The Impact of Nanoparticles on Proton Therapy: A Review Study.

Background/Objectives: Proton therapy provides superior dose conformity and better normal tissue sparing than conventional radiotherapy but is limited by its relatively low relative biological effectiveness (RBE). Nanoparticles have emerged as promising proton radiosensitizers capable of enhancing physical dose deposition and biological responses. Methods: A narrative literature review was conducted using PubMed, Scopus, Web of Science, and Google Scholar. Results: Gold nanoparticles were the most extensively studied radiosensitizers, while platinum, gadolinium, hafnium oxide, titanium dioxide, iron oxide, and other nanoparticles also demonstrated promising radiosensitizing effects. Evidence indicates that nanoparticles enhance local dose deposition, increase LET and ROS production, promote DNA damage, and improve tumor control. Conclusions: Nanoparticle-assisted proton therapy represents a promising strategy for improving cancer treatment by increasing therapeutic efficacy while preserving healthy tissues. Although preclinical studies demonstrate significant improvements in therapeutic efficacy, challenges related to tumor targeting, biodistribution, safety, and clinical validation remain. Further research is required to facilitate clinical implementation.