This narrative review charts the transformation of palliative radiotherapy from quick pain reliever to synergistic therapeutic employed to meaningfully halt disease trajectory. On the systems side, dedicated rapid-access palliative radiotherapy clinics are streamlining care with same-day consults and simulation-free workflows. Multidisciplinary teams featuring advanced practice providers and radiation therapists are offloading physician workload to further increase throughput. Meanwhile, embedded research programs are generating provocative data, including prophylactic radiation to high-risk bone mets improving survival. | Agrawa, Adv Radiat Oncol 2026
