The fourth International Conference on Advances in Radiation Oncology (ICARO) conference was held in the International Atomic Energy Agency (IAEA), Vienna, Austria, from 2-5 June 2025. This conference followed on from the themes of the three previous ICARO conferences and aimed to provide an opportunity for healthcare professionals in radiotherapy to hear about current developments in both technology and technique, and to consider ways to address the challenges of delivering high-quality and safe cancer care to patients in the IAEA member states. The purpose and objectives of ICARO 4 are defined on the IAEA website and given below:
“The conference will review important clinical, scientific, professional and educational topics covering different aspects of radiotherapy. It will have the following specific objectives:
- To review the current role and potential of clinical, medical physics, technological and molecular/biological innovations in radiation oncology.
- To explore the applications of improved imaging tools in treatment planning.
- To review the current status of evidence-based recommendations for the treatment of common cancers.
- To review the latest developments in medical dosimetry and dose auditing procedures for new radiotherapy technologies.
- To review the present situation of comprehensive audits in radiotherapy.
- To review resource-sparing approaches in clinical radiotherapy practices.
- To exchange information on the latest advances and implementation challenges in the field among leading experts.
- To define future challenges and directions in the clinical use of radiotherapy” (https://www.iaea.org/events/icaro-4).
A conference app was provided that gave full details of the programme and the different sessions offered, and each participant received a conference bag with one IAEA publication of their choice. Over 600 participants attended on-site and more than 800 participated online. The conference offered a special experience for participants from low and middle-income countries, in many of which radiotherapy services are undergoing rapid expansion.
The first morning comprised a single session with an overview of past ICARO conferences to the present and thoughts for the future, a keynote address on accessing evidence-based radiotherapy and bridging the second translational gap. A panel discussion on how to maximise impact, inspire and lead outlined the collaboration between the IAEA and professional organisations across the world and included a contribution from Alessandro Cortese, chief executive of ESTRO.
Over the following four days, a range of topics was covered over several sessions with four lunchtime side events. The conference was recorded, so anyone interested has the opportunity to view all the sessions.
Women’s issues were the main theme of the afternoon of 2 June. Sessions covered innovations in treatment and life beyond radiotherapy, the role of women in radiation oncology, and how women staff can be supported, including preparation for leadership roles. Over the remaining days, many site- and technique-specific topics were covered, with the majority of presentations being of 15-minute duration. Session topics included updates on a wide range of sites, paediatrics, reirradiation, adaptive radiotherapy, ethics and risk management, the role of immune therapy, theranostics, artificial intelligence, imaging in radiotherapy, and the strengthening of services in low and middle-income countries. Lectures and panel discussions were offered that addressed both education and implementation issues. The final sessions of each day comprised proffered papers, and poster sessions were facilitated throughout each day.
The closing session included a signing ceremony between the IAEA and the European Federation of Organisations for Medical Physics and the closing ceremony with highlights of the conference, closing remarks and presentations of awards for oral presentations, proffered papers and posters.
Overall, it was a very interesting conference that covered a huge variety of topics and offered an invaluable opportunity for participants to gain knowledge, to understand the challenges of introducing new technology and techniques, and to establish networks across countries to enable learning and support for the future development of radiotherapy services globally. It was a pleasure and an honour to be part of this ICARO.
Mary Coffey
Adjunct associate professor in radiation therapy
Department of Medicine
Trinity College Dublin
Dublin, Ireland