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Proton and carbon-ion machines began as building-sized accelerators and are shrinking towards a single room. This is the chain of models, from Loma Linda's hospital proton centre to compact cyclotrons, upright chairs, superconducting carbon gantries and FLASH.
Loma Linda's proton system was cleared by the FDA in February 1988 (K872369) and treatments began in October 1990. IBA's proton therapy system followed in 2001 (K983024), Hitachi's PROBEAT in 2006, Varian's in 2010, Sumitomo's in 2013 and ProTom's in 2014. Compactness drove the next decade: Mevion's S250 put the accelerator on the gantry (K120676, 2012) and added scanning with an adaptive aperture in the S250i (2017); IBA's single-room Proteus ONE with a superconducting synchrocyclotron was cleared in 2016 (K152224); Varian's ProBeam 360 brought a smaller gantry and a 226 MeV cyclotron in 2022 (K221791). Upright treatment removed the gantry: P-Cure (2023), Leo Cancer Care's Marie (2025) and Mevion's S250-FIT (2025), which Mevion says fits a standard linac vault.
Carbon-ion machines remain few. Toshiba and Japan's national institute developed a superconducting rotating gantry about 13 m long against 25 m for the conventional design, installed in 2017; Toshiba's two gantry rooms at Yonsei began treating in 2024. Hitachi began heavy-ion treatment in Osaka in 2018. China's first domestically developed carbon-ion system, at Wuwei, was approved by the NMPA in 2019, and a Shanghai 360-degree proton system was registered in 2026. FLASH remains investigational on every platform: FAST-01 and FAST-02 used a modified ProBeam, and IBA and IntraOp state that their FLASH modes are not cleared.
Loma Linda's proton beam therapy system was cleared by the FDA in February 1988 (K872369, product code synchrotron) and its accelerator team reported that treatments began in October 1990. Massachusetts General's Northeast Proton Therapy Center (K983332) and IBA's proton therapy system (K983024) were cleared in 2001.
Hitachi's PROBEAT synchrotron (K053280, 2006) and its discrete spot scanning (K073059, 2007), Varian's superconducting cyclotron system (K101294, 2010; named ProBeam in K133191, 2014), Sumitomo's cyclotron (K130426, 2013, scanning added in K160612, 2016) and ProTom's Radiance 330 synchrotron (K134052, 2014) built the multi-room centres, and scanning replaced scattered beams.
Mevion's S250 (K120676, 2012), described in its summary as "a low cost, one-room integrated device", mounted the accelerator on the gantry; the S250i (K172848, 2017) added scanning with an adaptive aperture. IBA's Proteus ONE (K152224, 2016) used a superconducting synchrocyclotron, "a compact and more affordable alternative to the isochronous cyclotron". Varian's ProBeam 360 (K221791, 2022) brought a smaller gantry, a compact beam line, a 226 MeV cyclotron and cone-beam CT; Hitachi's PROBEAT-CR (2019) and PROBEAT-FR (2024) added a 360-degree gantry and faster imaging.
P-Cure (K221996, 2023) treats a seated patient in front of a fixed beam; Leo Cancer Care's Marie (K250970, 2025) positions and images upright patients; Mevion's S250-FIT (K250986, 2025) pairs Marie with its compact cyclotron, and Mevion states it fits a standard 110 square metre linac vault. The first S250-FIT patient was treated at Stanford in June 2026, and the system is also CE-marked.
Japan's national institute and Toshiba installed a superconducting rotating gantry about 11 m in diameter and 13 m long, against 25 m long for the conventional design, in 2017; Toshiba's Yonsei system began treating with a fixed beam in April 2023 and its first gantry room in May 2024. Hitachi's first heavy-ion system began treatment in Osaka in October 2018. China's NMPA approved the first domestically developed carbon-ion system, at Wuwei, in 2019. Siemens discontinued its proton and carbon facility at Kiel in 2011; its IONTRIS system remains in clinical use in Shanghai. Toshiba has orders from Asan Medical Center and Cleveland Clinic Abu Dhabi.
FAST-01 (10 patients, 2020 to 2022) and FAST-02 (10 treated) delivered proton FLASH at 40 Gy per second or more on a modified ProBeam for painful bone metastases, with mild side effects. IBA says its ConformalFLASH and DynamicARC are in development and not cleared; IntraOp says Mobetron FLASH is investigational; THERYQ's FLASHKNiFE is a research device and its very-high-energy electron FLASHDEEP is in development.
The unmet need is cost and footprint relative to photon radiotherapy, and randomised evidence of which adults benefit. OnCo carries proposals for compact FLASH and proton systems priced like a linac, for pooled coverage with evidence, and for a registry comparing upright and supine treatment.
Every era's records, trial outcomes and papers, and every watch item, as JSON.
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Shares IntraOp Medical, Varian (Siemens Healthineers), Radiotherapy roadmap: X-rays → shaped beams → fewer fractions, particles and FLASH, Surgery and radiotherapy cure most, get least and the tag machines-wave3.
Shares IntraOp Medical, FLASH research accelerators (Oriatron, Mobetron FLASH, ProBeam FLASH) and the tag machines-wave3.
Shares Varian (Siemens Healthineers), Radiotherapy roadmap: X-rays → shaped beams → fewer fractions, particles and FLASH, Surgery and radiotherapy cure most, get least, Most of the world has almost no cancer care and the tag machines-wave3.
Shares Radiotherapy roadmap: X-rays → shaped beams → fewer fractions, particles and FLASH, Surgery and radiotherapy cure most, get least and the tag machines-wave3.
Shares Leo Cancer Care, P-Cure, Mevion Medical Systems, Hitachi (particle therapy).
Shares Pencil-beam scanning and intensity-modulated proton therapy, Pooled coverage-with-evidence for proton therapy across all centres, Carbon-ion therapy, Radiotherapy roadmap: X-rays → shaped beams → fewer fractions, particles and FLASH.
Shares A coordinated FLASH radiotherapy evidence programme with shared dose-rate standards, FLASH radiotherapy, Carbon-ion therapy, Surgery and radiotherapy cure most, get least.
Shares Pencil-beam scanning and intensity-modulated proton therapy, Pooled coverage-with-evidence for proton therapy across all centres, Carbon-ion therapy, Radiotherapy roadmap: X-rays → shaped beams → fewer fractions, particles and FLASH.
Every source this page cites, grouped by who published it. Grouping is read from the web address, not assigned by hand.
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