If stereotactic radiation therapy (SRT) is everywhere, why are phase III trials demonstrating its benefit nowhere? A thoughtful analysis dissects why SRT has outpaced the level I evidence needed to define its true value. Despite radiation being a cornerstone of cancer care, only ~2% of phase III oncology trials between 2002–2020 addressed a primary radiation question, compared with 79% focused on systemic therapy. On a related note, only 6% of radiation trials receive industry funding versus 43% overall. The authors suggest diversified funding, pragmatic and efficient trial design, validated patient-centered endpoints, and consensus on evidentiary standards for adoption and reimbursement. | Hanna, Int J Radiat oncol Biol Phys 2026
