Radiation Therapy Quality — the article + the world, ranked

A fuller editorial guide to radiation therapy quality is coming soon. For now, the ranking below compares every country we have assessed on it — open a country's report for the cited detail behind its score.

The country comparison

Which countries are best for radiation therapy quality

The destinations ranked high→low under this lens — each with the reasoning behind its score, the cited evidence one click down, and its full report. The verdict is free; the report is the depth.

19 / 19 Countries ranked

Researched and assessed by the Epidaurus editorial pipeline against our published scale. A country below the rule is not yet assessed enough — never ranked last.

1 Spain ES 5.0/5 Good Spain operates three operational proton therapy centers with pencil beam scanning, CyberKnife M6, Gamma Knife ICON, and MR-linac adaptive therapy capabilities across JCI-accredited facilities. Over 1,000 SEOR-certifie... Full report
The evidence behind this score 8 cited points
- Three operational proton therapy centers (Quirónsalud Madrid, CUN, FJD) with expansion programme adding 10+ by 2027; Quirónsalud treated ~1,000 patients since December 2019; FJD unique in combining proton therapy with MR-linac
- Stereotactic radiosurgery platforms: CyberKnife M6 at Hospital Ruber Internacional and Centro Médico Teknon; Gamma Knife ICON at Teknon for submillimetre cranial treatments with specialist Dr. Bartolomé Oliver (900+ CyberKnife procedures)
- 1,000+ SEOR-certified radiation oncologists trained to ESTRO Core Curriculum; virtually every major Spanish university has radiation oncologist on faculty; specialist working groups covering all tumor types and techniques
- JCI accreditation at Centro Médico Teknon (7 consecutive cycles since 2002), Quirónsalud, and Clínica Universidad de Navarra; ESMO Designated Centre status; 96% of departments maintain documented QAPs; 86% incorporate medical exposure justification criteria
- Private-sector wait times: 1-2 weeks for consultation, 1 week for treatment start; 24/7 multilingual international patient coordination (HM Hospitales, CUN); 120,000+ medical tourists annually for cancer care
- Cost savings 40-70% vs US (conventional IMRT €8,000-€15,000 vs $25,000-$100,000; proton therapy €36,500-€93,000 vs $120,000-$300,000)
- MD Anderson Cancer Center Madrid (only MD Anderson affiliate outside USA) providing institutional protocols, tumor boards, and Phase 1 trial access
- CUN treated 1,300+ proton therapy patients with 27% pediatric caseload, indicating mature subspecialty programs
Read the full Spain report →
2 Singapore SG 5.0/5 Good Singapore demonstrates excellent radiation therapy infrastructure with state-of-the-art facilities, world-class expertise, and comprehensive medical tourism coordination. NCCS operates 17 linear accelerators, 2 MRI-Li... Full report
The evidence behind this score 6 cited points
- NCCS operates 17 linear accelerators, 2 MRI-Linac systems, and 4-gantry Hitachi proton therapy center with pencil beam scanning; three proton facilities total in Singapore as of mid-2024 [Goh Cheng Liang Proton Therapy Centre - NCCS - 2024]
- Full spectrum of advanced techniques (IMRT, VMAT, SBRT, SRS, MRI-guided adaptive radiotherapy, Gamma Knife, TomoTherapy, HDR/LDR brachytherapy, proton therapy) routinely available across public and private hospitals [Radiation Therapy - NCCS - 2024]
- NCCS has 20+ qualified radiation oncologists; AARO's 7 senior consultants hold FRCR/FRANZCR certifications with one elected to Board of Directors of International Stereotactic Radiosurgery Society [Radiation Oncology - NCCS - 2024; AARO Singapore - 2024]
- JCI accreditation at NCCS and multiple private hospitals; 350 peer-reviewed publications annually with 10%+ in top-quintile journals; 220+ active clinical trials [About NCCS - 2024]
- Dedicated international patient coordinators with multilingual support (Mandarin, Indonesian, Vietnamese, Russian); CanHOPE post-treatment program operates in 20 cities globally [International Patients Guide - Parkway Cancer Centre - 2024]
- Proton therapy costs SGD $40,000 (~USD $30,000) versus ~USD $115,000 in USA (73% savings); IMRT costs USD $6,000-$12,000 versus USD $25,000-$59,000 in USA (50-75% savings) [Proton Therapy Cost - Singapore Advanced Medicine - 2024]
Read the full Singapore report →
3 Brazil BR 4.5/5 Good Brazil delivers nearly all Score 5 requirements through elite private centers offering state-of-the-art technology (409 radiotherapy machines across 263 centers, Varian TrueBeam systems, Leksell Gamma Knife at four si... Full report
The evidence behind this score 5 cited points
- 409 therapy machines across 263 active centers; Varian TrueBeam at Hospital Israelita Albert Einstein (first in South America); Elekta Versa HD LINACs at Rede D'Or DF Star; Leksell Gamma Knife Icon at four sites (São Paulo, Brasília, Curitiba, Rio de Janeiro)
- 646 radiation oncologists and 533 certified medical physicists (2020); formal partnerships with MD Anderson Cancer Center (Albert Einstein), Princess Margaret Hospital and Institut Curie (A.C. Camargo); continuous exchange of best practices
- Hospital Sírio-Libanês maintains active agreements with 70+ international insurance companies; quadrilingual support (English, Portuguese, Spanish, Japanese); private-sector consultation and treatment start within days to 2 weeks versus 113-day average in public SUS system
- JCI accreditation at A.C. Camargo Cancer Center and Hospital Israelita Albert Einstein; INCA's PQRT quality assurance program covers ~90% of Brazilian radiotherapy services since 1999; costs 40-60% below US and European benchmarks
- No operational proton therapy facilities in Brazil as of 2025; ANVISA approved IBA's ProteusOne system in 2018 but no facility has been constructed or opened; patients requiring proton therapy must seek treatment in North America or Europe
Read the full Brazil report →
4 Thailand TH 4.5/5 Good Thailand demonstrates exceptional radiation therapy capabilities meeting or exceeding most Score 5 criteria, including multiple JCI-accredited facilities with state-of-the-art technology (IMRT, VMAT, CyberKnife, opera... Full report
The evidence behind this score 6 cited points
- TrueBeam STx at Bumrungrad and IMRT adopted by 82% of Thai radiotherapy centers by 2020, with VMAT and SBRT capabilities widely available
- Proton therapy facility (HRH Princess Maha Chakri Sirindhorn Proton Center) operational since August 2021, with second facility planned for 2029
- Multiple JCI-accredited facilities plus IAEA QUATRO audit at center of competence level with dedicated training center status
- Zero wait times once cleared for treatment with comprehensive medical tourism coordination including travel coordinators and language interpreters
- 90-95% documented success rate for radiotherapy with cost savings of 60-70% compared to Western countries
- 2022 global workforce analysis shows 87% radiation oncologist needs met but only 72.6% of medical physicist needs and 68.8% of radiation therapist needs
Read the full Thailand report →
5 Turkey TR 4.5/5 Good Turkey's leading private hospital centers (Acibadem, Memorial, Anadolu, Florence Nightingale, Hisar Intercontinental) deploy world-class radiation therapy technology including MR-LINAC, CyberKnife (10 units), Gamma Kn... Full report
The evidence behind this score 6 cited points
- 10 CyberKnife units (5 in Istanbul, including M6 models) and Gamma Knife Icon with 7,000 patients treated since 2005 at Acibadem
- MR-LINAC systems at Acibadem Maslak (2018), Hisar Intercontinental, and Baskent University enabling daily adaptive replanning
- 1,000+ TROD-member radiation oncologists with Prof. Banu Atalar (TROD President 2025–2027) simultaneously chairing ESTRO National Societies Committee (2024–2027)
- 46 JCI-accredited hospitals plus ESMO certification at Anadolu, ISO accreditations, HIMSS and Planetree certifications at Acibadem
- IMRT pricing $6,000–$10,000 (vs. $20,000–$25,000 US); CyberKnife $5,000–$8,000 (vs. $18,000–$20,000 US); Gamma Knife from $3,000 (10× cheaper than US)
- Proton therapy not operationally available despite marketing claims, identified as meaningful gap for specific cancer types (pediatric tumors, skull base lesions)
Read the full Turkey report →
6 Israel IL 4.5/5 Good Israel demonstrates exceptional radiation therapy capabilities with state-of-the-art equipment across multiple JCI-accredited facilities, board-certified oncologists trained at leading international centers, comprehen... Full report
The evidence behind this score 8 cited points
- Sheba Medical Center ranked 7th globally by Newsweek 2026 across 11 specialties, demonstrating world-class quality infrastructure
- Ichilov operates Israel's only Elekta Unity MR-Linac for real-time MRI-guided adaptive radiation therapy, among few worldwide
- Hadassah published 2024 peer-reviewed outcomes showing 91.3% adaptive plan selection and 95.5% local control in head/neck cancer patients
- CyberKnife available at 13+ hospitals with 85–95% reported efficacy; Gamma Knife at multiple JCI-accredited centers (~95% tumor control)
- Six major hospitals hold JCI accreditation; multiple centers passed IAEA audits; ESMO-designated oncology center at Rambam
- Radiation therapy costs 40–70% below US/UK benchmarks ($12,500–$23,500 vs. $30,000+ in US)
- Radiation oncologists trained at MD Anderson, Memorial Sloan Kettering, and Institut Gustave Roussy with English-language proficiency universal
- Medical physics structural concern: no formal certification pathway; practitioners trained ad hoc rather than via standardized residency equivalent to ABR/IPEM
Read the full Israel report →
7 India IN 4.5/5 Good India's top-tier radiation oncology centers meet nearly all Score 5 criteria: proton therapy (JCI-accredited Apollo Proton with 2,500+ international patients treated), stereotactic radiosurgery (5+ Gamma Knife, 7 Cybe... Full report
The evidence behind this score 6 cited points
- Apollo Proton Cancer Centre is the only JCI-accredited proton cancer hospital in South Asia and Middle East; operates IBA Proteus PLUS with PBS across multiple treatment rooms; treated 2,500+ patients from 147 countries; manages 200+ international consultations monthly
- Multiple facilities operate state-of-the-art LINACs: TrueBeam STx at Rajiv Gandhi, Manipal, and Max; Tomotherapy Radixact at Rajiv Gandhi, Apollo Proton, HCG, and Medanta; MR-LINAC (Elekta Unity) at HCG Hebbal and Yashoda Hyderabad
- Stereotactic infrastructure: 5+ Gamma Knife centers (Fortis now has Gamma Knife Esprit as of June 2024); 7 CyberKnife centers including Apollo, BLK-Max, Medanta, Artemis; AIIMS New Delhi operating Gamma Knife since 1995
- Proton therapy costs $14,500–$29,000 versus $100,000–$200,000 in USA (60–90% savings); IMRT/VMAT $2,200–$5,500 versus $15,000–$50,000 in USA/UK
- 594 MD Radiation Oncology postgraduate seats across 87 NMC-approved institutions; senior oncologists hold FRCR (UK) or completed US/European fellowships; AERB-certified medical physicists mandated at all radiotherapy facilities
- Private sector median time from diagnosis to treatment start approximately 20 days; same-week palliative radiation available; DICOM-compatible treatment planning systems enable international coordination
Read the full India report →
8 United Arab Emirates AE 4.5/5 Good The UAE demonstrates exceptional radiation therapy capabilities across nearly all excellence criteria: multiple state-of-the-art facilities with MR-Linac, CyberKnife, and AI-assisted adaptive systems; board-certified ... Full report
The evidence behind this score 6 cited points
- State-of-the-art technology: 13+ linear accelerators, 1 CyberKnife, 1 MR-Linac (first in Middle East), 2 tomotherapy units, IMRT/VMAT/SBRT/SRS routinely available across 10 centers [Radiation Oncology in the UAE - Springer Nature - 2023]
- Expertise: Burjeel Medical City operates 8 radiation oncologists and 10 PhD medical physicists; ESMO and Novalis dual accreditation; Cleveland Clinic Abu Dhabi offers Varian Ethos (AI-adaptive radiation) [Burjeel Cancer Institute - ESMO - 2024]
- Quality standards: JCI accreditation at Cleveland Clinic Abu Dhabi and Burjeel; 0.2% treatment-interruption rate; 95% same-day CT-simulation to plan approval for urgent cases; DHA-IAEA coordination for radiation safety [Radiation Therapy in Abu Dhabi - Burjeel Medical City - 2024]
- Medical tourism: Dedicated international patient coordinators, 90-180 day medical visas (renewable), 24-hour consultation, multilingual staff, accommodation coordination [Medical Tourism Visa Dubai 2025 - Zami Tours - 2025]
- Cost savings: USD 22,000-36,790 for radiotherapy, representing 40-60% savings versus US/Western Europe equivalents [Cancer Treatment Abroad - Medical Tourism Co - 2024]
- Primary limitation: Proton therapy not yet operational; DHA-approved facility in partnership with National Cancer Centre Singapore targeted for completion late 2028 [Revolutionizing Cancer Care: Dubai's Proton Therapy Center 2028 - Nukta - 2026]
Read the full United Arab Emirates report →
9 Japan JP 4.5/5 Good Japan operates world-leading radiation therapy infrastructure with state-of-the-art particle therapy (HIMAC, 12+ proton centres, world's first ProBeam 360° rotating gantry), 24 CyberKnife systems, and near-universal S... Full report
The evidence behind this score 5 cited points
- World's largest concentration of carbon ion therapy: HIMAC operational since 1994 with 10,000+ patients treated; Gunma, Kanagawa (i-ROCK), HIBMC also operational [Heavy Ion Radiotherapy - QST Hospital - 2024]
- Advanced conventional radiotherapy: SBRT available at 87.8% of facilities, VMAT dominant at 78.3% of IMRT centres, 24 CyberKnife systems nationally [National Survey 2023–2024 - Nakajima et al. - Journal of Radiation Research - 2025]
- Multiple JCI-accredited hospitals with international patient departments: St. Luke's International, Saitama Medical University IMC, Fujita Health University; Medical Stay Visa available [JCI Accredited Organizations - 2024]
- Board certification and QA: JASTRO (4,000+ members) and JRS (7,500 members) certify radiation oncologists through rigorous two-stage process; JASTRO QA guidelines adapted from IEC standards [JASTRO Welcome - 2024; JRS About - 2024]
- Wait times: Consultations typically 2–4 weeks for non-urgent cases; treatment start 1–3 weeks (exceeds Score 5 <2 week and <1 week thresholds) [Japan Radiation Therapy Report - 2026]
Read the full Japan report →
10 Germany DE 4.5/5 Good Germany operates world-leading radiation therapy infrastructure including two of the world's fourteen carbon-ion therapy centers, three proton therapy facilities, and advanced MR-guided adaptive radiotherapy across mu... Full report
The evidence behind this score 5 cited points
- Dual carbon-ion therapy centers (HIT Heidelberg, MIT Marburg)—one of only four in Europe and unmatched dual capacity globally
- Three proton therapy centers (Essen WPE, Heidelberg HIT, Marburg MIT) with over 7,300 patients treated at HIT alone since 2009
- Advanced MR-Linac adaptive radiotherapy deployed across four major centers (Tübingen, Heidelberg, Munich, Düsseldorf)
- Mandatory biennial government inspections, DEGRO-enforced standards, and 2,000+ DKG-certified cancer centers providing comprehensive quality floor
- Costs €14,000–€87,000 for standard to proton therapy—matching or exceeding UK/US/French rates, not achieving cost advantage needed for higher score
Read the full Germany report →
11 South Korea KR 4.5/5 Good South Korea demonstrates world-class radiation therapy capabilities exceeding most Score 4 criteria. The country operates multiple JCI-accredited facilities with comprehensive advanced technologies (IMRT at 44.5%, VMA... Full report
The evidence behind this score 9 cited points
- IMRT utilization reached 44.5% by 2019 with annual increase of 33.5%, demonstrating rapid adoption of advanced techniques
- Multiple radiation therapy centers with international accreditation: Samsung Medical Center and Seoul National University Hospital hold JCI accreditation
- Heavy ion therapy leadership: Yonsei Cancer Center is 16th facility worldwide, treated 676 patients between April 2023-June 2025
- Stereotactic capabilities: Samsung Medical Center is only facility in Asia with two Gamma Knife ICON units; Asan Medical Center operates both Gamma Knife and CyberKnife systems
- Proton therapy availability: Three operational centers (National Cancer Center, Samsung Medical Center, Keimyung University) with sophisticated pencil beam scanning capabilities
- Advanced treatment planning: RayStation systems with adaptive therapy capabilities for IMRT, VMAT, proton, and carbon ion therapy
- Cost structure: Photon therapy $15,000-$30,000 USD, 3-5 times lower than USA/Europe; proton therapy costs as low as 1/5 of USA pricing
- Medical tourism infrastructure: Samsung Medical Center's International Healthcare Center (established 1995) dedicated to international patient care with translation and visa services
- Diagnostic efficiency: Asan Medical Center's computerized system reduces full diagnostic procedure timeline to maximum 3 days
Read the full South Korea report →
12 Malaysia MY 4.5/5 Good Malaysia demonstrates nearly all characteristics of a score 5 (excellent) facility, with multiple state-of-the-art centers offering advanced technologies (Gamma Knife ICON at five centers, TrueBeam, VMAT, SBRT, HDR br... Full report
The evidence behind this score 5 cited points
- Multiple facilities with state-of-the-art technology: SJMC (ExacTrac Dynamic sub-millimetre system 2025, JCI + 4 ACHS Centre of Excellence), Sunway Medical Centre (Gamma Knife ICON, TrueBeam STx, Radixact X9 TomoTherapy, JCI + ACHS + ESMO), Gleneagles KL (Gamma Knife ICON since 2014 with 600+ patients treated)
- Rapid access to treatment: International patients begin treatment within days of consultation rather than weeks, exceeding the score 5 requirement of <1 week for treatment start
- Excellent cost savings: USD 3,000–8,000 for radiation therapy, representing 50-70% savings vs US/UK benchmarks, meeting the score 5 cost criterion
- Proton therapy gap: No proton therapy facilities in Malaysia; IHH Healthcare offers proton only through Singapore subsidiary (Mount Elizabeth Novena), requiring patients to travel internationally
- Workforce limitations (184 oncologists vs 342 needed) and medical physicist shortages identified in 2025 survey, though mitigated at top-tier accredited hospitals serving international patients
Read the full Malaysia report →
13 United States US 4.0/5 Good The United States maintains world-class radiation therapy capabilities with 47 proton therapy centers, advanced technologies (IMRT/VMAT/stereotactic systems) widely deployed, rigorous board certification for radiation... Full report
The evidence behind this score 8 cited points
- 47 proton therapy centers operating — world's largest concentration [National Association for Proton Therapy - 2024]
- State-of-the-art equipment standard: VMAT, IGRT, SBRT capabilities across thousands of linear accelerators; CyberKnife and Gamma Knife widely deployed
- ABR certification requires written and oral exams for radiation oncologists and board-certified medical physicists; 60 CAMPEP accredited graduate programs and 121 medical physics residency programs
- ACR Radiation Oncology Practice Accreditation (ROPA) has accredited 600+ sites since 2006; ASTRO APEx provides additional quality benchmarking
- 58 NCI-Designated Comprehensive Cancer Centers with subspecialty expertise in pediatric radiation oncology, CNS radiosurgery, and rare tumor treatments
- Mean radiation therapy costs: $115,501 for proton therapy and $59,012 for IMRT — 50-70% higher than developed nations in South Korea, Germany, Singapore
- Median wait time to treatment initiation: 21-29 days (manages but exceeds 1-2 week target for medical tourists)
- Established medical tourism infrastructure at major centers (Johns Hopkins, Mayo Clinic, MD Anderson) with international patient coordinators and accommodation services, though cost-prohibitive for most medical tourists
Read the full United States report →
14 Colombia CO 4.0/5 Good Colombia has multiple facilities with modern radiation therapy technology including IMRT/VMAT systems, CyberKnife (2 centers), VERSA HD, Radixact X9, and TomoTherapy, supported by qualified board-certified radiation o... Full report
The evidence behind this score 5 cited points
- State-of-the-art equipment at flagship centers: Radixact X9 with Synchrony motion tracking (Fundación Santa Fe), VERSA HD enabling intracranial/extracranial SRS/SBRT (INC), CyberKnife at FOSCAL and CTIC, TomoTherapy at FOSCAL
- 101-124 board-certified radiation oncologists with participation in international bodies CARROS and ASTRO; documented subspecialty expertise at major centers including CNS radiosurgery, pediatric oncology, and multidisciplinary programs
- Four JCI-accredited hospitals with radiation oncology services: Fundación Valle del Lili, Fundación Santa Fe de Bogotá, Centro Médico Imbanaco, Hospital Pablo Tobón Uribe
- Comprehensive dedicated international patient services at major centers including coordinators, translation services, airport transfers, and accommodation support for extended fractionated treatments
- Cost savings of 50-80% below US/European equivalents (USD 2,000-15,000 at major private centers vs. USD 4,500-50,000 in US) with treatment initiation within weeks for international patients
Read the full Colombia report →
15 United Kingdom GB 4.0/5 Good The UK operates a technically excellent radiation therapy ecosystem with multiple state-of-the-art facilities (proton therapy, MR-Linac, Gamma Knife Icon, CyberKnife, SABR), world-leading expertise at centres like Roy... Full report
The evidence behind this score 3 cited points
- Two NHS proton beam therapy centres (Christie, UCLH) plus Proton International London private proton therapy; MR-Linac at Royal Marsden and GenesisCare Cromwell; Gamma Knife Icon at Wellington and Cromwell; multiple CyberKnife systems; SABR network with 300+ professionals across NHS England.
- Royal Marsden became first centre worldwide to deploy online adaptive replanning (March 2025); TORPEdO trial (world-first proton vs IMRT head-neck randomised trial) conducted at Christie; leading research roles in EORTC and international consortia.
- Private sector wait times: GenesisCare Cromwell and HCA UK facilities initiate treatment within 5-10 working days; Proton International London provides full international concierge services (visa, flights, accommodation, interpretation); NHS waiting target met for only 88% of patients (target 96%).
Read the full United Kingdom report →
16 Jordan JO 4.0/5 Good Jordan, anchored by King Hussein Cancer Center (KHCC), demonstrates solid modern radiation therapy capabilities with four facilities offering IMRT/VMAT and X-Knife stereotactic treatments, supported by internationally... Full report
The evidence behind this score 5 cited points
- KHCC operates six ultra-modern linear accelerators with X-ray tracking/IGRT, X-Knife stereotactic SRS/SBRT, HDR brachytherapy, and a new 2,700 m² Radiation Oncology building (July 2024) expanding monthly capacity from 260 to 400 patients; holds JCI Disease-Specific Oncology Certification (first cancer center outside US awarded this designation) and IAEA Collaborating Centre and Rays of Hope Anchor Centre designations
- Available treatment modalities include 3D-CRT, IGRT, IMRT, VMAT, X-Knife SRS/SBRT, HDR and LDR brachytherapy, total body irradiation, and total skin electron irradiation across 12 LINACs distributed across four facilities
- KHCC employs 17 radiation oncologists with mandatory US/UK externship training and ACR examination participation; IAEA-supported medical physics residency (first in Arab world) provides certified physics support; residents ranked top in North American fellowship programs on 2019 ASCO examination
- No proton therapy exists in Jordan or neighboring countries per 2025 feasibility study; no confirmed CyberKnife or Gamma Knife systems in operation; all four radiotherapy centers concentrated in Amman limiting regional access
- Costs approximately 40-50% below Western rates for 3D-CRT and IMRT, but regional benchmarking shows IMRT pricing at ~$16,000 in Amman versus ~$5,000 in Istanbul, indicating variable competitive advantage compared to alternative destinations
Read the full Jordan report →
17 Mexico MX 4.0/5 Good Mexico provides good-quality radiation therapy services at select JCI-accredited centers in major cities, with modern linear accelerators capable of IMRT/VMAT/SBRT, some stereotactic capabilities (Gamma Knife at 2 cen... Full report
The evidence behind this score 8 cited points
- Modern linear accelerators with IMRT/VMAT/SBRT capabilities available at major centers including Hospital Angeles, Christus Muguerza, Zambrano Hellion TecSalud, and Instituto Nacional de Cancerologia
- Stereotactic radiosurgery options available but limited: 2 Gamma Knife centers (Mexico City, Guadalajara) and 3 CyberKnife systems (Monterrey, Mexico City), plus 7 helical Tomotherapy systems
- JCI accreditation at select facilities including Galenia Hospital (Cancún), Hospital Angeles, and other major hospital groups ensuring international quality standards
- Rapid treatment initiation with international patients able to begin treatment within days of consultation, significantly faster than US wait times
- Radiation therapy costs $5,000-$10,000 for full treatment course, representing 40-60% savings compared to US prices
- Well-developed medical tourism infrastructure with dedicated international patient coordinators, bilingual support, and logistical assistance, particularly at border facilities like Angeles Hospital Tijuana
- 346 active certified radiation oncologists with international training; many specialists at major centers board-certified or trained at US/European institutions
- Significant limitations: no operational proton therapy facilities, equipment density critically low at 1.19 linear accelerators per million inhabitants, only 250 medical physicists with only 36% holding internationally-recommended master's degrees, and no national certification program for medical physicists
Read the full Mexico report →
18 Poland PL 4.0/5 Good Poland operates three world-class flagship radiation therapy centers (NIO Gliwice, NIO Warsaw, WCO Poznań) equipped with state-of-the-art linacs, stereotactic systems (CyberKnife at three sites), proton therapy, and a... Full report
The evidence behind this score 7 cited points
- NIO Gliwice operates 11 linacs (7 TrueBeam with IGRT/SGRT, 1 CyberKnife M6, 1 Radixact, 1 Ethos online adaptive, 1 Edge) treating 7,035 patients in 2024; designated Varian European Reference Center for Education in Radiotherapy
- Three CyberKnife centers nationally with pricing €9,000–€16,000 versus $80,000+ in the US; IMRT/VMAT courses $5,500–$14,000 (40–70% below UK/US benchmarks)
- Proton therapy available at CCB Kraków (Proteus C-235, 1,500+ patients since 2016) with pencil-beam scanning; expansion to WCO Poznań by end 2026
- Advanced techniques including online adaptive radiotherapy (Ethos, 2024), respiratory gating, 4D CT planning, cone-beam CT verification; brachytherapy programs (HDR/LDR) and hyperthermia at major centers
- Dedicated international patient coordination at private facilities (Institute of Cybernetic Surgery Wieliszew entirely oriented to international patients; European Health Centre Otwock employs 2 international coordinators)
- Comprehensive dosimetry QA at WCO with PTW BEAMSCAN, OCTAVIUS systems; IAEA Secondary Standard Dosimetry Laboratory performs calibrations across all centers; ESMO Designated Centre and ESGO accreditations at NIO
- Public radiotherapy wait times average 12.7 weeks from suspicion to treatment start (far exceeding Score 5 requirement of <2 weeks consultation, <1 week treatment start); private-sector and international patients access substantially faster through dedicated medical tourism infrastructure
Read the full Poland report →
19 Hungary HU 3.5/5 Moderate Hungary operates multiple modern radiation therapy centers with state-of-the-art technology, including IMRT/VMAT, CyberKnife SBRT, and AI-guided adaptive radiotherapy (Ethos system at NIO). Board-certified radiation o... Full report
The evidence behind this score 5 cited points
- NIO Budapest operates Varian TrueBeam, two VitalBeams, Varian Unique, and Ethos AI-adaptive system; Debrecen has Elekta Versa HD-RS systems plus CyberKnife; Pécs has NOVALIS TX stereotactic unit
- 84 radiation oncologists and 66 certified medical physicists across 13 centers; NIO's Prof. Polgár leads GEC-ESTRO brachytherapy trials with international standing
- Debrecen CyberKnife program reports 400+ lung cancer cases with 92% 2-year and 85% 5-year local control; NIO Ethos adaptive system reduced irradiated healthy tissue by 43.9% in bladder cancer
- Public sector wait times average 30 days (exceeds Score 4 range of 2-4 weeks); private clinics average 8 days. OECI Comprehensive Cancer Center accreditation at NIO but no JCI/ACR radiation oncology-specific certification
- IMRT pricing $6,000–9,000 (90% below US at $59,000) and 35-60% below Germany/Spain; no proton therapy within Hungary but accessible at MedAustron Austria via cross-border cooperation
Read the full Hungary report →

See the full ranking, the 1–5 rubric and the reports →