The Contemporary Role of Virtual and Augmented Reality in Radiation Oncology: A Review

Purpose: Virtual reality (VR) and augmented reality (AR) are increasingly being explored as tools with potential applications in radiation oncology, with applications in education, patient care, and workflow optimization. This review evaluates the current landscape and future potential of immersive technologies in clinical practice. Methods: A comprehensive literature review was conducted via PubMed and Scopus (search date: January 2026) using a Boolean search strategy combining terms for virtual/augmented/mixed reality, radiotherapy, and education/anxiety/training; articles published between 2010 and 2026 were screened independently by two reviewers. An online survey assessed experience with and perceptions of VR among Canadian radiation oncologists. Semi-structured interviews with physicians, residents, therapists, physicists, and a staff psychologist at a large academic tertiary-care center in Canada explored qualitative insights into current use and attitudes toward immersive technologies. Results: VR and AR show utility across multiple domains. In education, platforms such as the Virtual Environment for Radiotherapy Training (VERT) enable therapists to practice in simulated treatment environments, while VR-based contouring tools reduce segmentation time by 41-58% and improve spatial understanding. For patient care, immersive VR interventions reduce pre-treatment anxiety by 26-56%, enhance understanding of procedures, and may decrease sedation in pediatric populations. AR-guided positioning systems demonstrate feasibility with acceptable accuracy, offering radiation-free setup verification. Survey findings revealed limited adoption (>80% reported no use), though 40% believed VR could enhance patient education and 39% desired expanded integration over the next decade. Barriers included cost, limited institutional awareness, and lack of training infrastructure. Conclusions: VR and AR show early potential for improving education, reducing patient anxiety, and enhancing positioning accuracy in radiation oncology. Despite implementation barriers, ongoing trials and technological advances are gradually building the evidence needed to clarify the role of immersive technologies in clinical practice.