How Much Has Radiotherapy Evolved in the 21st Century?

Over the past 25 years, radiotherapy has advanced greatly through the advent of new technologies, such as enhanced imaging, as well as the refining of already established techniques. As a result of this, the experience of the patient has significantly improved.

Following the release of a report detailing the landscape of radiotherapy in cancer care, CancerNetwork® spoke with one of the main contributors, Pat Price, MA, MD, FRCR, FRCP, visiting professor of Oncology at Imperial College London, in London, England; chair of Radiotherapy UK; and co-founder and chair of the Global Coalition for Radiotherapy, about key findings highlighted in the manuscript.1

Price noted that approximately one-third of all patients with prostate cancer will need to undergo radiotherapy. The National Cancer Institute estimated that there would be 313,780 new cases of prostate cancer in 2025; considering this number, over 100,000 patients would require radiotherapy.2 With old technologies, patients may have needed to receive radiotherapy for several weeks, receiving dozens of treatments. The new technology, with more precise imaging and targeted delivery, makes it so that some patients may only need to come in twice for treatment.

Read the full report here: Adaptive Radiotherapy | Precision Cancer Treatment

Transcript:

Clinically, how may these advances have altered a patient’s experience receiving radiotherapy?

The biggest change we see is in patients being able to tolerate their treatment better and get on with their lives. Often, if they tolerate it, they can take the dose and then be cured. For instance, in prostate cancer, radiotherapy is needed in about a third or nearly a half of men with prostate cancer; if they are not able to have the operation, if they prefer the radiotherapy, and if they are perhaps older, this is a curative treatment.

In the past, I remember years ago—probably in the 1960s—there would be a joke that you would have to have a 10-by-10 square and center it on the second trouser button because you had no imaging. You had to use surface markers. Can you imagine the toxicity from that? Then, we had to give treatment. We used to give radiotherapy for prostates over 32 treatments—that’s 6.5 weeks, and that’s a man coming in every day, Monday to Friday.

Now, in some sense, we can give [radiotherapy] with the targeted therapy, especially if we have spacer devices to move the bowel out of the way and target it in some of the intensity modulated radiotherapy [IMRT] and with the MR-based linacs. We can give this in 2 treatments accurately. Can you imagine the difference for a patient coming in twice, rather than coming in for much more toxic treatment over 6 weeks? It’s transformational.

References

1. Precision targeting, global impact: cancer radiotherapy in the 21st century. AboutAdaptive. 2025. Accessed October 6, 2025. https://tinyurl.com/4rah5v6k
2. Cancer stat facts: prostate cancer. National Cancer Institute. Accessed October 14, 2025. https://tinyurl.com/2vxaw632