certain conditions, it can be produced on two target nuclei at once, via (γ,n) and (n,γ) channels. As an example, we investigate the possibility of increasing the yield of 99Mo by means of its simultaneous production from 100Mo(γ,n)99Mo and 98Mo(n,γ)99Mo reactions. The method and the device have been developed to provide measurements of the 99Mo yield from the natural molybdenum target as it is placed inside the neutron moderator and without the latter. Experiments were performed at the NSC KIPT accelerator LU-40m at electron energies ranging from 30 to 60 MeV. It is demonstrated that the use of the moderator gives nearly a 30% increase in the 99Mo yield. The experimental results are in good agreement with the computer simulation data.
THPS084	Modification of the PENELOPE Transport System for HS Simulation of Isotope Production Mode	3630
	V.L. Uvarov, V.I. Nikiforov NSC/KIPT, Kharkov, Ukraine
	A method has been developed for high-speed computing the photonuclear isotope yield along with the absorbed radiation power in exit devices of electron accelerator. The technique involves a step-by-step calculation of isotope microyield along the photon trajectories. The approach has been realized in the computer programs based on the PENELOPE system of -2001, -2006 and -2008 versions. For their benchmarking, use has been made of the experimental data on activity distributions of the 67Cu produced from 68Zn(γ,p)67Cu reaction in thick zinc targets. The results of simulation using the PENELOPE-2006 and -2008 codes are in excellent agreement with all experimental data. At the same time, the PENELOPE-2001 computations give good agreement with the experimental results for target activation by the electron beam, but systematically underestimate (~15%) in case of the target exposed to bremsstrahlung. The proposed technique provides a ~ 104 times higher computation speed as compared with the direct Monte Carlo simulation of photonuclear events and that speed is independent of the reaction cross section.
THPS086	Compact Beam Delivery Systems for Ion Beam Therapy	3633
	C. Sun, D. Arbelaez, S. Caspi, D. Robin, A. Sessler, W. Wan LBNL, Berkeley, California, USA M. Yoon POSTECH, Pohang, Kyungbuk, Republic of Korea
	Funding: Work supported by the United States Department of Energy under Contract No. DE-AC02-05CH11231 In this paper we present a coil winding concept for a large aperture, combined-function 90 degree magnet that allows for a significantly more compact carbon ion gantry. The winding concept enables the reduction in the size and weight of the magnet without compromising the important beam transport properties. Alternatively, a small aperture gantry requires a post-gantry scanner. We present a compact design for a post-gantry point-to-parallel scanning system.
THPS087	Engineering Prototype for a Compact Medical Dielectric Wall Accelerator	3636
	A. Zografos, T. Brown, A. Hening, V. Joshkin, K. Leung, Y.K. Parker, H.T. Pearce-Percy, D. Pearson, M. Rougieri, J. Weir CPAC, Livermore, CA, USA R. Becker SSS, Gelnhausen, Germany D.T. Blackfield, G.J. Caporaso, Y.-J. Chen, S. Falabella, G. Guethlein, S.A. Hawkins, S.D. Nelson, B. R. Poole, J.A. Watson LLNL, Livermore, California, USA R.W. Hamm R&M Technical Enterprises, Pleasanton, California, USA
	Funding: Prepared by LLNL under Contract DE-AC52-07NA27344. The Compact Particle Accelerator Corporation has developed an architecture to produce pulsed proton bunches that will be suitable for proton treatment of cancers. Subsystems include a RFQ injection system with a pulsed kicker to select the desired proton bunches and a linear accelerator incorporating a High Gradient Insulator with stacked Blumleins to produce the required voltage. The Blumleins are switched with solid state laser driven optical switches that are an integral part of the Blumlein assemblies. Other subsystems include a laser, a fiber optic distribution system, an electrical charging system and beam diagnostics. An engineering prototype has been constructed and it has been fully characterized. Results obtained from the engineering prototype support the development of an extremely compact 150 MeV system capable of modulating energy, beam current and spot size on a shot to shot basis within the next two years. The paper will detail the construction of the engineering prototype and discuss experimental results. In addition, future development milestones and commercialization plans will also be discussed.
FRYAA01	Review of Hadron Therapy Accelerators Worldwide and Future Trends	3784
	K. Noda NIRS, Chiba-shi, Japan
	Hadron beams have attractive growing interest for cancer treatment owing to their high dose localization at the Bragg peak and owing to high biological effect there, especially for heavy-ion beams. Recently, therefore, hadron cancer radiotherapy has been successfully carried out at various facilities and several facility construction projects have also been progressing in the world, based on the development of the accelerator and beam-delivery technologies. This report will review the development of the accelerator and beam-delivery technologies in the hadron beam radiotherapy facilities in the world.