Annually in the United States, about 250 000 patients with advanced cancer receive palliative radiotherapy to lessen pain, control bleeding, or improve quality of life. To ensure reproducible positioning, patients are immobilized on laser-aligned treatment tables and have standard weekly imaging during treatment. Daily imaging, using radiography or computed tomography, can augment positioning. Although daily imaging is often used for curative radiotherapy, national guidelines consider it unnecessary for palliative radiotherapy.1,2 Unnecessary imaging can increase treatment time and expense for patients in distress.
Sharma S, Guttmann D, Small DS, et al. Effect of Introducing a Default Order in the Electronic Medical Record on Unnecessary Daily Imaging During Palliative Radiotherapy for Adults With Cancer: A Stepped-Wedge Cluster Randomized Clinical Trial. JAMA Oncol. Published online June 27, 20195(8):1220–1222. doi:10.1001/jamaoncol.2019.1432
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