Towards proton therapy guidelines for radiation therapists and dosimetrists: A scoping review

With the increasing number of proton therapy centers worldwide, particularly in Europe, proton therapy is becoming a more established treatment option. However, education and guidelines, specifically tailored to radiation therapists (RTTs) and dosimetrists, are lacking. Through the "Towards a Sustainable RTT Network" (TaSeRnet) project, efforts are underway to harmonize proton therapy practices among RTTs and dosimetrists across Europe. This scoping review aims to identify and summarize existing guidelines relevant to RTTs and dosimetrists working in proton therapy, providing a necessary first step toward the future development of specific guidelines and education for these professions. Ten articles were identified that include guidelines covering certain aspects of proton therapy workflows in several clinical indications. However, significant gaps remain regarding the specific tasks performed by RTTs and dosimetrists. In particular, no guidelines were found addressing treatment execution, a workflow typically performed by RTTs. Moreover, the limited involvement of RTTs and dosimetrists in the development of existing guidelines may result in the exclusion of essential practical knowledge and expertise. As they play a critical role in the daily delivery of proton therapy, their input is vital to ensure comprehensive and applicable guidelines. In conclusion, this review underscores the need for developing guidelines specifically for RTTs and dosimetrists in collaboration with the broader multidisciplinary team. Developing such guidelines will support the standardization of clinical practice and contribute to improved quality of care.