A review article looked at the development of RT advances. There is a growing awareness of the potential clinical benefits of proton therapy over IMRT in the definitive, postoperative and reirradiation settings given the unique physical properties of protons.

Evidence of the clinical translation of dosimetric advantages of IMPT over IMRT has been demonstrated with documented toxicity reductions. Ongoing investigations in image-guidance techniques and robust optimization methods are promising to address particle range uncertainties and high sensitivity to anatomical changes.