Research needed for improving heavy-ion therapy

The large interest in heavy-ion therapy is stimulated from its excellent clinical results. The bases of this success are the radiobiological and physical advantages of heavy-ion beams and the active beam delivery used for an intensity-modulated particle radiotherapy (IMPT). Although heavy-ion therapy has reached a high degree of perfection for clinical use there is still large progress possible to improve this novel technique: in order to extend IMPT to more tumor entities and to tailor the planning more individually for each patient in an adaptive way, radiobiological work is required both experimentally and theoretically. It is also not clear whether the neighboring ions to carbon could have a clinical application as well. For this extension basic biological studies as well as physics experiments have to be performed. On the technical side, many improvements of the equipment used seem to be possible. Two major topics are the extension of IMPT to moving organs and the transition to more compact and therefore cheaper particle accelerators. In the present paper, these topics are treated to some extent in order to give an outline of the great future potential of ion-beam therapy.