The increasing role of artificial intelligence in radiation oncology: how should we navigate it?

Why the role of AI in radiation oncology is set to growAs illustrated by this special issue, artificial intelligence (AI) technology [1] has a potential impact on all aspects of radiation oncology, ranging from automated treatment planning [2], adaptive radiotherapy, and IGRT [3,4], to clinical decision support, personalization [5], and improvement of patients' experience and quality of life [6].Radiation oncology may be impacted by AI more significantly than any other therapeutic medical field, as radiotherapy treatment planning and delivery are already fully computer based, thus greatly facilitating the introduction of AI technology.Given the increasing role of AI in radiation oncology, it is important to discuss potential implications and the optimal strategy for our field.In particular, the potential of AI to automate virtually all steps of the treatment planning chain is a double-edged sword that brings about some of the greatest benefits but also affects the unique competency of radiation oncology.Moreover, we must not overlook the clinical aspects of radiation oncology, such as patient care, supportive therapy, and integration with pharmacological cancer treatments.These are as fundamental to the discipline as the technical aspects and represent the second essential pillar of radiation oncology.