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J Oncol Pract. 2007 September; 3(5): 285.
PMCID: PMC2793833

Application of Lean Thinking to Radiation Therapy

To the Editor: The article on lean thinking in bone and brain metastases by Kim et al in the July 2007 issue of JOP provides yet another lesson to all of us on the potential advantages for patient care in applying innovative approaches based on production methods developed by the manufacturing industry.1

While I question the assertion that same-day irradiation in and of itself leads to rapid amelioration of symptoms in patients with bone and brain metastases, judicious pain management in the former and steroids in the latter provide the initial rapid relief, and the same-day approach has important psychological and logistical benefits to the patients and their families.

For other centers, the details may differ, as pointed out by the authors, but the broad principle of establishing a “uniform standard process” based on stepwise improvements from a detailed analysis of existing approaches will be similar.

Have the authors parlayed their system to a broader group of patients, and will this produce cost savings?


1. Kim CK, Hayman JA, Billi JE, et al: The application of lean thinking to the care of patients with bone and brain metastasis with radiation therapy. J Oncol Pract 3:189-193, 2007 [PMC free article] [PubMed]

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