Second List of 'Choosing Wisely' Oncology Guidelines Released

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ASTRO recommendations indicate treatment options that should be discussed before being prescribed.
ASTRO recommendations indicate treatment options that should be discussed before being prescribed.

The American Society for Radiation Oncology (ASTRO) has released a second list of five radiation oncology-specific treatments that should be discussed before being prescribed, as part of the national Choosing Wisely campaign.

Researchers from ASTRO narrowed a list of 28 topics to nine potential items. A list of eight items was submitted to ASTROS's Board of Directors, and they selected five targeted treatment options that are commonly recommended but may not always be appropriate. ASTRO recommends detailed patient-physician discussion before prescribing any of these treatment options.

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The five recommendations include: (1) for patients with low-risk endometrial cancer, radiation is not recommended following hysterectomy; (2) radiation therapy should not be routinely offered for patients with resected non-small-cell lung cancer with negative margins, N0-1 disease; (3) non-curative radiation therapy should not be initiated without defining treatment goals with the patient and considering referral to palliative care; (4) follow-up mammograms should not be routinely recommended more often than annually for women who have had radiotherapy following breast conservation therapy; and (5) for limited brain metastases, adjuvant whole brain radiation therapy should not be routinely added to stereotactic radiosurgery.

"ASTRO is dedicated to supporting a strong doctor-patient relationship to ensure that patients are able to make sound and informed health care decisions," Colleen A.F. Lawton, M.D., Chair of ASTRO's Board of Directors, said in a statement.


  1. "ASTRO releases second list of five radiation oncology treatments to question, as part of national Choosing Wisely campaign." ASTRO. San Francisco. September 14, 2014.

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