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The New Paradigm of Simulation-Free Radiation Therapy: Practical Recommendations for Successful Clinical
Stephanie Roderick1, Shelley Wong1, Alannah Kejda1
1Department of Radiation Oncology Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Practical Radiation Oncology
|May 19, 2025
Summary
Simulation-free radiation therapy (SFRT) offers a patient-centered approach to palliative care. This guide provides practical recommendations to overcome technical barriers and enable safe, scalable, and effective SFRT implementation.
Area of Science:
- Oncology
- Medical Physics
- Radiation Oncology
Background:
- Simulation-free radiation therapy (SFRT) is an emerging patient-centered paradigm for palliative radiation therapy.
- While feasibility and clinical benefits are demonstrated, technical barriers limit widespread adoption.
- Limited guidance exists for the practical implementation of SFRT.
Purpose of the Study:
- To provide practical recommendations for the clinical implementation of SFRT.
- To address technical barriers hindering SFRT adoption.
- To enable safe, scalable, and effective SFRT.
Main Methods:
- Recommendations cover offline preliminary studies.
- Guidance on patient and image selection and formatting.
- Considerations for planning, treatment, and quality control.
Main Results:
- Practical suggestions for overcoming technical barriers in SFRT.
- Framework for safe and scalable SFRT implementation.
- Guidance to facilitate effective clinical use of SFRT.
Conclusions:
- SFRT adoption can be facilitated through practical guidance.
- Addressing technical aspects is crucial for scalable SFRT.
- This report aims to enable effective and safe clinical SFRT.

