This article presents an overview of on-going technical developments and innovations that the authors felt most important today, as well as those that have the potential to significantly shape the future of proton therapy.

This review discussed the developments in the accelerator field, in transport and spatial resolution achievable with pencil beam scanning, or conformation of collimation, proton arc therapy and adaptive PT, as well as using FLASH ultra-high dose rate irradiation the differential effect between healthy tissues and tumor could be enhanced, resulting in a shift of the therapeutic index