Swedish medical technology company Elekta has placed its first Evo adaptive radiotherapy system in India, expanding the company’s presence in the country’s growing radiation oncology market.
The system has been installed at Manipal Hospital in Yelahanka, Bangalore, and is being used to treat patients with rectal, cervical and prostate cancers. (Incidentally, my first professional job as a mechanical engineer was at the Yelahanka factory of Larsen & Toubro, known as the “beer bottle building” since the architect had coated the upper half of the outside walls with large beer bottle split in half!)
The installation follows Elekta’s introduction of the Evo platform to the Indian radiation oncology community at the AROICON conference in Kolkata in 2025.
Headquartered in Stockholm, Elekta employs 4,500 people globally and specializes in equipment and software used to treat cancer and neurological conditions with radiation. The company operates in more than 40 countries. Elekta Evo combines a linear accelerator, which delivers radiation, with CT imaging and software designed to support adaptive radiotherapy. The technology allows clinicians to obtain images immediately before treatment and modify a patient’s radiation plan when appropriate.
That capability addresses a practical challenge in radiation oncology: a patient’s anatomy does not necessarily remain the same throughout a multi-week course of treatment. Tumors can change in size, patients can gain or lose weight, and the position of internal organs can vary from one treatment session to another.
Adaptive radiotherapy allows clinicians to account for some of those changes rather than relying exclusively on a treatment plan developed before therapy began.
Elekta’s Evo system incorporates its Iris AI-enhanced imaging technology and Elekta ONE Online software. Artificial intelligence can assist with tasks such as identifying and outlining anatomical structures on medical images, while the software supports treatment planning and dose calculations needed to adapt a radiation plan.
Manipal Hospital has already treated its first locally advanced rectal cancer patient using online adaptive radiotherapy with the new system. The hospital says it has subsequently been using the technology with cervical, rectal and prostate cancer patients and has observed good treatment tolerance and relatively limited side effects so far. These are early clinical observations, however, rather than results from a controlled study demonstrating improved outcomes.
The installation is noteworthy for Elekta because India represents a substantial and expanding market for cancer treatment technology. The country records an estimated 1.46 million new cancer cases annually, according to figures cited by the company from the Indian Council of Medical Research.
Introducing sophisticated radiation therapy systems into India also involves more than selling capital equipment. Manufacturers typically need to provide installation, clinician training, software support and ongoing technical service, while working with hospitals to integrate new technology into existing treatment workflows.
Elekta Evo has received registration from India’s Central Drugs Standard Control Organization (CDSCO), although the company notes that availability remains limited. installation therefore represents an early step in Elekta’s rollout of the platform in India rather than widespread adoption of the technology. Feras Al Hasan, Elekta’s regional head for Turkey, India, the Middle East and Africa (“TIMEA”), said the company intends to broaden access to adaptive radiation therapy in the country.
In my humble opinion it is shortsighted to try and grow a market of the size and complexity of India from Istanbul or Dubai. Today’s India demands in-country distribution or in-country staff.
For Elekta, India offers both scale and a healthcare system that is increasingly investing in sophisticated cancer treatment equipment. The first Evo installation provides the company with an operating reference site in India and gives Indian radiation oncologists an opportunity to gain clinical experience with a technology that is already part of Elekta’s broader international product portfolio.
