Abstract
PURPOSE: Radiation Oncology departments impacted by recent cyberattacks were unable to access data backups or their Record and Verify (R&V) system and therefore faced challenges to resume patient treatments in a timely manner. We present a novel software tool that backs-up critical radiotherapy treatment information and displays essential information for on-treatment patients in an intuitive and accessible dashboard allowing clinics to continue radiotherapy treatments. The purpose of this report is to describe implementation details, challenges, and share open-source code to facilitate radiation oncology clinics' efforts to develop tools to improve cyberattack resiliency. METHODS: The Radiotherapy Backup and Recovery Dashboard Tool (RBRDT) performs daily backups of treatment information and relationships between DICOM-RT objects from the R&V system and treatment planning system (TPS) to a Radiation Therapy Picture Archiving and Communication System (RT-PACS). If the R&V system is inaccessible, the RBRDT accesses the backed-up data in the RT-PACS to create a dashboard containing critical treatment information for patients currently undergoing radiotherapy. RESULTS: The RBRDT is successfully clinically implemented and generates backups to the RT-PACS every 10 minutes. Since its implementation in May 2024, the RBRDT backed up over 80,000 RTRECORDS and moved 322 RTPLANS and 142 RTSTRUCTS to the RT-PACS that were absent from this server caused by human error. The dashboard is generated nightly. CONCLUSIONS: The RBRDT fills a critical gap in existing approaches for radiotherapy treatment data backup and restoration. All relational data is transferred to the RT-PACS which is accessible during a cyberattack, reducing the reliance on the R&V system. The RBRDT retrieves connected data elements saved in separate locations. In the event of a cyberattack, this data is returned in a dashboard to rapidly resume patient treatments.