Radiotherapy contributes to about 40% of all cancer cures but still lags behind systemic therapy in funding and attention, according to a new impact report released at the American Society for Radiation Oncology’s (ASTRO) 67thAnnual Meeting.
The report, “Precision Targeting, Global Impact: Cancer Radiotherapy in the 21st Century,” draws on insights from 17 global oncology leaders. It highlights innovations such as adaptive radiotherapy (ART) and hypofractionation and explores their impact across multiple cancer types. Elekta, a Swedish producer of radiation therapy equipment, compiled the report.
“Radiotherapy is absolutely coming up on the fast lane, and with amazing technology, we can do so much more than people think we can do,” says Pat Price, a visiting professor at London’s Imperial College, the chair of both Radiotherapy UK and the Global Coalition for Radiotherapy, and a contributor to the report. “It has to reestablish its place in the cancer continuum, because when it’s not used, we are missing out, and patients are missing out.”
ART: Precise, Tissue-Sparing Therapy
The advent of ART, a type of radiotherapy capable of adjusting treatment in real time, represents a significant step forward, Price says.
“Instead of having to do big, square fields like we used to, [ART gives us] millimeter precision,” she says. “That means we can increase the dose and deliver treatment to the right spot at the right time in the right way while sparing more normal tissue.”
The report shows that ART delivers excellent efficacy with fewer side effects across multiple clinical studies. It’s used effectively for many types of cancer, including prostate, pancreatic, and lung cancer. Additionally, one study shows that ART can benefit nearly 75% of patients with head and neck cancer. 1
“These patients sustain significant amounts of anatomical changes during treatment, which also changes the anatomy of their tumors,” says Anthony Paravati, MD, the executive medical director of cancer care and chief of radiation oncology at Kettering Health, a large community health system in Ohio. “[ART allows us to] bring in those high-dose volumes, make sure we give the dose intended to the target, and drive those high-dose areas away from organs at risk.”
That precision is crucial, says Paravati, who also contributed to the report. “In head and neck cancer, the distance between the area we want to treat with the full dose and the tissues we want to avoid is very minuscule compared to other regions of the body,” he says.
Hypofractionation: More Tolerable Radiotherapy
Hypofractionation, a newer treatment strategy, allows clinicians to deliver curative radiation in significantly fewer sessions. Stereotactic Body Radiation Therapy (SBRT), for example, allows prostate cancer to be treated in only four or five fractions, as opposed to the 35 to 45 fractions required in conventional radiotherapy.2
“Hypofractionation has allowed us to get our patients through treatment, disrupt their lives less than an eight-week course of radiation therapy, and increase the throughput of patients through departments,” Paravati says.
Closing Global Access Gaps
Despite its clinical benefits, access to radiotherapy services varies across regions. The report finds that most high-income countries, such as the United States, have one radiotherapy unit available for every 130,600 people. That same unit must provide service for between 1 million and 5 million people in low-to-middle-income nations, and more than 15 million people in low-income countries.
“Even in Europe, there are great disparities, and it is costing lives,” Price says. “I run the Radar Therapy for Life campaign in the UK, [where] we’ve got some parts of the country where only 22% of lung cancer patients get access to radiotherapy.”
Improving access could save 1 million lives a year. 4 But progress, Price says, will require advocacy and education. “We’ve always thought if you start with an evidence base and actually give the data, there’s an inarguable case,” Price says. “If radiotherapy is needed in 40% of cures, you’re not going to improve your survival rates unless you get radiotherapy to your people.”
The full report is available for free at www.aboutadaptive.com.
References
1. Alfouzan AF. Radiation therapy in head and neck cancer. Saudi Med J. 2021;42(3):247-254.
2. Qureshy SA, Diven MA, Xiaoyue M, et al. Differential use of radiotherapy fractionation regimens in prostate cancer. JAMA Network Open. 2023;6(10):e2337165.
3. Atun R, Jaffray DA, Barton MB, et al. Expanding global access to radiotherapy. Lancet Oncol. 2015;16(10):1153-1186. doi:10.1016/S1470-2045(15)00222-3. PMID: 26419354
September 05, 2025 
