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Harnessing progress in radiotherapy for global cancer control

Nature Cancer volume 4, pages 1228–1238 (2023)Cite this article

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Abstract

The pace of technological innovation over the past three decades has transformed the field of radiotherapy into one of the most technologically intense disciplines in medicine. However, the global barriers to access this highly effective treatment are complex and extend beyond technological limitations. Here, we review the technological advancement and current status of radiotherapy and discuss the efforts of the global radiation oncology community to formulate a more integrative ‘diagonal approach’ in which the agendas of science-driven advances in individual outcomes and the sociotechnological task of global cancer control can be aligned to bring the benefit of this proven therapy to patients with cancer everywhere.

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Fig. 1: Timeline of the technological advances in radiotherapy from 1980 to today as well as those that can be anticipated by 2040.
Fig. 2: Technological convergence of image-guided IMRT.
Fig. 3: Radiation dose distributions can now be better targeted and shaped in 3D.
Fig. 4: Taking a diagonal approach to bring radiotherapy to the globe.

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Acknowledgements

We thank R. Kaul, former chief innovation officer of the MD Anderson Cancer Center for her initial strategy work on the quadrants of the ‘two worlds’ that contributed to our development of the diagonal view point.

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Authors and Affiliations

  1. Departments of Radiation Physics and Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    David A. Jaffray

  2. Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, USA

    Felicia Knaul

  3. German Cancer Research Center (DKFZ), Heidelberg, Germany

    Michael Baumann

  4. Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada

    Mary Gospodarowicz

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  1. David A. Jaffray
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  2. Felicia Knaul
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  3. Michael Baumann
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  4. Mary Gospodarowicz
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Corresponding author

Correspondence to David A. Jaffray.

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Competing interests

D.A.J. is an inventor of the technology described in ref. 36; it is under the management of the University Health Network, Toronto, Canada. M.B., as CEO of DKFZ, Heidelberg, Germany, has signed contracts for research collaborations and commercial transfers with a large number of companies, including the transfer of 177Lu-PSMA mentioned in this Review. F.K. and M.G. declare no competing interests.

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Jaffray, D.A., Knaul, F., Baumann, M. et al. Harnessing progress in radiotherapy for global cancer control. Nat Cancer 4, 1228–1238 (2023). https://doi.org/10.1038/s43018-023-00619-7

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