Advancements in Proton and Carbon Ion Therapy for Precision Radiotherapy of Complex Tumors

Authors

  • Putta Chandana Centre for Multidisciplinary Research, Anurag University, Hyderabad, Telangana, India Author https://orcid.org/0009-0001-1370-5048
  • Anand Gudur Krishna Institute of Medical Sciences, Krishna Vishwa Vidyapeeth “Deemed To Be University” Malkapur, Karad (Dist. Satara), Maharashtra, India Author
  • Aniket Madhukar Zope Department of Radiology, Symbiosis Medical College for Women & Symbiosis University Hospital and Research Centre, Symbiosis International (Deemed University), Pune, Maharashtra, India Author https://orcid.org/0000-0002-1152-4956
  • Sidhant Das Chitkara Centre for Research and Development, Chitkara University, Himachal Pradesh-174103 India Author https://orcid.org/0009-0003-3540-5817
  • Anoop Dev Centre of Research Impact and Outcome, Chitkara University, Rajpura- 140417, Punjab, India Author https://orcid.org/0009-0001-1301-6891
  • Niranjan Sahu Department of Radiology, IMS and SUM Hospital, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India Author https://orcid.org/0000-0002-4712-5033

DOI:

https://doi.org/10.56294/hl2025850

Keywords:

Proton Therapy, Carbon Ion Therapy, Precision Radiotherapy, Tumor Targeting, Particle Therapy

Abstract

Precision radiation has changed a lot because of progress in proton and carbon ion therapy. This has made it much easier to treat complicated cancers. These particle treatments are becoming more well known for their ability to give highly targeted radiation doses that cause the least amount of damage to healthy tissues while still effectively targeting cancer. As a type of charged particle therapy, proton therapy uses protons instead of regular X-rays to treat cancer. It does this by taking advantage of the way protons are made, especially their Bragg peak, which is where they release their most energy. This makes it possible to deliver the amount more precisely, protecting healthy cells from too much radiation, especially in places that are hard to reach with regular photon-based treatment. Carbon ion treatment is a more advanced type of particle therapy that uses carbon ions, which are heavier than protons and have more mass and energy. These ions give a higher amount of radiation with more accuracy, which makes it more effective at treating tumors that are resistant to radiation, like those in the head, neck, and brain, as well as juvenile cancers. The biological efficiency of carbon ions is higher because they can hurt cells more severely than protons or regular X-rays. This means that they are better at controlling tumors in many therapeutic situations. Advanced technologies like synchrotrons and cyclotrons have made proton and carbon ion therapy more widely available. This means that patients can get these treatments more easily. Adding high-tech imaging methods like MRI and CT scans has also made these medicines more accurate, letting doctors watch patients in real time and change their treatment plans as needed. Using these technologies along with particle therapy has led to better treatment results, especially for tumors that are complicated and close to important structures.

References

[1] Zhao, B.; Zhao, B.; Chen, F. Diagnostic value of serum carbohydrate antigen 19-9 in pancreatic cancer: A systematic review and meta-analysis. Eur. J. Gastroenterol. Hepatol. 2022, 34, 891–904. [Google Scholar] [CrossRef]

[2] Wu, Z.; Zhao, P.; Wang, Z.; Huang, X.; Wu, C.; Li, M.; Wang, L.; Tian, B. Adjusting CA19-9 values with clinical stage and bilirubin to better predict survival of resectable pancreatic cancer patients: 5-year-follow-up of a single center. Front. Oncol. 2022, 12, 3939.

[3] Okamoto, M.; Shiba, S.; Okazaki, S.; Miyasaka, Y.; Shibuya, K.; Kiyohara, H.; Ohno, T. Feasibility and Safety of Repeated Carbon Ion Radiotherapy for Locally Advanced Unresectable Pancreatic Cancer. Cancers 2021, 13, 665.

[4] Hagiwara, Y.; Yamada, S.; Isozaki, Y.; Takiyama, H.; Shinoto, M.; Kawashiro, S.; Bhattacharyya, T.; Nemoto, K.; Tsuji, H. Efficacy and feasibility of re-irradiation using carbon ions for pancreatic cancer that recurs after carbon-ion radiotherapy. Clin. Transl. Radiat. Oncol. 2021, 26, 24–29.

[5] Kawashiro, S.; Yamada, S.; Isozaki, Y.; Nemoto, K.; Tsuji, H.; Kamada, T. Carbon-ion radiotherapy for locoregional recurrence after primary surgery for pancreatic cancer. Radiother. Oncol. 2018, 129, 101–104.

[6] Kumari, S.; Mukherjee, S.; Sinha, D.; Abdisalaam, S.; Krishnan, S.; Asaithamby, A. Immunomodulatory Effects of Radiotherapy. Int. J. Mol. Sci. 2020, 21, 8151.

[7] Hagiwara, Y.; Oike, T.; Niimi, A.; Yamauchi, M.; Sato, H.; Limsirichaikul, S.; Held, K.D.; Nakano, T.; Shibata, A. Clustered DNA double-strand break formation and the repair pathway following heavy-ion irradiation. J. Radiat. Res. 2019, 60, 69–79.

[8] Lu, Z.; Zheng, X.; Ding, C.; Zou, Z.; Liang, Y.; Zhou, Y.; Li, X. Deciphering the Biological Effects of Radiotherapy in Cancer Cells. Biomolecules 2022, 12, 1167.

[9] Chiblak, S.; Tang, Z.; Lemke, D.; Knoll, M.; Dokic, I.; Warta, R.; Moustafa, M.; Mier, W.; Brons, S.; Rapp, C.; et al. Carbon irradiation overcomes glioma radioresistance by eradicating stem cells and forming an antiangiogenic and immunopermissive niche. JCI Insight 2019, 4, e123837

[10] Averbeck, D.; Rodriguez-Lafrasse, C. Role of Mitochondria in Radiation Responses: Epigenetic, Metabolic, and Signaling Impacts. Int. J. Mol. Sci. 2021, 22, 11047.

[11] van Weverwijk, A.; de Visser, K.E. Mechanisms driving the immunoregulatory function of cancer cells. Nat. Rev. Cancer 2023, 23, 193–215.

[12] Bagchi, S.; Yuan, R.; Engleman, E.G. Immune Checkpoint Inhibitors for the Treatment of Cancer: Clinical Impact and Mechanisms of Response and Resistance. Annu. Rev. Pathol. 2021, 16, 223–249.

[13] Johnson, D.B.; Nebhan, C.A.; Moslehi, J.J.; Balko, J.M. Immune-checkpoint inhibitors: Long-term implications of toxicity. Nat. Rev. Clin. Oncol. 2022, 19, 254–267.

[14] Liu, L.; Shah, K. The Potential of the Gut Microbiome to Reshape the Cancer Therapy Paradigm: A Review. JAMA Oncol. 2022, 8, 1059–1067. [Google Scholar] [CrossRef]

[15] Kroemer, G.; McQuade, J.L.; Merad, M.; Andre, F.; Zitvogel, L. Bodywide ecological interventions on cancer. Nat. Med. 2023, 29, 59–74.

[16] Chandra, V.; Li, L.; Le Roux, O.; Zhang, Y.; Howell, R.M.; Rupani, D.N.; Baydogan, S.; Miller, H.D.; Riquelme, E.; Petrosino, J.; et al. Gut epithelial Interleukin-17 receptor A signaling can modulate distant tumors growth through microbial regulation. Cancer Cell 2023, 42, 85–100.

[17] Routy, B.; Jackson, T.; Mahlmann, L.; Baumgartner, C.K.; Blaser, M.; Byrd, A.; Corvaia, N.; Couts, K.; Davar, D.; Derosa, L.; et al. Melanoma and microbiota: Current understanding and future directions. Cancer Cell 2024, 42, 16–34.

[18] Tay, C.; Tanaka, A.; Sakaguchi, S. Tumor-infiltrating regulatory T cells as targets of cancer immunotherapy. Cancer Cell 2023, 41, 450–465. [Google Scholar] [CrossRef]

[19] Savage, P.A.; Klawon, D.E.J.; Miller, C.H. Regulatory T Cell Development. Annu. Rev. Immunol. 2020, 38, 421–453.

[20] Sakaguchi, S.; Mikami, N.; Wing, J.B.; Tanaka, A.; Ichiyama, K.; Ohkura, N. Regulatory T Cells and Human Disease. Annu. Rev. Immunol. 2020, 38, 541–566.

[21] Veglia, F.; Sanseviero, E.; Gabrilovich, D.I. Myeloid-derived suppressor cells in the era of increasing myeloid cell diversity. Nat. Rev. Immunol. 2021, 21, 485–498.

[22] van Vlerken-Ysla, L.; Tyurina, Y.Y.; Kagan, V.E.; Gabrilovich, D.I. Functional states of myeloid cells in cancer. Cancer Cell 2023, 41, 490–504.

[23] Pantel, K.; Alix-Panabieres, C. Crucial roles of circulating tumor cells in the metastatic cascade and tumor immune escape: Biology and clinical translation. J. Immunother. Cancer 2022, 10, e005615.

Downloads

Published

2025-08-29

How to Cite

1.
Chandana P, Gudur A, Madhukar Zope A, Das S, Dev A, Sahu N. Advancements in Proton and Carbon Ion Therapy for Precision Radiotherapy of Complex Tumors. Health Leadership and Quality of Life [Internet]. 2025 Aug. 29 [cited 2025 Sep. 8];4:850. Available from: https://hl.ageditor.ar/index.php/hl/article/view/850