Practical Clinical Workflows for Online and Offline Adaptive Radiation Therapy

Area of Science:

• Radiation oncology
• Medical physics
• Clinical workflow optimization

Background:

• Adaptive radiotherapy (ART) has been clinically established for over two decades.
• ART is not a single solution but a complex process involving multiple technologies.
• Effective implementation of ART requires careful consideration of workflow.

Purpose of the Study:

• To discuss the available tools for both online and offline adaptive radiotherapy.
• To introduce and analyze workflow concepts for different types of adaptive radiotherapy.
• To highlight commonalities, differences, controversies, and research areas in ART workflows.

Main Methods:

• Review of existing tools for imaging, adaptation assessment, treatment planning, and quality assurance in ART.
• Introduction and discussion of workflow principles for online and offline ART.
• Comparative analysis of different ART workflow strategies.

Main Results:

• No single universal solution exists for adaptive radiotherapy.
• Workflow is a critical determinant of ART safety, efficacy, and efficiency.
• Distinct themes and differences exist between online and offline ART workflows.

Conclusions:

• Adaptive radiotherapy is an established, multi-faceted process requiring optimized workflows.
• Understanding and refining ART workflows is essential for clinical practice.
• Further research is needed to address current controversies and advance adaptive radiotherapy techniques.