The Evolving Role of Radiation Therapy Technologists in Head and Neck Cancer: A Narrative Review and Operational Framework

Head and neck cancer (HNC) management requires highly coordinated multidisciplinary care. Radiation Therapy Technologists (RTTs) have increasingly expanded their role beyond technical execution, contributing to patient positioning, treatment delivery, monitoring, and supportive care. This narrative review integrates evidence from published literature with structured experiential insights collected through focus group discussions with RTTs and other multidisciplinary team (MDT) members. The resulting conceptual and operational framework highlights RTT contributions across the radiotherapy pathway, including adaptive planning, workflow coordination, and patient-centered interventions, supported by imaging and artificial intelligence (AI) tools for predictive modeling and treatment optimization. By facilitating communication, monitoring anatomical and functional changes, and integrating AI-informed insights, RTTs support timely interventions, reduce treatment interruptions, and enhance treatment safety and precision. Structured training, formal recognition of advanced practice roles, and interprofessional collaboration are key to maximizing the impact of RTTs in HNC care. This review provides a practical roadmap for institutions, professional societies, and research initiatives to support the evolution of RTT roles in complex radiotherapy settings.