Online adaptive particle therapy is still an emerging approach. Because it requires substantial additional resources, the field needs a clear clinical rationale: which patients, indications, or treatment strategies justify the extra complexity, and what new opportunities become possible only when adaptation is available at the treatment unit?
It is therefore essential to define which clinical scenarios and treatment concepts may truly benefit from online workflows, so that the field can prioritise those areas where the additional resources is most likely to translate into meaningful clinical benefit.
The value of online adaptive particle therapy should not be assessed only by asking whether adaptation improves plan quality on a given treatment day. Its broader value may be that it changes what can be safely attempted in particle therapy: simulation-free or direct-to-unit pathways, reduced margins, safer hypofractionation, adaptive dose escalation or de-escalation, response-guided treatment, and future biological personalisation.
This workshop will focus on identifying where online adaptive particle therapy matters clinically, where it may enable new treatment strategies, and which use cases should be prioritised.