Intense and rapid technological advances in computer software, imaging and engineering projected to radiotherapy over the past decades. As the main objective of radiotherapy is sterilization of tumor cells at a defined target with adequate safety margins, treatment planning and dose delivery systems allowed the precise radiation dose to the target volume, sparing the adjacent structures. The breakthrough development of computer-controlled multileaf collimators and adaptation of computer tomography-based planning enabled three-dimensional conformal therapy. Intensity- modulated radiotherapy, volumetric modulated arc therapy, image-guided radiotherapy, adaptive radiotherapy, stereotactic radiotherapy, intraoperative radiotherapy, brachytherapy, charged particle radiotherapy, and hyperthermia are the technological reflection of these improvements. As radiotherapy is one of the most technology-driven treatment modalities in the management of cancer, future innovations and knowledge gained from clinical trials will help to improve new treatment strategies.

Keywords: 3D conformal radiotherapy, intensity-modulated radiotherapy, image guided radiotherapy, stereotactic radiotherapy, intraoperative radiotherapy, proton beam radiotherapy