Bibliometric analysis of global research trends in spatially fractionated radiotherapy

Spatially Fractionated Radiotherapy (SFRT) is an innovative radiation oncology technique that strategically redistributes doses within a tumor volume to optimize tumor ablation while preserving normal tissue integrity. Despite substantial technological advancements and growing interdisciplinary interest, a systematic characterization of the global research environment remains absent. This study aims to provide a comprehensive bibliometric evaluation to map research trajectories and identify future priorities.

A systematic search was performed across the Web of Science Core Collection (WoSCC) and PubMed databases, covering the period from January 1, 2005, to December 31, 2025. Following the standard PRISMA guidelines, 427 eligible publications (385 primary articles and 42 reviews) were selected from an initial pool of 1,221 records. Three analytical platforms-VOSviewer, CiteSpace, and Biblioshiny-were integrated to synthesize data on publication trends, institutional contributions, collaborative networks, and thematic evolution.

The SFRT landscape demonstrates a distinct three-phase evolutionary pattern, characterized by a substantial acceleration in publications and citations from 2020 to 2025. The United States maintains the highest cumulative research output, whereas France exhibits leading institutional productivity and significant citation impact. Foundational works in physical dosimetry and early preclinical models have established the disciplinary knowledge base. Thematic evolution identifies five core clusters, revealing a paradigm shift from early investigations into microbeam technology and cellular radiobiology toward recent advancements in proton minibeam therapy, computational precision, and clinical feasibility assessment.

SFRT is a maturing interdisciplinary field that increasingly integrates dose heterogeneity with complex radiobiological responses. To facilitate broader clinical implementation, future research must focus on identifying robust biological markers, refining delivery technologies, and establishing standardized protocols through large-scale prospective trials.