Cancer therapy using protons and heavier ions such as carbon has demonstrated advantages over other radiotherapy treatments. To bring about the next generation of clinical facilities, the requirements are likely to reduce the footprint, obtain beam intensities above 1E10 particles per spill, and achieve faster extraction for more rapid, flexible treatment. This review follows the technical development of ion therapy, discussing how machine parameters have evolved, as well as trends emerging in technologies for novel treatments such as FLASH. To conclude, the future prospects of ion therapy accelerators are evaluated.
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