Palliative radiation oncology programs: improving value through high-quality and cost-effective care

An estimated 40% of all radiation treatments are delivered with non-curative intent, and there is strong evidence that this cohort of patients benefits from the early integration of palliative care services. Palliative radiation oncology programs (PROPs) are teams, processes, or systems that were developed to meet these needs. PROPs address specific issues related to the delivery of palliative radiation therapy (PRT) and try to enhance and improve the quality, cost, timeliness, and value of patient care. While PROPs can be tailored to specifically meet any institutional needs, establishing a sustainable PROP requires commitment from the institution, the systemic integration of standardized care pathways, workflows, and best practice guidelines, collaboration within the oncology team, and dedicated infrastructure resources. PROPs have been shown to improve timely access to care, increase patient and provider satisfaction, advance guideline-concordant care, standardize assessment of palliative care needs, improve palliative care education among radiation oncology residents, and reduce hospital stays and health care costs. While not yet widely adopted, the benefits they provide confirm their value and importance for patients with advanced cancer and for the health care system in general. This article outlines the reasons PROPs were developed, discusses elements related to developing sustainable PROPs, and highlights the value that they provide while reducing costs.