# Proton therapy machines: cyclotrons, synchrotrons and single-room systems

Source: https://onco.cc/technologies/proton-therapy-systems/  
OnCo record `proton-therapy-systems` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Proton centres are built around one of three accelerators, a cyclotron, a synchrotron or a compact synchrocyclotron, feeding one or several treatment rooms through magnets and a rotating gantry the size of a house. Single-room systems have cut the price of entry, and upright treatment chairs may shrink the building again.

## Summary

The first hospital-based proton centre opened at Loma Linda in 1990 with a synchrotron. Since then the industry has split into designs. Isochronous cyclotrons (IBA Proteus PLUS, Varian ProBeam) produce a continuous beam at a fixed energy that a degrader lowers for shallower targets, giving high dose rates but some neutron production and activation. Synchrotrons (Hitachi PROBEAT, ProTom Radiance 330, and the Japanese vendors) accelerate pulses to exactly the energy needed with no degrader, at lower intensity. Superconducting synchrocyclotrons small enough to mount on the gantry itself (Mevion S250i) or feed one room (IBA ProteusONE) created the single-room centre, which costs a fraction of a multi-room facility and is how most new centres are now built. Nearly all systems deliver pencil-beam scanning for intensity-modulated proton therapy, with cone-beam CT or in-room CT for image guidance, and vendors are adding proton arc delivery and ultra-high dose-rate FLASH modes. Upright positioning systems from Leo Cancer Care and P-Cure rotate the seated patient in front of a fixed beam, removing the gantry.

PTCOG lists more than a hundred centres in operation worldwide, concentrated in the United States, Japan, Europe and China; several countries have one national facility and most of the world has none. The clinical case rests on the absence of exit dose: firm for children, skull base and spine tumours, eye melanoma and re-irradiation, and still being tested in randomised trials for common adult cancers.

## Fields

- Kind: Technology
- Status: established
- Last checked: 2026-09-17
- Tags: machines-wave
- Principle: A cyclotron, synchrotron or synchrocyclotron accelerates protons to therapeutic energies; beam-transport magnets and a rotating gantry or fixed beamline deliver a scanned pencil beam whose Bragg peak stops in the target with no exit dose.
- Since: 1990
- Strengths: No exit dose beyond the target; Single-room systems lower capital cost; Scanning, arc and FLASH delivery on the same accelerators
- Limitations: Cost, building size and long commissioning; Range uncertainty and sensitivity to anatomy change; Randomised evidence in adults still accruing

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Proton_therapy
- PTCOG: particle therapy facilities in operation: https://www.ptcog.site/index.php/facilities-in-operation-public
- Wikipedia: https://en.wikipedia.org/wiki/Proton_therapy

## Connected records

- technologies: [Accelerator-based BNCT systems (NeuCure, nuBeam, NeuPex)](https://onco.cc/technologies/bnct-accelerator-systems/), [C-arm medical linear accelerators (TrueBeam, Versa HD and others)](https://onco.cc/technologies/c-arm-linac/), [Carbon-ion synchrotrons and facilities](https://onco.cc/technologies/carbon-ion-synchrotrons/), [FLASH radiotherapy](https://onco.cc/technologies/flash-rt/), [FLASH research accelerators (Oriatron, Mobetron FLASH, ProBeam FLASH)](https://onco.cc/technologies/flash-research-accelerators/), [Medical cyclotrons, hot cells, and synthesis modules](https://onco.cc/technologies/medical-cyclotrons-synthesis-modules/), [Pencil-beam scanning and intensity-modulated proton therapy](https://onco.cc/technologies/intensity-modulated-proton-therapy/), [Proton arc therapy](https://onco.cc/technologies/proton-arc-therapy/), [Proton therapy](https://onco.cc/technologies/proton-therapy/), [Radiotherapy access and the global machine gap](https://onco.cc/technologies/radiotherapy-access-gap/)
- cancers: [Brain and spinal cord tumours (all types)](https://onco.cc/cancers/brain-tumours/), [Breast cancer (all types)](https://onco.cc/cancers/breast-cancer/), [Childhood cancers (all types)](https://onco.cc/cancers/childhood-cancers/), [Chordoma](https://onco.cc/cancers/chordoma/), [Head and neck squamous cell carcinoma](https://onco.cc/cancers/head-and-neck/), [Medulloblastoma](https://onco.cc/cancers/medulloblastoma/), [Oesophageal cancer](https://onco.cc/cancers/esophageal/), [Prostate cancer](https://onco.cc/cancers/prostate/), [Uveal melanoma](https://onco.cc/cancers/uveal-melanoma/)
- fronts: [Devices & Physical Therapies](https://onco.cc/fronts/devices/), [Radiation Therapy](https://onco.cc/fronts/radiation/)
- companies: [Hitachi (particle therapy)](https://onco.cc/companies/hitachi/), [IBA (Ion Beam Applications)](https://onco.cc/companies/iba/), [Leo Cancer Care](https://onco.cc/companies/leo-cancer-care/), [Mevion Medical Systems](https://onco.cc/companies/mevion/), [P-Cure](https://onco.cc/companies/p-cure/), [ProTom International](https://onco.cc/companies/protom/), [Sumitomo Heavy Industries](https://onco.cc/companies/sumitomo-heavy-industries/), [Varian (Siemens Healthineers)](https://onco.cc/companies/varian/)
- institutions: [Aarhus University Hospital](https://onco.cc/institutions/aarhus-university-hospital/), [Abramson Cancer Center, University of Pennsylvania](https://onco.cc/institutions/penn-abramson/), [Advanced Centre for Treatment, Research and Education in Cancer](https://onco.cc/institutions/actrec/), [Apollo Hospitals (Apollo Cancer Centres)](https://onco.cc/institutions/apollo-hospitals/), [BC Cancer](https://onco.cc/institutions/bc-cancer/), [Centre Antoine Lacassagne](https://onco.cc/institutions/centre-antoine-lacassagne/), [Chang Gung Memorial Hospital](https://onco.cc/institutions/chang-gung-memorial-hospital/), [Charité Universitätsmedizin Berlin](https://onco.cc/institutions/charite/), [Cleveland Clinic Taussig Cancer Institute](https://onco.cc/institutions/cleveland-clinic/), [Fred Hutchinson Cancer Center](https://onco.cc/institutions/fred-hutch/), [Fudan University Shanghai Cancer Center](https://onco.cc/institutions/fuscc/), [Georgetown Lombardi Comprehensive Cancer Center](https://onco.cc/institutions/georgetown-lombardi/), [Heidelberg University Hospital / NCT / DKFZ](https://onco.cc/institutions/heidelberg-nct/), [Hokkaido University Hospital](https://onco.cc/institutions/hokkaido-university-hospital/), [Huntsman Cancer Institute, University of Utah](https://onco.cc/institutions/huntsman/), [Institut Curie](https://onco.cc/institutions/institut-curie/), [Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center](https://onco.cc/institutions/johns-hopkins/), [Maastricht UMC+ Comprehensive Cancer Center](https://onco.cc/institutions/maastricht-umc/), [Massachusetts General Hospital Cancer Center](https://onco.cc/institutions/mgh/), [Mayo Clinic](https://onco.cc/institutions/mayo-clinic/), [Mayo Clinic Comprehensive Cancer Center in Arizona](https://onco.cc/institutions/mayo-clinic-arizona/), [MD Anderson Cancer Center](https://onco.cc/institutions/md-anderson/), [National Cancer Center Hospital East](https://onco.cc/institutions/ncc-hospital-east/), [National Cancer Center Korea](https://onco.cc/institutions/ncc-korea/), [National Cancer Centre Singapore](https://onco.cc/institutions/nccs/), [NCT/UCC Dresden, University Hospital Carl Gustav Carus](https://onco.cc/institutions/nct-dresden/), [New York Proton Center](https://onco.cc/institutions/new-york-proton-center/), [Robert H. Lurie Comprehensive Cancer Center of Northwestern University](https://onco.cc/institutions/northwestern-lurie/), [Ruijin Hospital, Shanghai Jiao Tong University](https://onco.cc/institutions/ruijin-hospital/), [Samsung Medical Center](https://onco.cc/institutions/samsung-medical-center/), [Shizuoka Cancer Center](https://onco.cc/institutions/shizuoka-cancer-center/), [Siteman Cancer Center, Washington University](https://onco.cc/institutions/wustl-siteman/), [St. Jude Children's Research Hospital](https://onco.cc/institutions/st-jude/), [Sylvester Comprehensive Cancer Center, University of Miami](https://onco.cc/institutions/sylvester-miami/), [The Christie NHS Foundation Trust](https://onco.cc/institutions/the-christie/), [The Clatterbridge Cancer Centre NHS Foundation Trust](https://onco.cc/institutions/clatterbridge/), [The Ohio State University Comprehensive Cancer Center, James Cancer Hospital and Solove Research Institute](https://onco.cc/institutions/osu-james/), [The University of Kansas Cancer Center](https://onco.cc/institutions/ku-cancer-center/), [University College London Hospitals / UCL Cancer Institute](https://onco.cc/institutions/uclh/), [University Medical Center Groningen Comprehensive Cancer Center](https://onco.cc/institutions/umcg-groningen/), [University of Florida Health Cancer Center](https://onco.cc/institutions/uf-health-cancer-center/), [University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center](https://onco.cc/institutions/maryland-greenebaum/), [University of Michigan Rogel Cancer Center](https://onco.cc/institutions/michigan-rogel/), [UZ Leuven / Leuven Cancer Institute](https://onco.cc/institutions/uz-leuven/), [West German Cancer Center (WTZ), University Hospital Essen](https://onco.cc/institutions/essen-wtz/), [Winship Cancer Institute of Emory University](https://onco.cc/institutions/emory-winship/)

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