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Pract Radiat Oncol. 2016 Nov - Dec;6(6):e369-e381. doi: 10.1016/j.prro.2016.08.007. Epub 2016 Aug 24.

Standardizing dose prescriptions: An ASTRO white paper.

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Department of Radiation Oncology, Yale University, New Haven, Connecticut. Electronic address:
Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California.
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
School of Allied Health, Southern Illinois University, Carbondale, Illinois.
21st Century Oncology of Michigan, Farmington Hills, Michigan.
Radiation Oncology Associates of Lynchburg, Lynchburg, Virginia.
Department of Radiation Oncology, University of Washington, Seattle, Washington.
Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina.


This white paper recommends the standardization (content and presentation order) of several "key components" of the radiation therapy prescription to facilitate accurate communication between radiation therapy care providers. The rationale, other similar efforts, and detailed considerations are described. In brief, the Task Force recommends that the prescription's "elements" include: treatment site, method of delivery, dose per fraction, total number of fractions, total dose (eg, right breast, tangent photons, 267 cGy * 16 = 4272 cGy). A similar formalism is recommended for brachytherapy (eg, cervix, Ir-192 brachytherapy, 600cGy * 5 = 3000 cGy) and other modalities. The white paper also considers future directions for other items such as the simulation order, treatment planning objectives, prescription point or volume, treatment schedule, localization imaging, laboratory monitoring, concurrent chemotherapy, patient instructions for treatment, etc. The intent of this white paper is to facilitate accurate communication among providers to support safe practice as well as to guide vendors in product development that is consistent with this standard prescription.

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