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.
背景：多学科协作在癌症诊断与治疗中至关重要。多学科团队由外科、内科治疗及放射治疗等领域的专家组成，各专业在肿瘤诊疗中发挥独特作用。放射治疗作为重要治疗手段，由放射肿瘤学家主导实施。本文旨在为非肿瘤专科医师、医学生及非临床研究人员系统介绍现代放射治疗的临床实践。 方法：本报告遵循放射治疗计划制定与实施的全流程展开论述。从多学科团队的决策过程开始，至放射治疗完成及后续患者随访结束，全面阐述放射肿瘤学家的工作内容，为非肿瘤专科医师提供系统性认知框架。 结果：放射治疗的首要步骤是制定治疗计划，包括对靶区进行CT扫描定位（即CT模拟定位）。患者需保持与治疗时完全一致的体位接受影像采集。第二步涉及治疗靶区与危及器官的勾画，此环节是治疗不确定性的主要来源，其核心目标在于确保靶区精准照射的同时最大限度保护危及器官。临床采用多种放射治疗模式，包括电子线、光子线或粒子束（含质子与碳离子）外照射治疗，以及近距离放射治疗。在这些治疗模式中，运用三维适形放疗、调强放疗、容积旋转调强放疗、散射束质子治疗及调强质子治疗等技术以实现最佳治疗效果。治疗计划制定是由医学物理师、剂量师与放射肿瘤学家共同参与的迭代过程，其复杂程度与耗时存在差异（1小时至1周不等）。计划获批后即开始实施治疗，其中图像引导放疗已成为确保患者体位准确性的标准实践。放射肿瘤学家在治疗期间需处理急性毒性反应，治疗结束后需完成治疗总结。临床实践存在显著差异，部分放射肿瘤学家会提供终身随访服务以管理潜在的远期治疗相关效应。 结论：非肿瘤专科医疗人员对放射治疗临床效应的深入理解，能显著提升患者的长期照护质量。因此，加强对非肿瘤专科人员的放射治疗教育，对优化放射治疗患者的全程管理具有重要意义，这也凸显了本报告的价值所在。
A Comprehensive Primer on Radiation Oncology for Non-Radiation Oncologists
肿瘤(癌症)患者之家