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In the last decade interest and investments in Hadron Therapy Systems have been steadily increasing resulting in a substantial number of projects currently under construction or entering detailed planning stage. Main routes are pure proton therapy systems and Carbon ion therapy systems which can also run on protons. While the basic accelerator concept for hadron therapy systems is well established there are many considerations on the type and layout of the particle delivery system including the accelerator, an energy selection system, either a fixed beam set up or a rotating gantry, the "nozzle" containing either a scattering or a scanning system, the patient positioner, and all associated control systems. The requirements for the accelerator include most stable beams to match the demand of modern fast scanning systems as well as fast switching between treatment rooms. Currently an ion/proton synchrotron, a pure proton synchrotron, a normalconducting proton cyclotron and a newly developed compact superconducting proton cyclotron are the accelerators of choice for the various hadron therapy systems, which will be analysed and compared in this paper.
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