The International Atomic Energy Agency (IAEA) is organizing the second International Conference on Advances in Radiation Oncology (ICARO-2), following the success of the first conference (ICARO-1), which was held in 2009. The advances in radiotherapy in the last years have been striking, although numerous challenges are still to be faced, including achieving access to high standard cancer care in many countries. New radiotherapy techniques have been implemented in the past decade, including three-dimensional conformal therapy, stereotactic radiotherapy, intensity modulated radiation therapy, image guided radiation therapy, tomotherapy, new brachytherapy and unsealed-source techniques, and proton and heavy ion therapy. The increased use of these complex techniques, coupled with the need to treat more patients in less time, will continue to drive a reliance on high-end technologies and impose a financial burden on health care programmes. In addition, the development and implementation of a quality assurance programme for these new techniques is a major challenge in Member States.