RTT advanced practice and how it can change the future of radiotherapy

•Integration of Advanced Practice Radiation Therapists (APRTs) within the multi-professional team enhances service delivery in radiation therapy (RT).•APRT goes beyond task shifting, using unique skills and innovation to enhance patient care.•Future APRT roles should be based on the level of practice, not the technology or an individual.•There is a need for standardisation of APRT through consensus, including education frameworks, levels of practice and career progression.•Challenges may be overcome through international collaboration and practice sharing across jurisdictions. The radiation therapy (RT) landscape is continuously evolving, necessitating adaptation in roles and responsibilities of radiation therapists (RTTs). Advanced Practice Radiation Therapists (APRTs) have taken on a proactive role in expanding services and assuming responsibilities within multi-professional teams. A European Society for Radiotherapy and Oncology (ESTRO) brought geographically diverse and experienced RTTs together, to discuss how advanced practice (AP) in the RTT profession should be future-proofed and create a global platform for collaboration. Challenges in achieving consensus and standardisation of APRT was identified across jurisdictions, emphasising the importance of international collaboration. Whilst highlighting the pivotal role of APRTs in driving innovation, improving patient care, and navigating the complexities of modern RT practice, this position paper presents outcomes and recommendations from the workshop. Discussions highlighted the need for standardised role definitions, education frameworks, regulatory support, and career development pathways to enable the advancement of APRT effectively. Increasing networks and collaboration is recommended to ensure APRTs can shape the future of RT.