Advanced Practice
     Radiation Therapy

Shaping the future of patient care
and the radiation therapy profession

Advanced practice radiation therapists (APRT’s) are experienced radiation therapists who perform clinical and patient care responsibilities, while also receiving training and specialization in additional areas of practice under the guidance of a radiation oncologist as part of the task-sharing radiation oncology team. These additional responsibilities are based on the needs of the institution and the interdisciplinary team. Examples of these additional responsibilities may be integrated into palliative care, brachytherapy and adaptive radiation therapy pathways. This advanced practice role creates a professional development clinical pathway for radiation therapists to grow their knowledge, skills and judgement through appropriate education and competency, to provide an enhanced level of care.

The advanced practice radiation therapy model employs shared decision-making to support the radiation oncologist to focus on essential and higher-level activities, leading to a more manageable patient caseload and enhancing patient throughput. This new model of care focuses on shifting tasks from the radiation oncologist to the APRT that align with the elevated radiation therapist skillset rather than reimbursable activities. Under the guidance of a radiation oncologist and with appropriate education, APRTs have demonstrated clinical competency in tasks such as target delineation, patient assessment, image evaluation and other skills throughout various steps in the patient pathway.

Although advanced practice radiation therapy education programs exist internationally, currently there are none available in North America. Across the globe, master’s- or doctoral-level education is widely adopted. A combination of didactic education and clinical competence may best provide innovative opportunities to advance education and practice and prepare individuals to engage in research. Current research initiatives in the United States exist to develop a proper APRT education preparation model.

ASRT leading the way in supporting the APRT role with its radiation therapy members and collaborating organizations

The ASRT is planning a special issue of ASRT’s peer-reviewed journal Radiation Therapist that will focus on advanced practice radiation therapy. This special issue aims to explore the critical aspects of advanced practice radiation therapy practice within the contemporary landscape of radiation oncology. The ASRT supports advanced practice radiation therapists through advocacy and professional development opportunities. Radiation oncology teams value each professional role for the different practice areas and skills they bring to treating patients. For more information, please contact [email protected].

In 2021, the APRT working group formalized a grassroots effort to systematically study and establish advanced practice radiation therapy in the United States. The APRT role now exists in the U.S. and its effectiveness is being studied through multiple grant-funded awards. Research on the appropriate level of APRT education and practice in the U.S. is also underway. ASRT supports the APRT working group, which is co-led by ASRT members and was initiated by ASRT members at Mount Sinai Hospital in New York and includes various parties of interest including radiation oncologists, medical physicists and executive leadership. The APRT working group recommends an internationally recognized and adopted educational and clinical practice framework based on four pillars:

  •  Clinical practice
  •  Leadership and management
  •  Education and training
  •  Research and scholarship

Credit: Society and College of Radiographers

APRTs who are educationally prepared and clinically competent can currently establish recognition by completing the appropriate training and education within their institution’s task-sharing framework under the guidance of a radiation oncologist, functioning in all four pillars of the framework, and following state laws and institutional policies.