Radiotherapy (RT) has undergone transformative advancements since its inception over a century ago. This review highlights the most promising and impactful innovations shaping the current and future landscape of RT. Key technological advances include adaptive radiotherapy (ART), which tailors treatment to daily anatomical changes using integrated imaging and artificial intelligence (AI), and advanced image guidance systems, such as MR-LINACs, PET-LINACs, and surface-guided radiotherapy (SGRT), which enhance targeting precision and minimize collateral damage. AI and data science further support RT through automation, improved segmentation, dose prediction, and treatment planning. Emerging biological and targeted therapies, including boron neutron capture therapy (BNCT), radioimmunotherapy, and theranostics, represent the convergence of molecular targeting and radiotherapy, offering personalized treatment strategies. Particle therapies, notably proton and heavy ion RT, exploit the Bragg peak for precise tumor targeting while reducing normal tissue exposure. FLASH RT, delivering ultra-high dose rates, demonstrates promise in sparing normal tissue while maintaining tumor control, though clinical validation is ongoing. Spatially fractionated RT (SFRT), stereotactic techniques and brachytherapy are evolving to treat challenging tumor types with enhanced conformality and efficacy. Innovations such as 3D printing, Auger therapy, and hyperthermia are also contributing to individualized and site-specific solutions. Across these modalities, the integration of imaging, AI, and novel physics and biology-driven approaches is redefining the possibilities of cancer treatment. This review underscores the multidisciplinary and translational nature of modern RT, where physics, engineering, biology, and informatics intersect to improve patient outcomes. While many approaches are in various stages of clinical adoption and investigation, their collective impact promises to redefine the therapeutic boundaries of radiation oncology in the coming decade.
自一个多世纪前诞生以来，放射治疗（RT）经历了革命性的发展。本综述重点探讨当前及未来放射治疗领域最具前景和影响力的创新技术。关键技术进展包括：自适应放疗（ART）——通过整合影像学与人工智能（AI）技术实现基于每日解剖结构变化的个体化治疗；先进影像引导系统——如磁共振直线加速器（MR-LINAC）、正电子发射断层扫描直线加速器（PET-LINAC）及表面引导放射治疗（SGRT）等，显著提升靶区定位精度并减少附带损伤。人工智能与数据科学通过自动化流程、优化分割算法、剂量预测和治疗计划设计，为放射治疗提供进一步支持。 新兴生物靶向治疗技术，如硼中子俘获治疗（BNCT）、放射免疫治疗及诊疗一体化方案，体现了分子靶向与放射治疗的融合趋势，为个体化治疗策略开辟新路径。粒子治疗技术，特别是质子与重离子放疗，利用布拉格峰实现精准肿瘤靶向的同时降低正常组织受照剂量。FLASH放疗通过超高剂量率照射在保持肿瘤控制的同时展现保护正常组织的潜力，目前正在进行临床验证。空间分割放疗（SFRT）、立体定向技术和近距离放疗技术正朝着提升适形性与疗效的方向发展，以应对复杂肿瘤类型的治疗挑战。 三维打印技术、俄歇电子治疗及热疗等创新手段，正在推动个体化与病灶特异性治疗方案的发展。纵观这些治疗模式，影像技术、人工智能与新型物理学及生物学方法的融合正在重塑癌症治疗的格局。本综述强调现代放射治疗的多学科转化特性——物理学、工程学、生物学与信息学的交叉融合共同推动患者治疗效果的提升。尽管许多创新技术处于不同的临床转化与研究阶段，但这些技术的协同效应有望在未来十年重新定义放射肿瘤学的治疗边界。
肿瘤(癌症)患者之家