# Towards proton therapy guidelines for radiation therapists and dosimetrists: A scoping review

## TL;DR

This paper highlights the lack of proton therapy guidelines for radiation therapists and dosimetrists and emphasizes the need for collaborative efforts to develop them.

## Contribution

The paper identifies gaps in proton therapy guidelines for RTTs and dosimetrists and advocates for multidisciplinary collaboration in their development.

## Key findings

- Existing proton therapy guidelines lack RTT-specific workflow steps.
- No guidelines address treatment execution, a task performed by RTTs.
- RTTs and dosimetrists are underrepresented in guideline development.

## Abstract

•RTT-specific workflow steps are missing in existing proton therapy guidelines.•Guidelines for RTTs in proton therapy are lacking and need to be developed.•Multidisciplinary collaboration is crucial for RTT-focused guideline development.•RTT-focused guidelines are essential for improving the quality of proton therapy.

RTT-specific workflow steps are missing in existing proton therapy guidelines.

Guidelines for RTTs in proton therapy are lacking and need to be developed.

Multidisciplinary collaboration is crucial for RTT-focused guideline development.

RTT-focused guidelines are essential for improving the quality of proton therapy.

With the increasing number of proton therapy centers worldwide, particularly in Europe, proton therapy is becoming a more established treatment option. However, education and guidelines, specifically tailored to radiation therapists (RTTs) and dosimetrists, are lacking. Through the “Towards a Sustainable RTT Network” (TaSeRnet) project, efforts are underway to harmonize proton therapy practices among RTTs and dosimetrists across Europe. This scoping review aims to identify and summarize existing guidelines relevant to RTTs and dosimetrists working in proton therapy, providing a necessary first step toward the future development of specific guidelines and education for these professions. Ten articles were identified that include guidelines covering certain aspects of proton therapy workflows in several clinical indications. However, significant gaps remain regarding the specific tasks performed by RTTs and dosimetrists. In particular, no guidelines were found addressing treatment execution, a workflow typically performed by RTTs. Moreover, the limited involvement of RTTs and dosimetrists in the development of existing guidelines may result in the exclusion of essential practical knowledge and expertise. As they play a critical role in the daily delivery of proton therapy, their input is vital to ensure comprehensive and applicable guidelines. In conclusion, this review underscores the need for developing guidelines specifically for RTTs and dosimetrists in collaboration with the broader multidisciplinary team. Developing such guidelines will support the standardization of clinical practice and contribute to improved quality of care.