According to the European Organisation for Research and Treatment of Cancer and the European Society for Radiotherapy and Oncology, radiation oncology research continues to represent a small fraction of the global oncology portfolio despite radiotherapy remaining a cornerstone of cancer care. To bridge this evidence gap, the E2-RADIatE infrastructure platform has spent five years collecting prospective real-world data across Europe, establishing cohorts like OligoCare and ReCare to evaluate advanced treatment practices in routine clinical settings.
How the E2-RADIatE Platform Gathers Real-World Radiotherapy Evidence
Launched in 2019, the EORTC-ESTRO Radiotherapy Infrastructure for Europe (E2-RADIatE) was built as a pragmatic, observational, prospective multi-cohort platform. According to project organizers, generating evidence for radiotherapy innovations is notoriously difficult through randomized controlled trials alone due to high upfront hospital costs, long-term endpoints, and operator-dependent technologies. E2-RADIatE utilizes a centralized database to capture clinical outcomes, planning data, imaging, economic metrics, and patient-reported outcomes across multiple European centers.
OligoCare Cohort Enrollment and Early Safety Data
OligoCare serves as the first and most mature cohort within E2-RADIatE, evaluating radical metastasis-directed radiotherapy for oligometastatic breast, non-small cell lung, prostate, and colorectal cancers. Data shows that by November 2025, OligoCare had enrolled 3,768 patients across 67 centers in 13 European countries. An early analysis of the first 1,004 patients indicated that prostate cancer was the primary tumor most frequently treated with stereotactic body radiotherapy (SBRT), with non-vertebral bone, lung, and distant lymph nodes as the top treatment sites.
Did you know? Early safety analyses from the OligoCare cohort reported fatal events in just 0.1% of patients undergoing metastasis-directed SBRT, with overall patient quality of life remaining largely stable during the first six months post-treatment.
ReCare Addresses the Clinical Gap in High-Dose Re-Irradiation
Launched in 2023, the ReCare cohort tackles high-dose re-irradiation, an increasingly common clinical scenario with historically limited prospective evidence. According to the initiative’s data, ReCare had enrolled 653 patients from 19 centers across 9 countries by November 2025. A first interim analysis of 290 patients revealed that over 80% of re-irradiations involved an overlap between the first and second radiotherapy volumes, with curative treatment intent documented in more than two-thirds of cases.
Translating Registry Data Into SPRINT and ALPHA-Care Trials
E2-RADIatE extends beyond observational reporting by actively generating new trial hypotheses from routine practice data. For example, because OligoCare revealed that over 90% of European SBRT treatments use multiple fractions, researchers launched SPRINT. Utilizing a Trial Within Cohorts (TwiCs) design, SPRINT directly compares single-fraction SBRT against multi-fraction delivery. Additionally, the planned ALPHA-Care cohort will address the safety of combining SBRT with newly approved systemic therapies.
Frequently Asked Questions
What is the primary goal of the E2-RADIatE platform?
According to the EORTC and ESTRO, the platform collects prospective real-world data to evaluate radiotherapy treatments, patient outcomes, and resource use across Europe to support evidence generation in radiation oncology.
How many patients have enrolled in OligoCare?
By November 2025, OligoCare had enrolled 3,768 patients across 67 centers in 13 European countries, according to project data.
What does the ReCare cohort study?
ReCare focuses on high-dose re-irradiation, collecting data on tumor control, toxicity, imaging, and quality-of-life outcomes to address persistent evidence gaps in retreatment safety.
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