Spain Radiotherapy Market Overview, 2031

Key Insights

• The Spanish radiotherapy market operates within the Sistema Nacional de Salud, a publicly funded healthcare system that ensures universal access to radiation oncology services. Cancer remains a leading cause of mortality in Spain, with radiotherapy playing a central role in curative and palliative treatment for approximately 50% of all cancer patients.
• External Beam Radiotherapy (EBRT) constitutes the largest therapy segment, supported by an extensive installed base of linear accelerators distributed across Spain's autonomous communities. Major equipment suppliers including Elekta, Varian Medical Systems, and Accuray maintain strong market positions through public procurement contracts.
• Radiotherapy systems and equipment represent the largest offering segment, with the market characterised by significant public investment through regional health authorities. The Castilla y León region operates 15 linear accelerators across its public hospitals, with recent investments including a €3.27 million accelerator for Palencia and a €1.41 million maintenance contract for the León accelerator.
• Hospitals and integrated cancer centres are the largest end-user segment, operating within the public health system. The market is experiencing substantial transformation through the national proton therapy deployment programme, with ten proton therapy units being installed across seven autonomous communities through a collaboration between the Ministry of Health, regional governments, and the Amancio Ortega Foundation, representing a €280 million investment.
• Regulatory oversight is provided through the Ministry of Health and regional health authorities, with public procurement conducted through open tender procedures. Recent procurement activity includes the Hospital Provincial de Castellón's €238,000 tender for an SGRT-guided radiotherapy system, and the Generalitat de Catalunya's €4.63 million tender for twin linear accelerators.

Market Outlook

• According to the research report, "Spain Radiotherapy Market Overview, 2031," published by Bonafide Research, the Spain Radiotherapy market was valued at more than USD 200 Million in 2025. This valuation reflects the scale of Spain's publicly funded radiation oncology infrastructure, with equipment procurement and maintenance funded through regional health budgets and central government investment programmes.
• The market is expected to benefit from significant infrastructure investment. The National Proton Therapy Plan, formalised through a collaboration agreement between the Ministry of Health, seven autonomous communities, and the Amancio Ortega Foundation, provides for the deployment of ten proton therapy units across Spain. The foundation is contributing €280 million for equipment acquisition, while regional governments assume responsibility for installation, management, and maintenance. The programme has been extended through to 2029 to accommodate the complex installation and commissioning process.
• Technology adoption is accelerating across Spanish radiotherapy centres. In Catalonia, twelve radiotherapy oncology services have been equipped with modern high-energy linear accelerators through the INVEAT Plan, which foresees a total investment exceeding €94 million in the renovation and expansion of high-tech equipment, including magnetic resonance, digital brachytherapy, and tomography systems.
• The market is also characterised by significant autonomous community investment. Castilla y León has expanded its radiotherapy network with the construction of satellite radiotherapy units, including Ávila (operational since 2023), Soria (operational since July 2025), and planned units in El Bierzo and Segovia, alongside the new Palencia accelerator. The region's most recent accelerator purchase was valued at €3.27 million, with a €1.41 million maintenance contract approved for the León facility.
• Long-term growth is supported by demographic trends and sustained public investment. The National Health System's commitment to modernising radiotherapy infrastructure, combined with the proton therapy deployment programme, positions Spain as a significant and growing radiotherapy market through 2031.

Market Dynamics

Driver: Sustained Public Investment and National Proton Therapy Deployment
The primary driver of the Spanish radiotherapy market is sustained public investment through regional health authorities and the national proton therapy deployment programme. The collaboration between the Ministry of Health, seven autonomous communities (País Vasco, Cataluña, Galicia, Andalucía, Comunidad Valenciana, Canarias, and Madrid), and the Amancio Ortega Foundation represents one of the most significant radiotherapy infrastructure investments in Spanish history. The foundation is donating €280 million for ten proton therapy units, with the Ministry of Health coordinating procurement through a contract with Ion Beam Applications S.A. valued at €271 million. Regional governments are responsible for facility construction, installation, and ongoing maintenance. The deployment schedule envisions the first unit operational in Galicia by late 2026 or early 2027, with subsequent units in Madrid (two units), Barcelona (two units), Valencia, Cantabria, Andalusia (two units), the Basque Country, and the Canary Islands through 2029. This sustained investment cycle ensures consistent demand for equipment, installation services, training, and comprehensive maintenance contracts.

Challenge: Regional Disparities and Infrastructure Constraints
A significant challenge facing the Spanish radiotherapy market is the regional disparity in equipment availability and access to care. While the proton therapy programme aims to ensure equitable access across participating regions, the distribution of linear accelerators varies substantially. Castilla y León, for example, operates 15 accelerators across its hospital network, with recent investments in Ávila (2023), Soria (2025), and Palencia. However, not all regions have equivalent coverage, and the complexity of proton therapy installation requiring bunker construction, shielding, and regulatory approval from the Consejo de Seguridad Nuclear has caused delays. The Ukraine war has increased raw material and component costs, while administrative procedures have extended the timeline for some installations. The Ministry of Health has had to reallocate budget annualities multiple times to accommodate the revised deployment schedule, reflecting the complexity of coordinating infrastructure investment across multiple autonomous communities.



Trend: Proton Therapy Deployment and Advanced Technology Adoption
A major trend shaping the Spanish radiotherapy market is the national deployment of proton therapy and the adoption of advanced treatment technologies. Proton therapy represents a significant advancement in precision radiotherapy, reducing damage to healthy tissues and offering particular benefits for paediatric tumours and cancers in difficult-to-access locations. The deployment plan includes ten units across seven autonomous communities: two in Madrid (Hospital de Fuenlabrada and Hospital La Paz), two in Barcelona (Parc Sanitari Pere Virgili), one in Galicia (Complejo Hospitalario Universitario de Santiago), one in Valencia (Hospital La Fe), one in Cantabria (Hospital de Valdecilla), two in Andalusia (Hospital Virgen del Rocío in Seville and Hospital Materno Infantil in Málaga), one in the Basque Country (Hospital Universitario Donostia), and one in the Canary Islands (Hospital Dr. Negrín). The first unit, in Galicia, is expected to treat patients by late 2026, with capacity estimated at 250 patients annually. This deployment is accompanied by workforce training programmes, including the "Proton Therapy Academy" launched by the Valencia La Fe Hospital to train approximately 100 professionals for its unit. The trend toward advanced technology adoption is also reflected in the INVEAT Plan in Catalonia, which has equipped twelve radiotherapy services with modern linear accelerators enabling nearly 450 treatments per accelerator annually.

Policies

• The Ministry of Health coordinates the National Proton Therapy Plan through a collaboration agreement with seven autonomous communities and the Amancio Ortega Foundation. The agreement, initially signed in 2021 and extended through 2029, provides for the acquisition of ten proton therapy units valued at €280 million, funded by the foundation, with regional governments responsible for installation, management, and maintenance.
• The Ministry of Health has entered into a contract with Ion Beam Applications S.A. for the supply of proton therapy equipment, with a budget base of €271 million (IVA included). The contract has required multiple budgetary reallocations to accommodate the revised installation timeline.
• The INVEAT Plan, implemented in Catalonia, foresees a total investment exceeding €94 million in the renovation and expansion of high-tech equipment, including magnetic resonance, digital brachytherapy, tomography, and vascular angiographs, with twelve radiotherapy oncology services equipped with modern linear accelerators.
• Regional health authorities conduct public procurement for radiotherapy equipment through open tender procedures. Recent examples include the Castilla y León region's €3.27 million tender for the Palencia linear accelerator, the €1.41 million maintenance contract for the León accelerator, and the Generalitat de Catalunya's €4.63 million tender for two twin linear accelerators for ICO Badalona.
• The Hospital Provincial de Castellón has tendered a €238,000 contract for an SGRT-guided radiotherapy system for a linear accelerator, reflecting the adoption of surface-guided radiotherapy technology.
• The Consejo de Seguridad Nuclear provides regulatory oversight for radiotherapy facilities, including proton therapy bunkers, requiring testing and accreditation before units become operational. The testing process for proton therapy units is expected to take approximately nine months from installation completion.
• The National Health System's framework agreements for radiotherapy equipment include requirements for comprehensive maintenance, both preventive and corrective, as well as environmental criteria including energy efficiency standards and sustainability certifications.

Segment Analysis

Spain Radiotherapy Market By Therapy Type
• External Beam Radiotherapy (EBRT): This is the largest therapy segment, reflecting the widespread installed base of linear accelerators across Spain's autonomous communities. Castilla y León operates 15 linear accelerators across its hospital network, with recent expansions including Ávila (operational 2023), Soria (operational 2025), and Palencia (under installation). The segment is driven by the clinical dominance of IMRT, VMAT, IGRT, and SBRT techniques. Modern accelerators enable advanced radiotherapy treatments with high precision, destroying tumours without affecting healthy tissue, with capacity to administer approximately 450 treatments per accelerator annually.
• Internal / Brachytherapy: This segment remains clinically essential, particularly for prostate, gynaecological, breast, and head and neck cancers. The INVEAT Plan in Catalonia includes digital brachytherapy equipment as part of its €94 million investment programme. Brachytherapy services are concentrated in specialised centres with dedicated physics support.
• Systemic Radiotherapy: This is the fastest-growing therapy segment, driven by the emergence of novel radiopharmaceuticals and targeted radionuclide therapies. The segment benefits from Spanish academic research institutions and clinical trial infrastructure. The proton therapy deployment programme includes research and clinical investigation components, with the Ministry of Health emphasising the importance of "agilising clinical investigation with this type of treatment."

Spain Radiotherapy Market By Offering
• Radiotherapy Systems/Equipment: This segment holds the largest market share by revenue, driven by the high capital cost of linear accelerators and significant public investment. Major equipment suppliers active in the Spanish market include Elekta, Varian Medical Systems, and Accuray. Recent procurement includes the Castilla y León region's €3.27 million purchase of a linear accelerator for Palencia, and the Generalitat de Catalunya's €4.63 million tender for twin linear accelerators. The proton therapy procurement, valued at €271 million for ten units, represents the largest single radiotherapy equipment investment in Spanish history.
• Software & Services: This is the fastest-growing segment, reflecting increasing digitalisation of radiation oncology. The software component includes advanced treatment planning systems, SGRT systems, and AI-powered tools. The Hospital Provincial de Castellón's €238,000 tender for an SGRT system demonstrates demand for advanced guidance technologies. The services component encompasses installation, comprehensive maintenance, clinical training, and physics support. The Castilla y León region approved a €1.41 million maintenance contract for the León linear accelerator, reflecting the significant ongoing service expenditure required for radiotherapy equipment. Framework agreements increasingly require comprehensive maintenance, including both preventive and corrective services, as well as guarantees of operational availability.

Spain Radiotherapy Market By Application
• Breast Cancer: This is a major application segment, with breast cancer ranking among the most frequent malignancies in Spain. Radiotherapy plays a central role in breast-conserving therapy and post-mastectomy treatment. Hypofractionation protocols are widely adopted to optimise treatment efficiency and patient convenience.
• Prostate Cancer: A significant application area, with widespread use of EBRT, SBRT, and brachytherapy. Spanish radiation oncology departments offer advanced prostate cancer treatment with image guidance. Proton therapy is particularly beneficial for prostate cancer due to reduced dose to surrounding organs.
• Lung Cancer: This segment is growing, with increased adoption of SBRT for early-stage and oligometastatic disease. Proton therapy is being deployed for lung cancer treatment, with the Galicia unit expected to treat patients from Castilla y León, Asturias, and northern Portugal.
• Head & Neck Cancer: This is a critical application due to anatomical complexity, requiring highly conformal radiation delivery. Proton therapy offers particular advantages for head and neck cancers, reducing dose to salivary glands and other sensitive structures.
• Central Nervous System / Brain: This is a significant application, with stereotactic radiosurgery for brain metastases and primary CNS tumours. Proton therapy is particularly important for paediatric brain tumours and gliomas, and paediatric cancers are a specific priority for the proton therapy deployment programme.
• Gastro-intestinal: Applications include oesophageal, rectal, liver, and pancreatic cancers. The proton therapy units will serve gastrointestinal cancer patients requiring precision radiotherapy.
• Other Applications: Includes paediatric cancers, which are a specific priority for the proton therapy programme, as well as gynaecological, haematological, and palliative care indications.

Spain Radiotherapy Market By End User
• Hospitals & Integrated Cancer Centres: This is the largest end-user segment, operating within the public hospital system. Major centres hosting new proton therapy units include the Hospital de Fuenlabrada and Hospital La Paz (Madrid), Parc Sanitari Pere Virgili (Barcelona), Complejo Hospitalario Universitario de Santiago (Galicia), Hospital La Fe (Valencia), Hospital de Valdecilla (Cantabria), Hospital Virgen del Rocío (Seville), Hospital Materno Infantil (Málaga), Hospital Universitario Donostia (Basque Country), and Hospital Dr. Negrín (Canary Islands). These institutions manage the most complex equipment fleets and are the primary beneficiaries of national and regional investment programmes.
• Standalone Radiotherapy Centres: This segment includes accredited private hospitals and community-based radiotherapy centres. The INVEAT Plan's distribution of modern accelerators throughout Catalan territory includes both public and accredited private facilities to guarantee accessibility and territorial balance.
• Academic/Research Institutions: This is the fastest-growing segment, reflecting their central role in advancing the field through clinical trials and technology validation. The proton therapy deployment includes a clinical research component, with the Ministry of Health highlighting the importance of "agilising clinical investigation" with proton therapy. The Valencia La Fe Hospital has launched the "Proton Therapy Academy," a high-level training programme to instruct approximately 100 professionals who will staff its unit.
• Other Healthcare Facilities: Includes community hospitals and satellite radiotherapy units. Castilla y León has invested in satellite radiotherapy units in Ávila (operational 2023), Soria (operational 2025), and planned for El Bierzo and Segovia, reflecting the strategy of decentralising radiotherapy services to improve regional access.

Spain Radiotherapy Market Economics

• Equipment procurement in Spain is predominantly conducted through public tenders by regional health authorities and central government. The proton therapy procurement, coordinated by the Ministry of Health, is valued at €271 million for ten units, with the Amancio Ortega Foundation funding €280 million of equipment costs.
• Linear accelerator costs vary by specification and configuration. Recent Castilla y León tenders indicate accelerator purchases in the €2.5-3.3 million range. The Generalitat de Catalunya's tender for twin accelerators at ICO Badalona is valued at €4.63 million. SGRT systems are tendered separately at approximately €238,000.
• Service contract pricing reflects the critical clinical role of equipment uptime. The Castilla y León region approved a €1.41 million maintenance contract for the León linear accelerator, representing a significant ongoing operational expenditure. Framework agreements increasingly require comprehensive maintenance including preventive and corrective services, as well as operational availability guarantees.
• The economic impact of the proton therapy programme is substantial. The deployment of ten units represents an investment of over €550 million including equipment, facilities, and installation. Facility construction costs are significant, with the Cantabria Valdecilla bunker requiring deep excavation, and the Catalan centre involving an 8,000 m² building. The Ukraine war has increased raw material and component costs, contributing to budget reallocations.
• Equipment downtime directly affects patient access, treatment schedules, and clinical outcomes. The INVEAT Plan's distribution of modern accelerators throughout Catalan territory ensures territorial balance and accessibility in oncology care.
• The cost of cybersecurity maintenance is an emerging economic factor, with framework agreements increasingly including requirements for software patch management and vulnerability remediation across connected radiotherapy device fleets.

Market Outlook by Infrastructure, Investment and Industry Development

• The National Proton Therapy Plan represents the most significant radiotherapy infrastructure investment in Spanish history. The deployment of ten units across seven autonomous communities, funded by the Amancio Ortega Foundation with €280 million for equipment acquisition, will place Spain "at the same level as Germany" in proton therapy availability. The first unit, in Galicia, is expected to treat patients by late 2026, with all units operational by 2029.
• The INVEAT Plan in Catalonia, with investment exceeding €94 million, has equipped twelve radiotherapy oncology services with modern high-energy linear accelerators, enabling advanced precision treatments with capacity for nearly 450 treatments per accelerator annually.
• Regional health authorities continue to invest in radiotherapy infrastructure. Castilla y León has expanded its network to 15 accelerators, with satellite units in Ávila (2023), Soria (2025), and Palencia (under installation), and planned units for El Bierzo and Segovia. The region's recent investments include €3.27 million for the Palencia accelerator and €1.41 million for the León maintenance contract.
• Workforce development is a critical priority for the proton therapy programme. The Valencia La Fe Hospital has launched the "Proton Therapy Academy," a high-level training programme to prepare approximately 100 professionals who will staff the unit. The Basque Country unit at Hospital Universitario Donostia, which completed its bunker in April 2026, is preparing for equipment installation in July 2026.
• Digital transformation is enabling remote diagnostics, predictive maintenance, and real-time performance monitoring of radiotherapy equipment. The adoption of SGRT systems, as demonstrated by the Castellón tender, reflects the shift toward surface-guided radiotherapy and precision treatment delivery. Framework agreements increasingly incorporate environmental criteria including energy efficiency standards and sustainability certifications.
• The Ministry of Health continues to coordinate the proton therapy programme through budget reallocations and schedule adjustments. The contract with Ion Beam Applications S.A. for €271 million has required multiple annuality modifications to accommodate construction delays caused by the Ukraine war and administrative procedures.
• The long-term outlook remains positive as cancer incidence continues to rise, technology innovation accelerates, and public investment through the National Proton Therapy Plan and regional health programmes sustains equipment modernisation across Spain's public healthcare system.



Considered in this report
• Historic Year: 2020
• Base year: 2025
• Estimated year: 2026
• Forecast year: 2031

Aspects covered in this report
• Radiotherapy Market with its value and forecast along with its segments
• Various drivers and challenges
• On-going trends and developments
• Top profiled companies
• Strategic recommendation

By Therapy Type
• External Beam Radiotherapy (EBRT)
• Internal / Brachytherapy
• Systemic Radiotherapy

By Offering
• Radiotherapy Systems/Equipment
• Software & Services

By Application
• Breast Cancer
• Prostate Cancer
• Lung Cancer
• Head & Neck Cancer
• Central Nervous System / Brain
• Gastro-intestinal
• Other Applications

By End User

• Hospitals & Integrated Cancer Centers
• Standalone Radiotherapy Centers
• Academic/Research Institutions
• Other Healthcare Facilities