Medical Consultation and Treatment for Overseas Patients
The QST hospital has been a world-leader in carbon ion radiotherapy since 1994 and also
accepts patients from overseas. Patients who wish to contact us regarding carbon ion
radiotherapy, should enquire below via a registered guarantor (medical coordinator ortravel agency).

Advanced Radiation Therapy
Leading the World in Solid Cancer Treatment

1. Contact for enquiries:
QST Hospital International Particle Therapy Research Center
4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba 263-8555
Email：kokusaiml@qst.go.jp
2. List of registered guarantors (medical coordinator and travel agency) :- Heavy Ion Medical Accelerator in Chiba -ACCESS
From central Tokyo, Tokyo-Haneda Airport<by train> Take the JR Sobu line to Inage station.
Walk for 10 minutes to QST, or take the bus for Sanno-cho
from Inage station to Houiken-mae/QST's main gate.
<by car> About 1.8 km to QST from Anagawa IC on Keiyo Highway.

From Tokyo-Narita Airport<by train> Take the JR Sobu line (rapid service) to Inage station.
Walk for 10 minutes to QST, or take the bus for Sanno-cho fromInage station to Houiken-mae/QST's main gate.
<by car> About 5.5 km from Chiba-kita IC on Higashi-Kanto Expressway.
NARITA
INTERNATIONAL AIRPORTR16

MIYANOGIJCT

QST, Chiba district

Research Building for
Charged Particle Therapy

NewParticle Therapy
Research
Facility

ANAGAWA
IC
R126

TOKYO

INAGE WARD OFFICE

BUS STOP
HOIKEN-SEIMONAEON

EASTTOKYO

JR-INAGE

WEST
HANEDA AIRPORT

●QST

BOOK
STORE ●QST
Hospital

ANAGAWASTATION

●

食堂

HIMAC
Building

Guard Station

CHIBA

HIGASHI-KANTO EXP. WAY

平日9:30〜11:30、 12:30〜15:00

Main Gate

R16

KEIYO RdTOKYO

Guest House
2.セカンドオピニオン（医療相談）
Buildingsand Facilities

CH IB AU R B ANR AILWAY

R126

CONVENIENCE
STORE● KEIAIUNIV.

●CHIBAUNIV.

JR-SOBU-LINE
CHIBA

NARITA INTERNATIONAL AIRPORT

National Institutes for Quantum Science and Technology

Treatment of Intractable Cancers
Short-term Treatment
High Quality of Life

National Institutes for Quantum Science and Technology

4-9-1 Anagawa, Inage-ku, Chiba City 263-8555, Japan

2023.7

Carbon Ion Radiotherapy

Principles and Advantages
Carbon Ion Beam・Physical and Biological Features

tment of intractable canceaerrsTnt

P a ti etreatme

Live an energetic lif e

nt-friendly treatmen t

QST constructed the first original machine in the world specialized for carbon ion radiotherapy
named HIMAC (Heavy Ion Medical Accelerator in Chiba). HIMAC has achieved remarkable
results as health insurance treatments, advanced medicine and clinical trials.

Cancer, the No.1 Cause of Death
The key to treatment is radiotherapy.

生物＜腫瘍＞The numbers of patients with cancer, and ofdeaths resulting from cancer are increasing.
In 2021, the number of people who died ofcancer in Japan amounted to 380,000, which is27% of the total yearly deaths.

320300280260240220200180160140120100806040200

1947

CancerDeath Rate (per 100,000)

What is a carbon ion beam?
Heart diseases
Senility

2 ・1955

1965

1975

1985

year・

1995

2005

2015

CerebrovasculardiseasesPneumonia
Accidents& Suicide
Diseases of liver
Tuberculosis

2022

Annual death rates from major causes

Cited from the Vital statistics (approximation) by the Ministry of Health, Labour and Welfare (2022)

What is Radiotherapy?

Radiotherapy is a sophisticated method of annihilating cancer cells with radiation, by making microscopic damage
within the molecules of DNA (deoxyribonucleic acid) in a cell nucleus, and of preventing further cell division.
Cancer Treatment Methods
Advantage

Local treatment
Radiotherapy

Systemic treatment Drug therapy

1Less strain on the body
Fast recovery
Treatment can be continued while living a normallife

Less effective than surgery in controlling
cancerSide effects such as skin redness, fatigue, andmalaise may occur

Since it circulates throughout the body, it is effective
even for small metastases regardless of the locationof the cancer
Helps shrink or prevent cancer

Damage normal non-cancer tissueSide effects such as nausea, anorexia, andmalaise may occur

protoncarbon ion
0tumor510－πProton beam: Beam of protons (nuclei of hydrogen) flying at anextraordinarily high speed.
Photon beam: X-rays and gamma-rays are photon beams at highenergy.

15n HepX-raysgamma-rays

Ne SiCAr

Sizes of particles*） When these ions are used for treatment, an extremely large number of flying particles make up a bundle

in the same direction for irradiating the tumor.

(beam)

Biological features of a carbon ion beam・The depth where the ion stops is exactly predetermined. ・The biological effect is stronger than X-rays for the same
dose.
・The radiation dose becomes enormous only when the ionstops.

Comparison of X - ray and carbon ion dose distributions

Disadvantage
Heavy strain on the body
Take a long time to recover
Need to take time off from workneutron

Dose distributions of various therapeuticradiations in the body*）

Intensity-modulated X-ray (9 angles)

Highly effective in controlling cancer
If there is no metastasis, the chances of complete
recovery are highThe spread of cancer can be confirmed directly withthe eye50

Depth from skin (cm)

Carbon ion beam: Beam of carbon (C ions), flying at
extraordinarily high speed. QST is using carbon ion
beam for cancer treatment.

Other radiation

X-raysgamma-rays*）

Physical features of a carbon ion beam

Radiotherapy = Cancer treatment without surgery: neither painful nor hot

Surgery

As you can see in the figure on the right, X-rays become
gradually less and less effective as they travel through thebody, so in order to treat cancers located in a deep regionof the body, the radiation dose is concentrated by irradiating from multiple directions.
In comparison, heavy ions are suitable for the treatment ofthese cancers because they affect cells only weakly until
they reach the tumor, and demonstrate an enormous effectat the moment they stop in the tumor.

(%)
100

Relative dose

Easy life after

Carbon Ion
Radiotherapy

Advantages of Carbon Ion Radiotherapy: Treatment of intractable cancers, short-term treatment,high quality of life
Treatment of unresectable cancer and radiation resistantcancerCarbon ion (3 angles)

Dose distribu�on96%skull base50%

SkullbaseStumor30%
skull base tumors

10%S
Skullbase
tumor

tumor
skull base, Sangakusha Pub.
Reference:H.Tsujii
Reference:H.Tsujii and T. Kamada,2017(in Japanese), ISBN:978-4-7825-3464- 9

Carbon ions stop at the exact depth given by the injection energy. In addition, they have the advantage thatthe strongest effect on killing cells is shown at the point where they stop. Therefore, one can concentrate
the damage to cancer cells by adjusting the stopping point for them. As a result, the irradiation rangeand irradiation dose of normal tissue can be reduced.

2Instruments for Carbon Ion Radiotherapy
Research on Compact Facility for Carbon Ion Radiotherapy

HIMAC, First Machine for Carbon Ion Radiotherapy in the WorldHIMAC is the first machine in the world constructed for research on carbon ion radiotherapy. The missionof HIMAC is to verify the effectiveness and safety of carbon ion radiotherapy and to develop new medicaltechnologies. HIMAC consists of various instruments shown below.

Train car

20 m

120ｍ

HIMAC

Gunma UniversityHeavy Ion Medical Center
60m

65ｍ

Synchrotron

40m

EV③ Alvarez Linac② RFQ Linac

Linear accelerator for mediumspeed ions. Length:24 m/up to11% of the speed of light

Linear accelerator for low-speed
ions. Length:7.3 m /up to 4% ofthe speed of light5

New Particle Therapy
Research Facility⑥ Treatment rooms

1988

1993

1994

・NIRS was ・National HIMAC project・Basic design of ・Construction of ・Construction of HIMAC was ・Clinical trial of carbon
established started under the first 10-year
HIMAC started. HIMAC started. accomplished.
ion radiotherapy started.
comprehensive strategy against
・Research Center of Charged ・Research on upgrading ofcancer by the Japanese government.
Particle Therapy was established. HIMAC started.

3[Development of Three-dimensional Scanning Irradiation system][Development of Rotating Gantry]

There are three treatment rooms. In
particular, Treatment Room G isequipped with a rotating gantry
that can irradiate patients with thecarbon ion beam from any direction
at 360 degrees.

・We have developed a rotating gantry that can irradiate thecarbon ion beam from any direction at 360 degrees so thatpatients can receive treatment in a comfortable posture.
・By using superconducting technology for the first timein the world, it has achieved a compact size of 13 m inlength and 300 tons in weight, despite being designed forcarbon ion beams.

History of Carbon Ion Radiotherapy
1986

Research and Development of Next-generation Irradiation System
・We have developed a respiratory gated three-dimensional scanning
irradiation system to further concentrate the effects of the carbon ion
beam on the cancer, thereby reducing side effects and enhancing
therapeutic effect.

61984

SAGA Heavy Ion
East Japan Heavy Ion CenterYamagata University
Medical Accelerator in Tosu

4The AC electromagnets are used
to adjust the trajectory of the ions.

1957

治療室 A
垂 直

Since HIMAC was constructed for research, it has a scale offootball court. The compact facility for carbon ion radiotherapy is one-third the scale and cost of HIMAC through theoptimization of ion species and energy. They are at work at
Gunma University, in Saga Prefecture, in Kanagawa Prefecture, in Osaka Prefecture, and at Yamagata University.

13By gradually increasing theradiofrequency, the ions areaccelerated up to 84% of thespeed of light.

治療室 B
水平垂直Compact Facility for Carbon Ion Radiotherapy

2⑤ RF Cavity

Osaka Heavy IonTherapy Center

Kanagawa Cancer Center

This type of ion source produces
highly charged carbon ions.

HIMAC Building④ Bending Magnet of Synchrotron

Synchrotron① ECR Ion Source

2001

2003

・Total number of treated patients ・Carbon ion radiotherapy wasexceeded 1000.
approved as advanced medicine
・Research Center for Charged by the Minister of Health, Japan.
Particle Therapy was established.

2004

2006

・Total number of treated patientsexceeded 2000.

・Research and developmentof Next Generation
Irradiation System started.

・Research on compact facility forcarbon ion radiotherapy was started.

2010

2011

New Particle Therapy Research FacilityCarbon
ion irradiation
炭素線照射
Carbon ion
炭素Dosemonitor
線量計

スキャニング
Scanningmagnets
電磁石

Rotating Gantry

Respiratory Gated Three-dimensional
Scanning Irradiation System

2016

2017

・First compact facility for ・Clinical trials of ・Insurance coverage
・Clinical trials of acarbon ion radiotherapy
the next-generation started for unresectable Rotating Gantry
bone and soft tissue
started the treatment at
scanning systemwere started.
tumorsGunma University.
were started.

2018

2019

・The incidence of secondary・Insurance coveragecancers after treatment ofextended to head andprostate cancer with carbon
neck cancer and prostate ion beams was found to besignificantly lower than withcancer
X-ray therapy.

2022
・Insurance coverage extended
to hepatocellular carcinoma,
intrahepatic bile duct cancer,
pancreatic cancer, colorectal
cancer (postoperative recurrence),and cervical adenocarcinoma

4Quantum
Scalpel Project
量子メスプロジェクト
The Quantum Scalpel:
A compact and high-performance carbon ion radiotherapy system

Quantum Scalpel Technology Development

In order to realize “zero cancer deaths and a healthy, long-lived society,” it is necessary to popularize
patientfriendly treatments that can maintain a high QOL during and after cancer treatment, such ascarbon ion cancer therapy.

Enables treatment while working for almost all cancers that are indicatedMulti-ion irradiation combining neon, oxygen, and helium in addition to carbon ions enhances treatment
effects, reduces side effects, and decreases the number of irradiations, making it possible to treat many
cancers while working and realizing medical treatment that enables individuals to live their own wayof life.

Achieves size compact enough to be installed in an existing hospital building
Intense laser and superconducting electromagnet technology will enable downsizing of the injector, synchrotron, and rotating gantry. Through the widespread use of the "quantum scalpel," which reduces thesize and cost of the device, we aim to create a society in which carbon ion radiotherapy is available inmore hospitals.

Expanding indications to diseases other than cancer
The Quantum Scalpel Project will also promote research and development for the treatment of cardiac
diseases such as arrhythmia as well as cancer. We are also working on the development of microsurgery
technology that can reduce the beam diameter to 1–3 mm to irradiate microscopic lesions such as neurological diseases with high precision.

Research and Development for Quantum Scalpel
Quantum Scalpel
20m

4th generation

2nd & 3rd generation
1st generation(Example:2010 Gunma Univ.)
60×45 m (Approx.1/3)

1994 NIRS
120×65 m

YearDevices

2017

2018

2019

2020

Laseracceleration
injector

5Element technology development

2021

2022

5th generation

Smaller and higher performance Further miniaturization
45×34 m (Approx.1/6)
10×20 m (Approx.1/40)
Superconducting synchrotron
Laser acceleration injector
Multi-ion irradiation

Design2023. .

1st gneration snchrotron(Diameter approx. 40 m)

C

4th & 5th generationsynchrotron
CTシミュレータ
制御室

制御室

CTシミュレータ室(Diameter approx. 8 m)

2nd & 3rd generationsynchrotron

室B

治療室A

(Diameter approx. 20 m)

Irradiation with ions heavier than carbon, such as
oxygen and neon ions, further improves the treatment outcome of radiation resistant intractable
cancers, while irradiating areas adjacent to normalorgans with helium ions, which is lighter thancarbon ions, reduces side effects and the numberof irradiation sessions.

Carbon ionirradiation

Multi-ion
irradiation

In the case of multi-ion irradiation (right), the biological effect becomes
uniformly high within the target area (contoured by yellow line).

Using laser-driven ion acceleration technology, the length of
the injector (ion source + linear accelerator) is reduced toaround 5m from around 15 m, which is the length ofconventional linear accelerators.
Kansai Institute for Photon Science, QST, with support by
the JST-Mirai Program, is conducting demonstration
experiments of this laser acceleration injector(see figure on the right).

20242025

2026

Production and testing oftreatment demonstrator

Ti:sapphire laser

High-intensity laser technology
Laser acceleration
injector

Approval and dissemination of a 4thgeneration machinefor pharmaceuticalequipment

Downsizing

Clinical trials

Highperformance
高性能化
Construction of technology
demonstrator. .

Distribution of the relative biological effects in the bodyMulti-ion irradiation

Multi-ion irradiation

Superconducting
Element technology development
synchrotron

Multi-ion
irradiation

By using superconducting magnets, which cancreate a high magnetic field, the electromagnets
that occupy a large space in the circular accelerators (diameter reduced to 20 m) of existing
carbon ion radiotherapy system can be mademuch smaller, requiring only 1/10th of theinstallation area.

Laser acceleration injector

Compact Facility for
Carbon Ion Radiotherapy

HIMAC

Superconducting synchrotron

Technology demonstrator upgrading

Construction of a
5th-generation
demonstration
machineSuperconducting
synchrotron

20 m

Superconducting technology

Quantum scalpel 5th-generation system

6