ASTRO Releases Additional Queries As a Part of the Choosing Wisely Initiative

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This recommendation follows the list of 5 released last year by the organization, with the aim of helping the patient and physician choose appropriate treatments.

The Choosing Wisely campaign, initiated by the American Board of Internal Medicine, aims at questioning procedures that may be redundant and in need of a revamp. The American Society for Radiation Oncology (ASTRO) released it's second set of 5 treatments used in radiation oncology that may not always be appropriate. The list includes the following recommendations:

1. Don't recommend radiation following hysterectomy for endometrial cancer patients with low-risk disease.

2. Don't routinely offer radiation therapy for patients who have resected non-small cell lung cancer, negative margins, N0-1 disease.

3. Don't initiate non-curative radiation therapy without defining the goals of treatment with the patient and considering palliative care referral.


4. Don't routinely recommend follow-up mammograms more than annually for women who have had radiotherapy following breast conserving therapy.

5. Don't routinely add adjuvant whole brain radiation therapy to stereotactic radiosurgery for limited brain metastases.

These guidelines were developed by a committee that included individuals working in health policy, government relations, and clinical affairs and quality. The team developed a survey that was then mailed out to ASTRO's members, to rate 28 potential topics that could be addressed. Eight of the top 9 items were then selected and sent to ASTRO's board of directors to create a final list of 5.

Detailed release: