Palliative radiotherapy: past, present and future—where do we go from here?

Radiotherapy is successful, time efficient, cost effective, and safe means to provide palliative relief for a variety of symptoms suffered by oncology patients. While the value of palliative radiotherapy has been understood for more than century, the radiation oncology specialty has only incompletely embraced its role in this setting. The optimization of palliative oncology requires accurate survival prognostication and a dedication to existing hypofractionated radiotherapy regimens that minimize toxicity and improve patient and caregiver convenience. The future of palliative radiotherapy demands more extensive treatment guidelines that explain the proper use of existing and novel technologies while remaining attentive to a growing population of cancer patients and a limited amount of resources with which to provide them care.