1st MESTRO Congress — Riyadh, Saudi Arabia, December 2–3, 2022

The inaugural Congress of the Middle East Society for Therapeutic Radiation Oncology (MESTRO) was held on December 2–3, 2022 at Alfaisal University, Riyadh, Saudi Arabia. The founding congress marked the establishment of a dedicated regional society for therapeutic radiation oncology — a milestone for the specialty across the Middle East. The congress theme was "Adaptive Radiotherapy and Hypofractionation — What are the Accuracy and Precision Needs?" The theme reflected two of the most consequential developments in radiation oncology practice: the shift towards shorter, higher-dose-per-fraction treatment courses, and the integration of real-time imaging and plan adaptation into the treatment workflow. Both advances demand higher levels of geometric accuracy and dosimetric precision, and the congress programme was designed to address those requirements directly. Prof. Saad Alrashidi, President of MESTRO and Conference Chairman, delivered a keynote address on adaptive radiotherapy and hypofractionation, drawing on his experience as a brachytherapy sub-specialist and radiation oncology consultant at King Fahad Medical City (KFMC), Riyadh. In a pre-congress interview with the Global Coalition for Radiotherapy, Prof. Alrashidi described MESTRO's mission: to foster collaboration between radiation oncologists, medical physicists, dosimetrists, therapists, clinical engineers, allied oncology specialties, and nurses from Turkey to Oman, Saudi Arabia to Pakistan, and beyond. The scientific programme featured presentations across the full breadth of radiation oncology practice. Dr. Nadeem Pervez presented on the management of ductal carcinoma in situ (DCIS), addressing the evolving evidence on radiotherapy indications and dose fractionation in early breast cancer. Dr. Ahmed AlShehri presented on the management of advanced-stage laryngeal cancer with a focus on systemic therapy integration. Dr. Mostafa Elhaddad addressed radiotherapy techniques for advanced larynx cancers, covering the evidence base for organ preservation approaches and the technical requirements for high-quality treatment delivery. Dr. Monther Qandeel, representing Jordan, presented on imaging and staging in head and neck oncology. Dr. Mir Khan addressed surgical margins and boost radiotherapy in breast cancer management. The 1st Congress was held in partnership with the Global Coalition for Radiotherapy (GCR), reflecting MESTRO's commitment to connecting the Middle East radiation oncology community with the broader international network of radiotherapy professionals and advocates. MESTRO thanks all delegates, faculty, sponsors, and the local organising committee at Alfaisal University for making the inaugural congress a success. The society looks forward to welcoming the radiation oncology community back to Riyadh for the 5th Congress on December 4–5, 2026.