The aim of this review article is to present new sophisticated techniques in radiotherapy, which occurred due to the advancement of technology over the past few decades. The paper will provide insight into their advantages and disadvantages, the importance of diagnostic imaging modality, precise contouring, treatment planning and control of patients' position during radiation treatment. The transition from two-dimensional to three-dimensional radiotherapy has allowed contouring of target volume and organs at risk and accurate information on radiation dosage delivered. With a further desire for more precision and protection of healthy tissues, techniques such as intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) have been developed with the ability to modulate beam intensity. Quality imaging diagnostics is an infallible part of the modern radiotherapy. Image-guided radiotherapy (IGRT) and adaptive radiotherapy enable the delivery of high precision radiation to the target volume and spares organs at risk by correcting interfractional and intrafractional variations. Respiratory gating and tracking technique are useful for tumours that change their position during respiratory cycle. Stereotactic ablative radiotherapy (SABR) is a technique that uses highly conformal high-dose hypofractionated radiation to treat small tumours. In some indication such as the treatment of early stage non-small lung cancer, it competes with radical surgery. SABR is also an important therapeutic modality in the management of oligometastatic disease. This paper will briefly discuss proton therapy and its unique physical properties.

Cancer of an unknown primary site is most commonly an aggressive metastatic tumor with a median patient survival of 6 to 9 months. Histologically, it is predominantly adenocarcinoma, and if the primary site is subsequently diagnosed, it is usually the pancreas or lung. Biopsy should be performed whenever possible to classify a tumor of unknown primary origin into one of the following entities: adenocarcinoma, poorly differentiated carcinoma with characteristics similar to adenocarcinoma, squamous cell carcinoma, neuroendocrine carcinoma, poorly differentiated neoplasm. After determining the primary tumor type, the subtype is determined by immunohistochemical staining. In oligometastatic disease, there is a possibility of surgical treatment. Radiotherapy is used as a part of combined modality treatment. Most patients with cancer of unknown primary have an unfavorable prognosis despite multiple chemotherapy agents, and no protocol can be recommended as standard therapy.

Emergency conditions in oncology may arise either as part of the malignant disease itself, or may be associated with its treatment. They are potentially life-threatening conditions that require urgent care, often with patient hospitalization and a multidisciplinary treatment approach. Consequently, it is important that all physicians are familiar not only with potential oncological emergencies which may occur in their clinical practice but also how to provide the most effective care in a timely fashion. In this review article we comprise the clinical features and treatment of several of these emergencies, namely the superior vena cava syndrome (SVCS), elevated intracranial pressure, metastatic spinal cord compression (MSCC), hypercalcemia and febrile neutropenia.