After many years on the periphery of cancer therapy, the successes of proton and ion beams in tumor therapy are gradually receiving a higher degree of recognition. The considerable construction and acquisition costs are usually invoked to explain the slow market penetration of this favorable treatment modality. Recently, high-intensity lasers have been suggested as a potential, cost-saving alternative to cyclotrons or synchrotrons for oncology. This article will detail the technical requirements necessary for successful implementation of ion beam therapy (IBT)-the general term for proton and heavier-ion therapy. It will summarize the current state of laser acceleration of protons and will outline the very substantial developments still necessary for this technology to be successfully applied to IBT.

Recently, un update of the important European Organization for Research and Treatment of Cancer study 26981 was published without correcting deficiencies that already were known and publicized in 2008. In the current commentary, the author specifies those issues to help prevent incorrect conclusions and discusses reasons why the journal that published the update dismissed a letter clarifying those shortcomings. Cancer 2010. © 2010 American Cancer Society.

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Ten years ago, the authors of this report published a first paper on the technical challenges that laser accelerators need to overcome before they could be applied to tumor therapy. Among the major issues were the maximum energy of the accelerated ions and their intensity, control and reproducibility of the laserpulse output, quality assurance and patient safety. These issues remain today. While theoretical progress has been made for designing transport systems, for tailoring the plumes of laser-generated protons, and for suitable dose delivery, today's best lasers are far from reaching performance levels, in both proton energy and intensity to seriously consider clinical ion beam therapy (IBT) application. This report details these points and substantiates that laser-based IBT is neither superior to IBT with conventional particle accelerators nor ready to replace it.

Doubly labeled [U-14C, 5-125I]iododeoxycytidine (IdC) triphosphate was synthesized and incorporated enzymatically into defined positions of the plasmid pBR322. After storage under various conditions, the stable end products were analyzed using radio-GC, radio-HPLC, and electron microscopy. In addition, solutions of 14C-IdC-labeled DNA containing Na125I as an internal radiation source were studied to investigate the influence of internal radiolysis. Transmutation of the covalently bound 125I leads to complete destruction of the labeled nucleotide, giving rise to 14CO2 and 14CO as major products. Fragmentation of the pyrimidine base is independent of solvent and DNA configuration. Internal radiolysis caused by Na125I leads to only minor damage. Electron microscopy studies reveal that decay-induced double strand breaks (dsb) occur both at the site of decay and in areas as far as hundreds of base pairs apart from that site. Number and distribution of the breaks is strongly dependent on solvent and DNA configuration. A direct correlation exists between the extent of fragmentation of the nucleotide and the mean number of dsb.