Clinical practice workflow in Radiation Oncology should be highly standardized.

Abstract

Radiotherapy (RT) treatment is a complex process that requires the entire radiation oncology team working together to ensure a safe, expeditious, and effective treatment of patients in the clinic. Standardizing the RT workflow is considered essential to improve RT treatment quality and reduce miscommunication or human errors. Our leading professional societies in medical physics and radiation oncology, that is the American Association of Physicists in Medicine (AAPM) and the American Society for Radiation Oncology (ASTRO), have invested tremendous resources in publishing task group reports, guidelines, and recommendations for best practice on almost every aspect of RT to ensure consistency and standardization. However, when it comes to every day routine clinical operation, different people might have different understanding or a proper workflow; and furthermore, there may be unpredictable scenarios that can potentially hinder the well‐established routine or standard RT workflow. The question raised in this debate is, should preset workflows be highly standardized and strictly followed? Herein, we have invited two experts in the field who both have distinguished themselves with years of experience in making these hard decisions in the clinic. Mr. Per Halvorsen argues for the proposition that “Clinical practice workflow in Radiation Oncology should be highly standardized”, while Dr. Nilendu Gupta shared some of his different opinions and experience. Mr. Halvorsen is the Chief Physicist in Radiation Oncology at Lahey Health in suburban Boston. He received his MS in Radiological Medical Physics from the University of Kentucky in 1990 and was certified by the American Board of Radiology in 1995. He has been a member of the AAPM for nearly 30 yr and has been an active volunteer in professional societies, chairing the AAPM Professional Council and serving on the Board of Directors. He has authored numerous peer‐reviewed manuscripts, most recently as the chair of the Medical Physics Practice Guideline for Stereotactic Radiosurgery and Stereotactic Body Radiotherapy (SBRT) and as a member of the ASTRO‐ASCO‐AUA Evidence‐Based Guideline for Hypofractionated Prostate treatment. He is a volunteer surveyor for the American College of Radiology (ACR), and served many years on its accreditation program oversight committee. He is Deputy Editor‐in‐Chief of the open‐access Journal of Applied Clinical Medical Physics (JACMP), and a Fellow of the ACR and AAPM. Dr. Nilendu Gupta is an Associate Professor of Clinical Radiation Oncology, the Chief of Medical Physics and the Director of the Medical Physics Residency Program in Radiation Oncology at The Ohio State University (OSU), James Cancer Hospital. Dr. Gupta received his Ph.D. in Biomedical Engineering at The Ohio State University. He plays a leadership role in quality and patient safety within the department and within the University and the OSU Health System.