KEY POINTS
- The review compares radiobiological model families used in proton therapy, heavy-ion therapy and boron neutron capture therapy, including their assumptions, validation status and clinical readiness.
- In proton therapy, fixed relative biological effectiveness of 1.1 remains the prescription standard; variable-relative-biological-effectiveness and linear-energy-transfer models are best treated as secondary review tools rather than alternative prescription systems.
- In carbon-ion therapy, local effect model- and microdosimetric kinetic model-based doses are embedded in different clinical calibration systems. Identical nominal values in gray relative biological effectiveness are therefore not directly interchangeable between centres.
- In boron neutron capture therapy, biological dose interpretation depends on component doses, boron compound and distribution, uptake assumptions and compound biological effectiveness factors; a single weighted-dose value is insufficient for cross-centre comparison.
- The authors propose four harmonization layers: minimum reporting, reference mapping, model-sensitivity quality assurance and registry-based clinical learning.
CLINICAL TAKEAWAY
The practical message is not to replace established clinical dose systems with one universal model. Particle-therapy publications, trials and registries should instead report the model family, version, parameters, radiation-quality descriptors and uncertainty assumptions needed to interpret biological dose across institutions. The proposed framework is thoughtful but remains a perspective requiring professional consensus and prospective outcome-linked validation.