The Hyogo Ion Beam Medical Center was established in May 2001, a leading project of the Hyogo Cancer Strategy . Its major feature is that both proton and carbon ion beams can be generated. Particle beam radiation therapy had been performed in 2,639 patients as of the end of March 2009. The diseases were prostate cancer, head and neck tumors, liver cancer, lung cancer, and bone soft tissue tumors, in decreasing order of frequency, and these 5 major diseases accounted for 87% of the cases. By beam-type therapy, 2,122 and 517 patients (80 and 20%) were treated with proton and carbon ion beams, respectively. The outcomes surpassed those of surgical therapy realizing cancer therapy without resection. Current problems of particle beam radiation therapy include the unclear effect of differential use of proton and carbon ion beams and the necessity of laying in large-scale equipment, which prevents its dissemination. We are now aiming at the development and clinical application of a laser-driven proton radiotherapy device in cooperation with the Japan Atomic Energy Agency.