Radiation treatment has been part of the cancer treatment landscape in Australia for over 50 years. Currently, it contributes to 40% of cancer cures and has a well defined role in all of the major common malignancies that affect our society. It is estimated that 48% of patients will require radiation therapy at some point in their illness. Along with surgery it remains one of the cornerstones of local therapy for cancer.

The success of radiation therapy relies on the accurate definition of the target which is the site of the tumour. The profession has undergone spectacular change which has largely been driven by technological improvements in imaging of tumours as well as the delivery of more conformal therapy to minimise the treatment of normal tissues. IMRT, VMAT and IGRT are increasingly being adopted as the standard of care in many tumour sites to provide treatments that are more targeted.

Clinical trials groups such Trans-Tasman Radiation Oncology Group (TROG) have entered over 12,000 patients into prospective clinical trials using radiation treatment in the past 25 years and this has helped forge the role of radiation treatment in a variety of different cancers.

The Tripartite working group has also been responsible for setting a set of quality standards for radiation treatment which is aimed at setting the highest possible standards for our professional groups.

Looking into the future, it is certain that there will be continued evolution of the role of radiation treatment. Stereotactic Body Radiation Therapy has a rapidly evolving role in the treatment of early stage lung cancer and oligometastatic disease. There needs to be continued efforts directed towards establishing the place of radiation treatment in the ever increasing number of chemotherapy drugs and targeted agents.