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Is there a role for arcing techniques in proton therapy?

Proton arc therapy (PAT) has been proposed as a possible evolution for proton therapy. This Commentary uses dosimetric and cancer risk evaluations from earlier studies to compare PAT with Intensity Modulated Proton Therapy (IMPT). It is concluded that, although PAT may not produce better physical dose distributions than IMPT, the radiobiological considerations associated with particular PAT techniques could offer the possibility of an increased Therapeutic Index.