Telemedicine and radiation oncology: state of the evidence

Radiation therapy is a therapeutic modality that uses ionizing radiation to treat cancer or improve its symptoms. With surgery and chemotherapy, it is part of the standard therapeutic approach for treating cancer. It is delivered through sophisticated technological infrastructures and by specialized human resources working together in multi-disciplinary teams.

The literature consulted on radiation therapy revealed two major findings: (1) cancer incidence is increasing in the industrialized world, including Canada and Québec; and (2) oncology centres are generally concentrated in large cities, while treatment needs are geographically dispersed. This situation leads to suboptimal radiotherapy service delivery. Faced with the reality that technical and organizational infrastructures are closely tied to population density, some countries have explored the use of telemedicine in radiation oncology as a possible solution. The primary purpose of this literature review was to examine telemedicine applications in radiation oncology and their potential modes of operation so as to draw lessons useful to Québec.

In conclusion, this literature review showed that the main application of telemedicine in radiation oncology is remote treatment planning. It can contribute to networking different centres and to decentralizing radiotherapy services by providing satellite centres with access to expertise not available on site. However, the success of this activity depends on implementing a stringent quality-assurance process.