| Summary: | We live in a golden age for the development of innovative radiotherapy technologies. Three major new treatment platforms are currently at various stages of being implemented globally: stereotactic ablative radiotherapy (SABR)[1]; MR-guided radiotherapy (MR-Linac)[2]; and proton beam therapy (PBT)[3]. Such technologies offer huge opportunities for clinical benefit, but also present significant challenges for development, assessment and rational implementation within an increasingly financially constrained National Health Service (NHS). However, the apparent restrictions imposed by the structure of the NHS can also be viewed as a benefit for developing and proving the value of new radiotherapy technologies. In large part, this is due to the need to provide robust evidence to support the implementation of new technological developments before they can become widely available nationally. For example, the recent development, assessment and widespread adoption of intensity-modulated radiotherapy (IMRT) in the UK was driven by a programme of preclinical and clinical studies that were led initially by a small number of academic centres, but which progressively involved and finally included the majority of radiotherapy units in the UK[4-7]. A by-product of this research is that the UK has provided the international community with the best evidence-base for the use of IMRT in a variety of indications (e.g. prostate, breast and head and neck cancers).
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