Objectives
  • To understand the role of radiation oncology in the multidisciplinary management of patients with cancer

Awareness
  • Recognition of the importance of providing patient-centric care

  • Recognition of the importance of the multidisciplinary approach to treat patients with cancer

  • Awareness of the difference between palliative and curative (definitive) radiotherapy indications

  • Appreciation of the difference between external beam radiotherapy (‘teletherapy’) and internal radiotherapy (‘brachytherapy’)

  • Appreciation of the relevance of the temporal relationship with other treatment modalities (neoadjuvant, concomitant, adjuvant)

  • Awareness of the existence of different radiation planning, delivery and position/dose-verification techniques

  • Awareness of a therapeutic window between tumour control and normal tissue toxicity

  • Awareness of the published research evidence and guidelines for radiation oncology

  • Appreciation of the importance of safety culture, a robust quality and safety infrastructure, and process improvement

  • Recognition of the importance of value-based healthcare delivery

Knowledge
  • Understanding of the indications for treatments and the risks and benefits of different radiation treatment options

  • Familiarity with the basic principles of radiation biology, including the effects of time, dose, fractionation and type of radiation

  • Understanding of the indications for curative radiation therapy and its side effects

  • Understanding of the benefits and toxicity of palliative radiation treatment

  • Understanding of the acute, late and very late reactions/complications of radiation treatment

  • Knowledge of differences in radiation tolerance of organs/tissues at risk

  • Familiarity with the risks of re-irradiation based on normal tissue tolerance limits

  • Understanding of the interaction between radiation and systemic drugs

  • Familiarity with the type and severity of the toxicity from the use of concomitant systemic drugs and radiation

  • Understanding of the interaction of radiation therapy on surgery in the preoperative and postoperative settings

  • Understanding of the basic principles of different radiation planning and delivery techniques such as intensity-modulated radiation therapy (IMRT), stereotactic, particle and adaptive radiotherapy

  • Understanding of the basic principles of brachytherapy and radionuclide therapy

  • Understanding of the basic principles of different radiation position/dose-verification techniques such as electronic portal imaging devices (EPID), image guided radiation therapy (IGRT) and in vivo dosimetry

  • Familiarity with the role of surgery, interventional radiology, radiation oncology, systemic antitumour therapy, symptom control and supportive/palliative care measures in patients with relapsed disease

  • Knowledge of relevant published research evidence, of the results of major randomised trials that have influenced present practice, of ongoing trials of radiation oncology and systemic therapy, and of national/international guidelines

  • Understanding of the fundamental concepts of value-based healthcare

Skills
  • Ability to deliver effective interdisciplinary consultations and contribute effectively to the discussions of multidisciplinary teams

  • Ability to elicit the patient's wishes with regard to the aims of treatment and to give the treatment alone or in collaboration with other specialists

  • Ability to inform patients on different radiation treatment options and discuss the risk/benefit ratio and to explain these in lay terminology to patients and families

  • Ability to communicate about considerations in prescribing external beam radiation and/or brachytherapy

  • Ability to communicate about basic considerations in prescribing various systemic agents and their potential interactions with radiation therapy

  • Ability to modulate the concomitant treatment of systemic drugs and radiation according to the patient's situation in collaboration with the multidisciplinary team

  • Ability to communicate about different radiation planning, delivery and position/dose-verification techniques

  • Ability to discuss relevant clinical trials and evidence-based guidelines

  • Ability to discuss options of entering a clinical trial involving radiotherapy

  • Ability to foster a robust safety culture, including the reporting of events and involvement in process improvement