Looking Ahead to Boston and the Future of Radiation Oncology

As we approach the 2026 Annual Meeting, we are also nearing the conclusion of another ASTRO year. The Annual Meeting is always a fitting moment to reflect on what we have accomplished, the challenges facing our specialty and where we are headed next.

Each Annual Meeting represents nearly two years of planning by the Society’s president, volunteers and ASTRO staff. This year’s meeting reflects the vision of ASTRO President Neha Vapiwala, MD, FASTRO, and is supported by an extraordinary team of volunteers and staff who have devoted countless hours to developing the programming that brings our community together each year. I am grateful to everyone who has contributed, and I look forward to seeing the results of that work in Boston.

This year’s meeting theme, Data to Dialogue: Communicating Radiotherapy’s Value to Advance Cancer Care, is particularly timely. Radiation oncology is generating more data than ever before, but data alone do not improve patient care. Our challenge is to translate evidence into meaningful conversations with patients, colleagues, payers and policymakers, and ultimately into better care. That concept dovetails nicely with several of ASTRO’s major priorities.

Building the Future of Radiation Oncology

One example is ASTRO’s continued effort to expand the role of radiation therapy beyond cancer. What has traditionally been referred to as the treatment of nonmalignant disease is increasingly being described as functional radiation medicine, reflecting the broad range of conditions in which radiation therapy can improve function, reduce pain and enhance quality of life.

Functional radiation medicine is not a one-time initiative or meeting theme. It has been a strategic priority for ASTRO for several years and represents a coordinated, multiyear effort. The 2025 Annual Meeting theme, Rediscovering Radiation Medicine: Expanding Indications, highlighted this work, but it was only one component of a much broader strategy.

ASTRO has developed a comprehensive educational and advocacy effort that includes a six-part series available through ASTRO Academy, dedicated coverage in ASTROnews, and multidisciplinary working groups focused on musculoskeletal and inflammatory conditions, cardiovascular applications, and neurologic indications. These groups are helping identify research priorities, educational needs and opportunities for future clinical guidance.

We also recognize that generating evidence alone is not enough. Broader adoption will require engagement with payers and policymakers. ASTRO is working to develop clinical guidance and advocacy strategies aimed at improving appropriate coverage so that patients who may benefit from these treatments have meaningful access to them.

Creating a More Sustainable Payment System

Another major focus continues to be reimbursement. The recently released Medicare Physician Fee Schedule (MPFS) proposed rule again underscores the uncertainty facing radiation oncology practices. While many specialties face similar challenges under the MPFS, we recognize the particular impact on radiation oncology practices, especially those providing care in community settings.

ASTRO will continue to advocate on the annual MPFS and Hospital Outpatient Prospective Payment System rules. But annual advocacy alone cannot solve the underlying structural problems in the current payment system.

That is why ASTRO has spent years pursuing a longer-term solution through the Radiation Oncology Case Rate (ROCR). Unlike simply advocating for higher annual payments, ASTRO has focused on developing a fundamentally different payment framework that better reflects how radiation therapy is delivered and supports long-term stability for patients and practices alike.

Payment reform is difficult and requires sustained engagement with our members, Congress, the Centers for Medicare and Medicaid Services (CMS) and other stakeholders. We will continue to advocate vigorously on the annual Medicare rules while simultaneously pursuing a longer-term solution that better serves patients and our specialty. We’re excited about the momentum around ROCR, which is approaching support from 50 bipartisan cosponsors in Congress.

Taking Our Message to Capitol Hill

That work also requires policymakers to understand the value radiation oncology brings to the healthcare system.

On July 14, ASTRO brought that message directly to Capitol Hill through a congressional briefing focused on the value of radiation therapy. Hosted in conjunction with the House Cancer Caucus and featuring Representatives Debbie Dingell and Brian Fitzpatrick, the briefing provided an opportunity to explain how radiation therapy delivers highly effective cancer care, often at a fraction of the cost of many other cancer treatments.

Our advocacy efforts also included meetings with congressional offices and key committees involved in healthcare policy. These conversations matter. Decisions about reimbursement, prior authorization, access to care and the future structure of Medicare are shaped by policymakers who may have limited familiarity with radiation oncology. ASTRO has an important responsibility to ensure they understand both the challenges facing our specialty and the extraordinary value radiation therapy provides to patients and the healthcare system.

Looking Ahead

As my term as Chair comes to a close, I remain optimistic about the future of our specialty. Radiation oncology continues to innovate, expand its role in cancer care and improve the lives of patients.

None of this happens without the dedication of our volunteers, committee members, Board and ASTRO staff. Thank you for everything you have done this year.

I look forward to seeing many of you in Boston as we celebrate another outstanding Annual Meeting, reconnect with colleagues and friends, and continue moving our specialty forward together.