How do you handle post-radiotherapy follow-up care? Results of a national pattern-of-care study

BACKGROUND: Post-radiotherapy follow-up care (PFC) is an essential part of radiotherapy and a legal requirement under the German Radiation Protection Act. The aim of this national study was to analyze current PFC structures and concepts in Germany. METHODS: A pattern-of-care study was conducted among all 366 Deutsche Gesellschaft für Radioonkologie (DEGRO)-registered radiotherapy institutions, whereby a 26-item questionnaire on organizational structures, patient selection, follow-up intervals, and the scope of examinations was completed anonymously online. RESULTS: A total of 95 institutions participated (response rate 26.6%; adjusted 30.2%). Almost all (99%) provide PFC, and 78% offer it regularly for oncology patients. In 84% of the studied institutions, PFC schedules are individually tailored according to the risk of radiation side effects and disease progression. The first follow-up visit occurs within 3 months in 94% of these institutions, and 72% offer PFC for 5 years. In 87% of cases, intervals are shortened for toxicities ≥ grade 3. Frail, very elderly, and palliative patients often receive a reduced PFC program. Telephone-based PFC is performed by 42% and written/digital approaches by 22% of institutions. CONCLUSION: Post-radiotherapy follow-up care is firmly established in German radiotherapy practice and is partly tailored to the patient's individual risk based on radiation side effects and treatment intent. Most institutions adhere to the recommendations of DEGRO and SSK. Digital and structured tools are currently only used to a limited extent in practice. However, they offer considerable potential for future use in further personalizing and optimizing the quality of PFC, also with regard to the still necessary definition and/or harmonization of PFC content.