Medical College of Wisconsin
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Adaptive Radiation Therapy Physician Guidelines: Recommendations From an Expert Users' Panel. Pract Radiat Oncol 2022;12(5):e355-e362

Date

06/02/2022

Pubmed ID

35644469

DOI

10.1016/j.prro.2022.05.007

Scopus ID

2-s2.0-85133890110 (requires institutional sign-in at Scopus site)   21 Citations

Abstract

PURPOSE: Online adaptive radiation therapy (ART) allows real-time plan generation and delivery to account for daily anatomic changes. Owing to the time-intensive nature of this process, physicians frequently cover adaptive treatments for patients whose original treatment plan was prescribed by another provider. There is currently no published guidance on the contents of physician sign-outs, or adaptive guidelines, to ensure the safe and consistent delivery of adaptive treatments.

METHODS AND MATERIALS: A group of radiation oncologists, each with at least 3 years of experience prescribing and covering online adaptive radiation treatments, formed a working group to identify the critical components of adaptive guidelines. The members of the working group collectively were experienced with the 3 commercially available real-time ART platforms. Key components of the adaptive guidelines necessary to preserve the prescribed treatment intent were identified.

RESULTS: Eleven radiation oncologists from 9 cancer centers, with a range of 3 to 6 years ART experience, formed the adaptive guidelines working group. Three categories of information that are essential for safely delivering an online ART approach were identified: recontouring instructions (including anatomic considerations for specific cases), defining replanning rules, and establishing motion management guidelines.

CONCLUSIONS: When physician coverage is needed for ART, clear communication is critical for treatment to be delivered according to the original intent of the prescription. The proposed ART recommendations that include physician sign-out for this highly technical treatment process can be especially beneficial in improving communication across potentially multiple transitions of care.

Author List

Kim H, Lee P, Tree AC, Chuong MD, Raldow AC, Kishan AU, Fuller CD, Rosenberg SA, Hall WA, Chie EK, Portelance L

Author

William Adrian Hall MD Chair, Professor in the Radiation Oncology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Humans
Physicians
Radiotherapy Planning, Computer-Assisted