The ABIM Foundation and the American Society for Radiation Oncology (ASTRO) have just released recommendations for five procedures that should be discussed in depth between doctors and patients before being prescribed. As part of the ABIM Foundation's "Choosing Wisely" campaign and concurrent with the 55th annual meeting of ASTRO in Atlanta, Georgia, the authors of this release seek to guide clinicians and patients in choosing treatments wisely. Questioning prescribed treatments is part of that wise decision-making process.
Richard Brown, MD, who heads the ABIM Foundation, lauded ASTRO for its effort: "ASTRO has shown tremendous leadership by releasing its list of tests and procedures they say are commonly done in radiation oncology, but aren't always necessary." Michael Steinberg, MD, ASTRO chairman of the board, added, "We are committed to assuring that treatment options align with individual patient needs and patient expectations and that our patients have the information they need to make wise healthcare decisions." Interested parties are welcome to listen to the briefing by Dr. Steinberg and Daniel Wolfson, EVP and COO of the ABIM Foundation, here.
The five recommendations from ASTRO all start with "Don't initiate" or "Don't routinely use / recommend." The first recommendation, "Don't initiate whole-breast radiotherapy as part of breast conservation therapy in women aged 50 and older with early-stage invasive breast cancer without considering shorter treatment schedules." The authors elaborate, explaining that although most studies focus on patients receiving five to six weeks of therapy, plus one or two weeks of "boost" therapy, "Recent studies [...] have demonstrated equivalent tumor control and cosmetic outcome in specific patient populations with shorter courses of therapy (approximately four weeks)."
The next scheduled release of Choosing Wisely guidelines is scheduled for September 26, 2013, from the American Association of Clinical Toxicology and the American College of Medical Toxicology.