Access to radical and palliative radiotherapy in low- and middle-income countries: challenges, progress, and future directions

PURPOSE OF REVIEW: Low- and middle-income countries (LMICs) bear over half of the global cancer mortality but have access to only 5% of global radiotherapy resources. As the cancer burden rises and equity in palliative care gains global attention, a focused review on palliative radiotherapy access in LMICs is both timely and necessary. RECENT FINDINGS: Barriers to radiotherapy access in LMICs are multifaceted, including infrastructure gaps, workforce shortages, geographic centralization, high out-of-pocket costs, and systemic underinvestment. Palliative radiotherapy, despite its proven cost-effectiveness and impact on quality of life, is often excluded from national cancer plans and health strategies. Innovative approaches such as hypofractionation, mobile units, AI-assisted planning, and public-private partnerships are emerging to address these gaps. Efforts by the International…