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Repositioning Radiation Oncology at the centre of integrated oncology care: A manifesto of the European Society for Radiotherapy and Oncology (ESTRO)

Meattini, I.
; 
Aznar, M. C.
; 
Boldrini, L.
; 
Borgmann, K.
; 
Clark, C. H.
; 
Faivre-Finn, C.
; 
Forde, E.
; 
van der Heide, U. A.
; 
Jereczek-Fossa, B. A.
; 
Jornet, N.
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Abstract
Modern oncology increasingly relies on integrated, multimodality care, yet radiation oncology remains undervalued in strategic frameworks despite its central therapeutic role. This ESTRO manifesto calls for a repositioning of radiation oncology as a core discipline in cancer care, scientifically, clinically, and politically. The field now extends beyond beam delivery to encompass systemic therapy integration, personalised strategies based on biology and imaging, and active participation in clinical decision-making and guideline development. Radiation oncology contributes to treatment sequencing, synergistic combinations, and innovation in areas such as radioligand therapy and artificial intelligence. ESTRO's initiatives, including education, research networks, and oncopolicy engagement, underscore the discipline's broad scope and societal value. Strategic partnerships with Pharma and MedTech, alongside a renewed emphasis on equitable access, are essential to sustaining progress. ESTRO invites all stakeholders to recognise radiation oncology as fundamental to the design, delivery, and evolution of modern cancer therapy.
Authors
Meattini, I.
Aznar, M. C.
Boldrini, L.
Borgmann, K.
Clark, C. H.
Faivre-Finn, C.
Forde, E.
van der Heide, U. A.
Jereczek-Fossa, B. A.
Jornet, N.
Kirby, A. M.
Ost, P.
Ratosa, I.
Tanderup, K.
Troost, E. G. C.
Cortese, A. J.
Guckenberger, M.
Affiliation
Department of Experimental and Clinical Biomedical Sciences 'M. Serio', University of Florence, Florence, Italy; Radiation Oncology Unit & Breast Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy. Electronic address: icro.meattini@unifi.it. Division of Cancer Science, University of Manchester, Manchester, UK. Fondazione Policlinico Universitario 'A. Gemelli' IRCCS, Rome, Italy. Department of Radiotherapy & Radiation Oncology, Hubertus Wald Tumor Center, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Department of Radiotherapy Physics, University College London Hospital, London, UK; Department of Medical Physics, University College London, Radiotherapy and Radiation Dosimetry Group, National Physical Laboratory, Teddington, UK. The Christie NHS Foundation Trust & University of Manchester, Manchester, UK. Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, Trinity College Dublin, Dublin, Ireland; Trinity St. James's Cancer Institute, Dublin, Ireland. Department of Radiation Oncology, the Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands. Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy; Department of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. Royal Marsden NHS Foundation Trust & Institute of Cancer Research, Sutton, UK. Department of Radiation Therapy, Iridium Network, Antwerp, Belgium; Department of Human Structure and Repair, University Ghent, Ghent, Belgium. Division of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. German Cancer Consortium (DKTK), Partner Site Dresden, Dresden, Germany; German Cancer Research Center (DKFZ), Dresden, Germany; OncoRay - National Center for Radiation Research in Oncology, Dresden, Germany; Technische Universität Dresden, Dresden, Germany; Helmholtz-Zentrum Dresden-Rossendorf, Germany, Dresden, Germany. European Society for Radiotherapy and Oncology (ESTRO), Brussels, Belgium; Antwerp Management School, University of Antwerp, Antwerp, Belgium. Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland.
Description
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2025
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All Christie Publications
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Article
Citation
Meattini I, Aznar MC, Boldrini L, Borgmann K, Clark CH, Faivre-Finn C, et al. Repositioning Radiation Oncology at the centre of integrated oncology care: A manifesto of the European Society for Radiotherapy and Oncology (ESTRO). Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 2025 Sep;210:111035. PubMed PMID: 40659192. Epub 2025/07/15. eng.
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https://christie.openrepository.com/handle/10541/628069
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