Radiation Therapy Documentation Deficiencies in Cancer Survivorship Documents

Survivorship care plans (SCPs) and treatment summaries (TS) are intended to bridge oncology and primary care, yet it is unclear how well publicly available templates capture radiation therapy (RT) details necessary for safe, coordinated follow-up. We evaluated RT content in US society-sponsored, non-paywalled SCP/TS templates against elements recommended by the American Society for Radiation Oncology (ASTRO).

We identified SCP/TS templates from national medical organizations via targeted web searches. Guided by the ASTRO survivorship template, we abstracted the presence of RT variables including site, technique/modality, total dose, dose per fraction, fractionation, special procedures (eg, brachytherapy), treatment dates, toxicity, sequencing within multimodality care, concurrent chemotherapy, and radiation oncology contact information. Variables were recorded as present/absent and summarized descriptively.

Eighteen templates met inclusion; 11/18 (61.1%) were by the American Society of Clinical Oncology, and 14/18 (77.8%) targeted adult populations. RT was mentioned in 17/18 (94.4%), and a radiation oncology contact was listed in 15/18 (83.3%). Key technical details were uncommon: total dose and/or modality 6/18 (33.3%); dose per fraction 4/18 (22.2%); fractionation 5/18 (27.8%); special procedures 3/18 (16.7%); toxicity 2/18 (11.1%). No template captured RT sequencing within multimodality therapy or concurrent chemotherapy. Treatment end dates were more commonly captured than start dates. The Children's Oncology Group template was the most comprehensive across RT variables.

Many public templates omit core radiation therapy data. Adopting a simple standard set of fields for site, technique, total dose, dose per fraction, fractionation, sequencing, toxicity, and a radiation oncology contact would improve clarity, safety, and care transitions.