ASTRO white paper: IMRT is tremendous advance but time intensive

The American Society for Radiation Oncology has developed a white paper on the safe use of integrating intensity-modulated radiation therapy (IMRT) into the radiation oncology clinic.

The executive summary of this white paper was published in Practical Radiation Oncology, ASTRO’s clinical practice journal (2011; 1:190-5).

The white paper raises these main concerns:

• IMRT is a time- and resource-intensive procedure. Practitioners must work together as a team to address environmental and technical concerns to improve patient safety.
• Timely treatment is important. However, pressure and real-time changes to treatment plans can lead to errors. This report encourages the use of standard operating procedures and "forced time-outs" to assure adequate time to perform reviews or quality assurance at key points in the process.
• Team members need to acknowledge that delays in initiation of treatment may be necessary to allow adequate time for quality assurance checks and to investigate any problems discovered.

"Intensity-modulated radiation therapy has been a tremendous advance in the way we treat patients by improving the planning and delivery of radiation therapy," said lead author Jean M. Moran, PhD, of the University of Michigan Medical Center in Ann Arbor. "IMRT is, however, incredibly time and resource intensive. It involves the use of sophisticated software and delivery systems and many hand-offs between team members throughout the simulation, planning, and delivery process. It is our hope that practitioners will use the tools and techniques presented in this document to reassess and strengthen their own IMRT programs."