Merck; past honoraria and travel expenses from the National Comprehensive Cancer Network; a past advisory board position with Regeneron; and past honoraria from the University of Florida and University of Rochester. Dr Bhatnagar reports a position of state chapter president for the Arizona Radiologic Society; stock with Cancer Treatment Services International; and consulting and research for Icad. Dr Devlin is the task force chair and reports membership of the Massachusetts Medical Society Finance and Audit Committee and past honoraria, travel expenses, and advisory board membership for Sirtex. Dr Geiger, an American Society of Clinical Oncology representative, reports research and advisory board membership for Regeneron and research for Genentech/Roche. Dr Likhacheva is task force vice chair and reports spouse employment with Reflexion and travel expenses from the Russian Society of Clinical Oncology. Drs Brady (Society of Surgical Oncology representative), Buzurovic, Parvathaneni, and Zaky reported no disclosures. Disclaimer and Adherence: American Society for Radiation Oncology (ASTRO) guidelines present scientific, health, and safety information and may reflect scientific or medical opinion. They are available to ASTRO members and the public for educational and informational purposes only. Commercial use of any content in this guideline without the prior written consent of ASTRO is strictly prohibited. Adherence to this guideline does not ensure successful treatment in every situation. This guideline should not be deemed inclusive of all proper methods of care or exclusive of other methods reasonably directed to obtaining the same results. The physician must make the ultimate judgment regarding therapy considering all circumstances presented by the patient. ASTRO assumes no liability for the information, conclusions, and findings contained in its guidelines. This guideline cannot be assumed to apply to the use of these interventions performed in the context of clinical trials. This guideline is based on information available at the time the task force conducted its research and discussions on this topic. There may be new developments that are not reflected in this guideline and that may, over time, be a basis for ASTRO to revisit and update the guideline.

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The ASTRO list for the Choosing Wisely campaign highlights radiation oncology interventions that should be discussed between physicians and patients before treatment is initiated. These 5 items provide opportunities to offer higher quality and less costly care.

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