Response to Letter to the Editor of Radiotherapy and Oncology regarding the paper entitled “50 years of radiotherapy research: Evolution, trends and lessons for the future“ by Berger et al. (December 2021, volume 165)

We read with much interest the letter by Tuscano et al. [1] relating to our analysis of 50 years of PubMed records on Radiotherapy [2] and thank them for sharing their reflections on how to rebalance and further develop our discipline in the future. We share their views on the importance of the role to be played by biology to achieve improved personalisation of Radiotherapy treatments, which they neatly encapsulated in the term dose painting by bio-features. More specifically, we strongly believe that incorporating patient-specific biological information such as, tumour and normal tissue radio-sensitivity [3–5] either evaluated pre-treatment via radio-genomics for instance, or in vivo via imaging and radiomic analysis [6,7], is a promising strategy which will ultimately translate into clinical benefits for patients [8].