Executive summary

This comprehensive review provides perspectives from the European Society for Radiotherapy and Oncology (ESTRO) 2022 physics workshop on particle arc therapy (PAT) which details current status, challenges and opportunities of treatment planning and delivery of PAT. PAT has not yet been used to treat patients. Available planning studies show that target coverage and plan homogeneity are maintained compared to IMPT while enhancing conformity and substantially sparing OARs. PAT plans have the potential to reduce treatment time and patient body integral dose across a wide range of patient geometries and clinical indications, however PAT plan robustness against uncertainties and interplay effects needs further study. Identifying treatment sites that would benefit most from proton arc therapy should involve a systematic patient selection strategy that takes into account tumor location, patient-specific characteristics, and clinical goals.

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