Radiotherapy using high-energy carbon beams from the Heavy Ion Medical Accelerator in Chiba (HIMAC) has been carried out at the National Institute of Radiological Sciences (NIRS) since June 1994, and more than 17,000 patients were treated by now. With the prospective clinical results for the first ten years, we designed a compact accelerator facility for carbon-ion radiotherapy (CIRT), and performed related Research and Development (R&D) works for widespread use of CIRT since 2004. Based on the design and the R&D works, five compact facilities for CIRT were constructed and are in treatment operation, and furthermore the compact facilities are being constructed around the world. To further develop the sophisticated CIRT, we constructed a new treatment facility at NIRS. This new facility is equipped with three treatment rooms; two of them have both horizontal and vertical fixed-irradiation-ports, and the other is a rotating-gantry port. For all ports, fast 3D raster-scanning irradiation technology is employed. Presently, we are further designing a next-generation compact facility as a future project; superconducting and laser technologies are to be used for accelerator design. In this article, a review of the medical accelerator development for carbon-ion radiotherapy is described in celebration of the 30th anniversary of HIMAC.
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