The 5Rs dilemma of radiotherapy for non-malignant diseases: 5Rs to darken OR 5Rs to shine

Many benign diseases, so called because they are not a direct cause of death, nevertheless cause significant damage to the health of patients due to the associated pain, reduced functionality, increased disability and the negative impact they have on quality of life, which, together with the limited efficacy of many of the available treatments, make their management a challenge for every specialist. Radiotherapy, which has demonstrated its efficacy not only against cancer but also in many non-tumorous diseases, appears as a therapeutic option that deserves to be taken into account. However, there is still much resistance to considering the use of radiotherapy as a valid and acceptable alternative. The 5Rs to darken summarize the doubts and contradictions many specialists face to accept radiotherapy in non-neoplastic diseases. However, other 5Rs (to shine) can be argued to claim for the safety, reliability, and usefulness of radiation treatment for benign disease and as radiotherapy specialists we have to help the evidence shine and the darkness disappear.