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Modern radiotherapy services rely heavily on Oncology Information Systems (OIS) for treatment planning, verification, and delivery. Failure of these systems, whether planned or unplanned, presents a significant risk to patient safety and treatment continuity. Recent cyberattacks and system outages have demonstrated the vulnerability of radiotherapy services to digital disruption.

This study describes the design and validation of the Automated Radiotherapy Continuity System (ARCS), an independent, vendor-neutral, read-only verification system developed to maintain safe radiotherapy delivery during OIS downtime. ARCS mirrors DICOM-RT data, independently verifies patient and machine metadata, enforces fractionation limits, and requires medical physics approval prior to use. Validation testing was performed using anonymized DICOM-RT datasets representative of Varian and Elekta workflows. Across 100 test plans, ARCS achieved a mirroring accuracy of 99%, with system failover occurring in under five minutes following simulated OIS failure. No unsafe irradiation sequences were observed. ARCS provides a practical and clinically safe approach to maintaining radiotherapy continuity during OIS downtime, reducing reliance on manual procedures and improving patient safety.

Keywords: radiotherapy, oncology information system, downtime, DICOM-RT, patient safety, verification, cyber resilience, risk management.