Development, Challenge and Future in Particle Therapy

Compared to photons, charged particles have unique radiophysical properties - the Bragg peak, which deposits most of the energy at the end of the range, can provide a similar dose to the target area while reducing body dose exposure by about 50%. The challenge of particle therapy lies in its uncertainty; a small deformation and movement of the organ lead to significant deviations between the planned and actual doses received by the patient, thereby reducing tumor control rates and increasing the risk of normal tissue damage. Therefore, the key of achieving the particle therapy's accuracy is to evaluate and reduce the dose deviations. In recent years, the development of new radiotherapy equipment, artificial intelligence technology, FLASH and other new technologies are expected to elevate the accuracy of particle therapy to new levels. This article comprehensively elaborates on particle therapy's theory and equipment development, the challenge and solution strategies of uncertainty, and new technologies such as AI and FLASH. Moreover, we concluded our experiences of particle therapy in robust planning, AI-based commissioning, and auto-planning. In the end, we summarized the possible development directions of particle therapy algorithms and facilities.