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In 2007, the National Radiotherapy Advisory Group (NRAG) report ‘Radiotherapy: developing a world class service for England was published. This set the commitment to develop and deliver world class radiotherapy for the benefit of cancer patients in England. Within the NRAG report, the concept of 4D Adaptive Radiotherapy was developed. The concept that you could visualise and adjust the radiation beam in real time to match the target treatment volume, accounting for changes in tumour position and patient movement, were revolutionary. This allowed the clinical community for the first time to think what may be possible if we were to be able to offer truly individualised therapy at the point of each delivery.

In order to deliver the concept of 4D Adaptive Radiotherapy, Image Guided Radiotherapy (IGRT) is an essential element. The ability to visualise the tumour in the treatment setting and then be able to use that information and adapt the treatment plan is vital.

In a Government Press release dated October 2012, the Prime Minister, David Cameron, set out  that all patients would  ‘have access to the most appropriate, safe, and cost effective radiotherapy that their doctor recommends’. Access to IGRT is a key part of meeting this pledge.

This report sets out the work that has been done to support clinical services delivering advanced levels of IGRT. I would encourage providers and commissioners to consider both the report and its findings. They will be important as we move ahead with world class radiotherapy in England.

Sean Duffy

National Cancer Director

NHS England



National Radiotherapy Advisory Group,  2007.    Radiotherapy: developing a world class service for England [accessed 17.08.13]

Department of Health Press release, 8th Oct 2012 [accessed 21.08.13]

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