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Proton and Light Ion Therapy for Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 30 June 2026 | Viewed by 1778

Special Issue Editor


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Guest Editor
German Cancer Research Center, Heidelberg Ion Beam Therapy Center, Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany
Interests: light ion therapy; advanced image-guided particle therapy; MR-guided particle therapy; adaptive radiotherapy; dosimetry for light ions beams; in vivo monitoring; secondary neutron production; therapy planning and dose calculation for ion beams

Special Issue Information

Dear Colleagues,

Proton and light ion beam therapy is undergoing an enormous development. Novel beam delivery technologies are being explored, which may substantially improve therapy. Among them are rotational delivery, delivery at ultra-high dose rates (FLASH), spatial fractionation (mini-beam or grid therapy), and treatment in an upright patient position. In parallel, image guidance for particle therapy is entering the next level, facilitating adaptive concepts. Beyond cone-beam CT, CT, and optical surface guidance, MRI guidance is also being explored. The in vivo monitoring of secondary radiation may support therapy adaption. More recently, novel ion beams have been used clinically, like helium and oxygen, which sparked the idea of multi-ion therapy, where different radiation qualities are applied to different target regions.  

All these technical developments go hand-in-hand with radiobiological investigations, trying to elucidate the mechanisms of particle beam radiation therapy, especially when connected to novel beam delivery systems, but also to question well-known concepts, like the fixed RBE for proton therapy.

For a more widespread application of proton and light ion therapy, however, clinical studies and comparative trials are needed, trying to create evidence for the efficacy of particle beam therapy and potentially demonstrate superiority compared to conventional concepts. Fortunately, more and more clinical studies are being conducted in our attempts to answer these questions.

Prof. Dr. Oliver Jäkel
Guest Editor

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Keywords

  • novel beam delivery concepts
  • image guidance
  • adaptive therapy
  • in vivo monitoring
  • radiobiological studies with protons and light ions
  • clinical studies
  • outcome reports

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Published Papers (1 paper)

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Review

16 pages, 992 KB  
Review
Current Advances in Proton FLASH Radiotherapy in Abdominal Cancers
by Xiao Wang, Yin Zhang, Xinxin Zhang, Zhenyu Xiong, Keying Xu, Ning J. Yue and Chi Ma
Cancers 2026, 18(5), 758; https://doi.org/10.3390/cancers18050758 - 27 Feb 2026
Viewed by 1285
Abstract
Proton FLASH radiotherapy represents a promising innovation in the treatment of abdominal cancers, offering the potential to expand the therapeutic window by delivering ultra-high dose rates (UHDR) that spare normal tissue while maintaining tumor control. This approach is particularly beneficial for gastrointestinal (GI) [...] Read more.
Proton FLASH radiotherapy represents a promising innovation in the treatment of abdominal cancers, offering the potential to expand the therapeutic window by delivering ultra-high dose rates (UHDR) that spare normal tissue while maintaining tumor control. This approach is particularly beneficial for gastrointestinal (GI) tumors, where radiation dose escalation is often limited by the radiosensitivity of nearby organs. This review explores recent preclinical, planning, and technical developments in proton FLASH for abdominal sites and outlines the challenges and future directions for clinical translation. We reviewed the available published literature on proton FLASH radiotherapy, with a focus on abdominal applications. Recent preclinical studies in abdominal models have shown encouraging, though inconsistent, evidence of reduced toxicity with proton FLASH. Parallel advances in treatment planning have also demonstrated technical feasibility in achieving UHDR across complex abdominal geometries. However, key challenges remain, including variability in biological responses, lack of standardized dose-rate definitions, delivery system constraints, and the absence of robust clinical data. Although only limited clinical trials are currently underway, proton FLASH may enable safer hypofractionation, reirradiation, and dose escalation strategies in the future. Its successful clinical translation will require coordinated advances in biology, physics, and technology, supported by rigorous preclinical validation and carefully designed clinical trials. Full article
(This article belongs to the Special Issue Proton and Light Ion Therapy for Cancer)
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