Roadmap for the implementation of particle minibeam therapy

Particle minibeam therapy (PMBT) has emerged as an advanced modality within spatially fractionated radiation therapy, using the physical properties of protons, ions, and electrons to achieve superior normal tissue sparing whilst preserving spatial dose distribution at depths that are unachievable in conventional kV or MV X-rays. As with any novel radiotherapy technique, successful translation into routine clinical practice requires robust evidence of efficacy, safety, and technical feasibility. This review presents a coordinated roadmap for the development and future implementation of PMBT, identifying the key challenges that must be addressed to enable safe and effective clinical implementation. This review highlights the interconnected nature of PMBT research and proposes the priority areas for future investigation, and the steps necessary to guide PMBT from experimental concept, towards clinical implementation. As most of the steps are relevant to all particle types, PMBT will be referred to in general, where specific particle types will be discussed where appropriate.