Pioneering Proton Therapy in Korea: Samsung Medical Center's Journey

On December 28, 2015, the second proton therapy service in Korea was launched. Following the National Cancer Center, Samsung Medical Center began full-scale operations of its Proton Therapy Center (hereinafter referred to as "the Center"). Despite the massive investment required, the hospital’s commitment to proton therapy was firm. It was an opportunity to treat cancer while protecting normal tissues and to extend the radiation oncology expertise accumulated over decades to more patients.

Proton therapy is characterized by a physical property known as the Bragg Peak. The proton beam delivers energy specifically to cancer cells and then dissipates, leaving surrounding normal tissues unaffected. Because it can target only the cancer cells, it is considered a next-generation treatment that overcomes the limitations of conventional radiation therapy.

■100,000 Treatment Sessions... Great Success in Difficult-to-Treat Cancers

Since treating 314 patients in 2016, the Center has grown exponentially, treating over 8,000 patients by its 10th anniversary. This marks a milestone of more than 100,000 cumulative treatment sessions. Notably, the Center has achieved significant success in complex and difficult-to-treat cancers. Liver cancer accounted for the largest portion with 2,403 patients (30.4%), followed by head and neck cancer (1,466 patients, 18.5%), lung cancer (1,304 patients, 16.5%), brain tumors (676 patients, 8.5%), and pancreatic/biliary tract cancer (377 patients, 4.8%).

"Proton therapy is effective for organs where protecting normal tissue is crucial," said Director Hee Chul Park, Director of the Center (Professor of Radiation Oncology). He added, "However, to precisely irradiate protons only onto the targeted treatment area, extensive research and a wealth of clinical experience are essential."

In particular, the Respiratory gated Radiotherapy (RGRT) technology, which the Department of Radiation Oncology has accumulated over 20 years, has been the driving force in achieving both safety and effectiveness. This technology allows for the precise calculation of a tumor's position as it moves with the patient's breath, ensuring that protons are irradiated only where they are needed.

The "pencil beam line-scanning treatment (PBS)" is the second treatment of its kind introduced in the world. This technique uses a pencil beam to draw and eliminate cancer cells according to the tumor's shape, and it is considered the most advanced difficulty level in the field. The Center performs over 90% of its treatments using the line scanning method. In 2022, the Center gained significant academic attention by confirming, for the first time in the world, the local tumor control effect of this method on inoperable liver cancer.

■Aiming to Establish Standard Guidelines... Leading Research on New Treatments

Abundant clinical experience has led to numerous research achievements. To date, the Center has published 91 research papers. Its ultimate goal is to establish standard treatment guidelines.

"The most important factor in cancer treatment is selecting the therapy best suited to the patient's condition," emphasized Director Hee Chul Park. "To achieve this, it is essential to have consistent criteria that can serve as a standard."

Recently, the Center has also ventured into research on "FLASH proton beams," a high-dose radiation therapy. This method, often called the next "game-changer," involves irradiating high doses of radiation (over 40 Gray per second) in less than a second. It maximizes the protection of normal tissues by reducing radiation exposure time while maintaining the ability to destroy cancer cells.

Leveraging its extensive experience in proton therapy and its superior technical environment, the Center plans to swiftly complete pre-clinical studies and develop ultra-precision treatments based on FLASH proton beams. The Center has already signed an agreement with Japan’s Sumitomo Heavy Industries and is conducting joint research.

"As FLASH proton beams-based therapy is still in its nascent stage, we will successfully conclude our research and contribute to growing Korea into a global hub for proton therapy," stated Director Hee Chul Park.