Radiation Oncology Section Report
Report to the membership by the Representative of Radiation Oncology to the Executive Committee of MRS (for PDF click here)
Date: February 2010
The field of Radiation Oncology continues to be in a state of flux with new technologies continuously being brought into clinical practice in effort to improve patient outcomes. With implementation of new technology into the clinic comes both excitement and uncertainty in treating cancer patients. Many years ago, cancer was treated with simple two-field or four-field techniques and maximal treatment dosages were limited by the radiation tolerance of large volumes of surrounding normal tissue. In this modern era patients can expect to have choices of treatment modalities. For example, whereas prostate cancer used to be treated by rotational or four-field box techniques, now we have at our disposal 3-D conformal radiation, Intensity Modulated Radiation Therapy (IMRT), prostate brachytherapy, proton therapy, and, more recently, Image-Guided Radiation Therapy (IGRT). These technologies facilitate tumor radiation dose escalation while still respecting tissue tolerance of adjacent normal organs. Whereas breast cancer was treated by simple tangential fields, one may now opt to treat by 3-D conformal, breast IMRT, as well as accelerated Partial Breast Irradiation delivered via either external beam therapy or temporary placement of an internal high-dose-rate brachytherapy applicator. The internet has allowed patients to be much more informed, and they often consult with a physician armed with extensive information on their particular disease.
It is crucial that Radiation Oncologists and Medical Physicists maintain a high standard to provide patients with the best possible care. I would encourage all radiation facilities to become accredited through the ACR to ensure that high level of performance. It is especially important to regulate the quality of new facilities in our state, and the Massachusetts Radiological Society is committed to this. An article in the Boston Globe in September 2006 stated that, due to the rise in the number of cancer patients, there will be a need for additional radiation facilities statewide. The efficacy of radiation therapy in the treatment of cancer patients has been highlighted in subsequent Boston Globe articles. In counterpoint, a January 2010 New York Times article on a New York City hospital patient’s catastrophic injuries from repeated radiation misadministration in the first days of treatment underscores the need for radiation oncology clinicians and physicists to understand the need for appropriate, rigorous quality assurance practices to be in place whenever new technology is brought into the clinic.
In addition, the MRS continues to work closely with the Carrier Advisory Committee both statewide and nationally, and with CARROS, the ASTRO liaison to the ACR, to keep Radiation Oncologists and Medical Physicists well informed on new government regulations, reimbursement issues, and state-of-the-art treatment modalities in our field.
I would encourage all Radiation Oncologists and Medical Physicists in Massachusetts to become active in our state chapter, the MRS, or nationally with the ACR or ASTRO, so that we can keep abreast of new developments, and have a voice in the future of our profession. I would be glad to assist anyone in that regard. Please feel free to contact me with any questions or concerns that might arise.
Respectfully submitted,
John E. Mignano, MD, PhD
Tufts Medical Center
jmignano@tuftsmedicalcenter.org
Tufts Medical Center
jmignano@tuftsmedicalcenter.org
Additional Resources: