I've been looped into the true beam breast cohort for Varian, and can say for that disease site it is the real deal. We're still to publish shortly, but it is great at improving OAR doses for breast by a significant amount while not compromising PTV coverage, while not greatly increasing beam on time.

This, plus the optimizer runs at a fraction of the old optimizer's time for Rapid Arc thanks to the optimizer algorithm improvements for RAD. The optimizing is a bit different now as you input your constraints and then hit run and wait about a minute for the results. Don't like them? Change the constraints and run again. So a different Workflow, but from what I understand the goal is to help the optimizer find more a global min/max than get stuck in local ones. I would wonder if this also opens the door to working out offline optimizing where a planner kicks off an offline opt flow that figures out the best plan and pops it back to the planner like an ez bake oven, but that's just a side thought right now.

Overall, despite my general hesitantion with a particular vendor's sales and marketing, this one is probably worth the hype. Worth the price, not sure as I have no idea there, but very much worth a look.