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Relative to X-ray beams, proton [¹H] and carbon ion [¹²C] beams provide superior distributions due primarily to their finite range. The principal differences are LET, low for ¹H and high for ¹²C, and a narrower penumbra of ¹²C beams. Were ¹²C to yield a higher TCP for a defined NTCP than ¹H therapy, would LET, fractionation or penumbra width be the basis?

Critical factors of physics, radiation biology of ¹H and ¹²C ion beams, neutron therapy and selected reports of TCP and NTCP from ¹H and ¹²C irradiation of nine tumor categories are reviewed.

Outcome results are based on low dose per fraction ¹H and high dose per fraction ¹²C therapy. Assessment of the role of LET and dose distribution vs dose fractionation is not now feasible. Available data indicate that TCP increases with BED with ¹H and ¹²C TCPs overlaps. Frequencies of GIII NTCPs were …