Hypervision Proton Surgery: The Future Direction of Proton Therapy

ABSTRACT Proton beams provide unique physical advantages characterized by a low entrance dose, negligible exit dose, and a sharp Bragg peak, which enable superior sparing of normal tissues and support safe dose escalation for improved tumor control. However, conventional photon‐based fractionation remains widely used in proton therapy, where prolonged treatment courses exacerbate anatomical changes and range uncertainties, ultimately limiting therapeutic precision, reducing efficiency, and increasing operational and financial burdens on proton centers. To overcome these limitations, we propose the hypervision proton surgery (HyPROS), a novel treatment paradigm that integrates the physical precision of protons, the biological benefits of hypofractionation, and advanced online image guidance to deliver high‐dose proton beams in a single or very few fractions. This approach enhances tumor eradication while minimizing normal tissue injury, shortens treatment duration, reduces costs, and substantially increases the service capacity and socioeconomic value of proton facilities. Therefore, we propose an integrated framework, hypervision particle surgery (HyPARS), which combines the principles of HyPROS and hypervision heavy ion surgery (HyHIS) to deliver single or ultrahypofractionated proton or heavy ion treatments under the guidance of multimodal imaging visualization technology, which we contend represents a critical future direction for radiotherapy.