1 INTRODUCTION

In the past three decades, all carbon ion treatment centers are mainly located in Europe and Asia, yet the therapeutic benefits of carbon ion therapy were first discovered in the United States in 1970s. Clinical outcome studies are coming out in the recent years from those centers comparing carbon ion treatment with conventional photon radiotherapy or surgery.^{1, 2} People might have been wondering, as one article published in Wired late last year put it, “Carbon ion radiation therapy (CIRT) is being used to blast tumors all over the world. Just not in the country that invented it. Why a promising, potent cancer therapy isn’t used in the US?”³ The article revealed that University of Texas Southwestern Medical Center hopes to be the front‐runner of building a carbon ion treatment facility in the United States, which is estimated to cost $300 million. Just around the same time, Mayo Clinic announced its agreement with Hitachi, Ltd in building the first carbon ion treatment facility at one of Mayo’s campuses located in Jacksonville, Florida. Major stakeholders in the cancer treatment field have shown strong interests in building a CIRT facility in the United States. Our previous Parallel Opposed editorial also debated on the need of having at least one carbon ion facility in the country.⁴ Yet the question remains whether it is clinically and financially ready for construction and implementation of a CIRT facility in the United States. Herein, we have the leading figure for the Mayo Clinic CIRT project, Dr. Chris Beltran, arguing for the proposition that CIRT is ready for clinical implementation in US, and the world‐renowned scientist in proton therapy and ion‐beam related research, Richard Amos, arguing against the proposition.

Chris Beltran is Chair of the Division of Medical Physics; Director of the Particle Therapy Technical Operations; Professor of Medical Physics in the Mayo Clinic School of Medicine; and Consultant, Dept. of Radiation Oncology; Mayo Clinic Jacksonville FL. Prof. Beltran received his Ph.D. in Nuclear and Accelerator Physics from Indiana University in 2004. He completed his Medical Physics Residency at Mayo Clinic in Rochester MN and subsequently accepted a position at St. Jude Children’s Research Hospital. In 2011 he rejoined Mayo Clinic to lead the proton treatment planning section for their new facility. In 2020 Prof. Beltran joined the team in Mayo Clinic Florida to help lead the new particle center. In the last several years, he has focused on particle therapy, including clinical responsibilities such as commissioning the treatment planning system for the Mayo Clinic spot scanning proton facility and leading the proton treatment planning group. Prof. Beltran’s research laboratory has focused exclusively on particle therapy in the last few years with a focus on computational and translational biology.

Richard Amos is Associate Professor of Proton Therapy and Research Lead for Translational Proton Therapy Physics in the Department of Medical Physics and Biomedical Engineering, University College London, London, UK. He completed his Medical Physics Residency in London with the National Health Service (NHS) before working as a clinical radiotherapy physicist for a number of years in the United Kingdom and Canada. He also spent a couple of years involved in ion‐microbeam research at the Gray Laboratory Cancer Research Trust in the United Kingdom. In 2002 Richard joined the faculty at Loma Linda University Medical Center in California, the world’s first hospital‐based proton therapy facility, before moving to The University of Texas MD Anderson Cancer Center in 2005 to help implement and develop a proton therapy program, including the first spot scanning system in the United States. He returned to London in 2013 to take leadership roles in both the development of a national proton therapy service for the NHS and in developing translational proton therapy physics research. He is a Chartered Physicist, a Chartered Scientist, Associate Editor of the British Journal of Radiology, and a Fellow of the Institute of Physics and Engineering in Medicine.

中文翻译：

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我们准备在美国进行碳离子放射治疗的临床实施

1 简介

在过去的三十年里，所有的碳离子治疗中心主要位于欧洲和亚洲，而碳离子治疗的治疗益处于 1970 年代在美国首次被发现。近年来，这些中心正在将碳离子治疗与常规光子放射治疗或手术进行比较的临床结果研究。^{1, 2}人们可能想知道，正如去年年底发表在《连线》杂志上的一篇文章所说，“碳离子放射疗法 (CIRT) 正被用于爆破全世界的肿瘤。只是不在发明它的国家。为什么美国不使用有前途的强效癌症疗法？” ³文章透露，德克萨斯大学西南医学中心希望成为在美国建设碳离子治疗设施的领跑者，该设施预计耗资 3 亿美元。大约在同一时间，Mayo Clinic 宣布与 Hitachi, Ltd 达成协议，在位于佛罗里达州杰克逊维尔的 Mayo 校区之一建造第一个碳离子治疗设施。癌症治疗领域的主要利益相关者对在美国建立 CIRT 设施表现出浓厚的兴趣。我们之前的 Parallel Opposed 社论还讨论了在该国至少拥有一个碳离子设施的必要性。⁴然而，问题仍然是它是否在临床和财务上为在美国建设和实施 CIRT 设施做好了准备。在此，我们有梅奥诊所 CIRT 项目的领军人物 Chris Beltran 博士，提出CIRT 已准备好在美国临床实施的主张，以及世界著名的质子治疗和离子束相关研究科学家 Richard阿莫斯，反对这个提议。

Chris Beltran 是医学物理系主任；粒子治疗技术运营总监；梅奥诊所医学院医学物理学教授；放射肿瘤学系顾问；佛罗里达州杰克逊维尔梅奥诊所。贝尔特兰教授获得了博士学位。2004 年在印第安纳大学获得核和加速器物理学博士学位。他在明尼苏达州罗切斯特的梅奥诊所完成了医学物理住院医师实习，随后接受了圣裘德儿童研究医院的职位。2011 年，他重新加入梅奥诊所，领导他们新设施的质子治疗计划部门。2020 年，贝尔特兰教授加入了佛罗里达州梅奥诊所的团队，帮助领导新的粒子中心。在过去的几年里，他专注于粒子疗法，包括临床职责，例如为 Mayo Clinic 点扫描质子设施调试治疗计划系统并领导质子治疗计划小组。过去几年，贝尔特兰教授的研究实验室专注于粒子疗法，重点是计算和转化生物学。

Richard Amos 是英国伦敦大学学院医学物理和生物医学工程系的质子治疗副教授和转化质子治疗物理研究负责人。在英国和加拿大担任临床放射治疗物理学家多年之前，他在英国国家卫生服务局 (NHS) 完成了医学物理住院医师实习。他还花了几年时间在英国格雷实验室癌症研究信托基金从事离子微束研究。2002 年，Richard 在加州洛马琳达大学医学中心任教，这是世界上第一个以医院为基础的质子治疗机构，之后于 2005 年搬到德克萨斯大学 MD 安德森癌症中心帮助实施和开发质子治疗计划，包括美国第一个点扫描系统。他于 2013 年回到伦敦，在为 NHS 开发国家质子治疗服务和开发转化质子治疗物理研究方面发挥领导作用。他是特许物理学家、特许科学家、英国放射学杂志的副主编，以及医学物理与工程研究所的研究员。