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A Comprehensive Primer on Radiation Oncology for Non-Radiation Oncologists

SIMPLE SUMMARY: The gap in understanding of radiation therapy (RT) procedures among non-radiation oncologists poses a significant barrier to optimal cancer care. Aimed at equipping non-oncologists, medical students, and non-clinical researchers with crucial insights into RT, this paper serves as a c...

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Autores principales: Beddok, Arnaud, Lim, Ruth, Thariat, Juliette, Shih, Helen A., El Fakhri, Georges
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10605284/
https://www.ncbi.nlm.nih.gov/pubmed/37894273
http://dx.doi.org/10.3390/cancers15204906
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author Beddok, Arnaud
Lim, Ruth
Thariat, Juliette
Shih, Helen A.
El Fakhri, Georges
author_facet Beddok, Arnaud
Lim, Ruth
Thariat, Juliette
Shih, Helen A.
El Fakhri, Georges
author_sort Beddok, Arnaud
collection PubMed
description SIMPLE SUMMARY: The gap in understanding of radiation therapy (RT) procedures among non-radiation oncologists poses a significant barrier to optimal cancer care. Aimed at equipping non-oncologists, medical students, and non-clinical researchers with crucial insights into RT, this paper serves as a comprehensive guide that demystifies the intricate, multi-step journey from treatment planning to patient follow-up. Highlighting the indispensable role of radiation oncologists (ROs) in this process, the paper delves into pivotal phases such as CT simulation, treatment target and organs at risk (OAR) delineation, and acute toxicity management. Ultimately, the manuscript aims to significantly elevate patient care standards by bridging the knowledge gap in non-oncology healthcare circles about RT. Its significance lies in its potential to foster improved interdisciplinary collaboration, thereby enhancing the effectiveness and safety of cancer treatment regimens. ABSTRACT: Background: Multidisciplinary management is crucial in cancer diagnosis and treatment. Multidisciplinary teams include specialists in surgery, medical therapies, and radiation therapy (RT), each playing unique roles in oncology care. One significant aspect is RT, guided by radiation oncologists (ROs). This paper serves as a detailed primer for non-oncologists, medical students, or non-clinical investigators, educating them on contemporary RT practices. Methods: This report follows the process of RT planning and execution. Starting from the decision-making in multidisciplinary teams to the completion of RT and subsequent patient follow-up, it aims to offer non-oncologists an understanding of the RO’s work in a comprehensive manner. Results: The first step in RT is a planning session that includes obtaining a CT scan of the area to be treated, known as the CT simulation. The patients are imaged in the exact position in which they will receive treatment. The second step, which is the primary source of uncertainty, involves the delineation of treatment targets and organs at risk (OAR). The objective is to ensure precise irradiation of the target volume while sparing the OARs as much as possible. Various radiation modalities, such as external beam therapy with electrons, photons, or particles (including protons and carbon ions), as well as brachytherapy, are utilized. Within these modalities, several techniques, such as three-dimensional conformal RT, intensity-modulated RT, volumetric modulated arc therapy, scattering beam proton therapy, and intensity-modulated proton therapy, are employed to achieve optimal treatment outcomes. The RT plan development is an iterative process involving medical physicists, dosimetrists, and ROs. The complexity and time required vary, ranging from an hour to a week. Once approved, RT begins, with image-guided RT being standard practice for patient alignment. The RO manages acute toxicities during treatment and prepares a summary upon completion. There is a considerable variance in practices, with some ROs offering lifelong follow-up and managing potential late effects of treatment. Conclusions: Comprehension of RT clinical effects by non-oncologists providers significantly elevates long-term patient care quality. Hence, educating non-oncologists enhances care for RT patients, underlining this report’s importance.
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spelling pubmed-106052842023-10-28 A Comprehensive Primer on Radiation Oncology for Non-Radiation Oncologists Beddok, Arnaud Lim, Ruth Thariat, Juliette Shih, Helen A. El Fakhri, Georges Cancers (Basel) Review SIMPLE SUMMARY: The gap in understanding of radiation therapy (RT) procedures among non-radiation oncologists poses a significant barrier to optimal cancer care. Aimed at equipping non-oncologists, medical students, and non-clinical researchers with crucial insights into RT, this paper serves as a comprehensive guide that demystifies the intricate, multi-step journey from treatment planning to patient follow-up. Highlighting the indispensable role of radiation oncologists (ROs) in this process, the paper delves into pivotal phases such as CT simulation, treatment target and organs at risk (OAR) delineation, and acute toxicity management. Ultimately, the manuscript aims to significantly elevate patient care standards by bridging the knowledge gap in non-oncology healthcare circles about RT. Its significance lies in its potential to foster improved interdisciplinary collaboration, thereby enhancing the effectiveness and safety of cancer treatment regimens. ABSTRACT: Background: Multidisciplinary management is crucial in cancer diagnosis and treatment. Multidisciplinary teams include specialists in surgery, medical therapies, and radiation therapy (RT), each playing unique roles in oncology care. One significant aspect is RT, guided by radiation oncologists (ROs). This paper serves as a detailed primer for non-oncologists, medical students, or non-clinical investigators, educating them on contemporary RT practices. Methods: This report follows the process of RT planning and execution. Starting from the decision-making in multidisciplinary teams to the completion of RT and subsequent patient follow-up, it aims to offer non-oncologists an understanding of the RO’s work in a comprehensive manner. Results: The first step in RT is a planning session that includes obtaining a CT scan of the area to be treated, known as the CT simulation. The patients are imaged in the exact position in which they will receive treatment. The second step, which is the primary source of uncertainty, involves the delineation of treatment targets and organs at risk (OAR). The objective is to ensure precise irradiation of the target volume while sparing the OARs as much as possible. Various radiation modalities, such as external beam therapy with electrons, photons, or particles (including protons and carbon ions), as well as brachytherapy, are utilized. Within these modalities, several techniques, such as three-dimensional conformal RT, intensity-modulated RT, volumetric modulated arc therapy, scattering beam proton therapy, and intensity-modulated proton therapy, are employed to achieve optimal treatment outcomes. The RT plan development is an iterative process involving medical physicists, dosimetrists, and ROs. The complexity and time required vary, ranging from an hour to a week. Once approved, RT begins, with image-guided RT being standard practice for patient alignment. The RO manages acute toxicities during treatment and prepares a summary upon completion. There is a considerable variance in practices, with some ROs offering lifelong follow-up and managing potential late effects of treatment. Conclusions: Comprehension of RT clinical effects by non-oncologists providers significantly elevates long-term patient care quality. Hence, educating non-oncologists enhances care for RT patients, underlining this report’s importance. MDPI 2023-10-10 /pmc/articles/PMC10605284/ /pubmed/37894273 http://dx.doi.org/10.3390/cancers15204906 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Beddok, Arnaud
Lim, Ruth
Thariat, Juliette
Shih, Helen A.
El Fakhri, Georges
A Comprehensive Primer on Radiation Oncology for Non-Radiation Oncologists
title A Comprehensive Primer on Radiation Oncology for Non-Radiation Oncologists
title_full A Comprehensive Primer on Radiation Oncology for Non-Radiation Oncologists
title_fullStr A Comprehensive Primer on Radiation Oncology for Non-Radiation Oncologists
title_full_unstemmed A Comprehensive Primer on Radiation Oncology for Non-Radiation Oncologists
title_short A Comprehensive Primer on Radiation Oncology for Non-Radiation Oncologists
title_sort comprehensive primer on radiation oncology for non-radiation oncologists
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10605284/
https://www.ncbi.nlm.nih.gov/pubmed/37894273
http://dx.doi.org/10.3390/cancers15204906
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