Quality assurance control in the EORTC cooperative group of radiotherapy1. Assessment of radiotherapy staff and equipment (original) (raw)
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European Journal of Cancer, 2003
In 1982, the European Organization for Research and Treatment of Cancer (EORTC) Radiotherapy Group established the Quality Assurance (QA) programme. During the past 20 years, QA procedures have become a major part of the activities of the group. The methodology and steps of the QA programme over the past 20 years are briefly described. Problems and conclusions arising from the results of the long-lasting QA programme in the EORTC radiotherapy group are discussed and emphasised. The EORTC radiotherapy group continues to lead QA in the European radiotherapy community. Future challenges and perspectives are proposed. #
The programme of quality assurance of the EORTC radiotherapy group. A historical overview
Radiotherapy and Oncology, 1993
A quality assurance programme was activated in 1982 in the EORTC Cooperative Group of Radiotherapy. Definitions and contents of quality assurance and quality control, definitions of errors and deviations (systematic, occasional) are given. The methodology and steps of the quality assurance programme adopted over the past ten years are briefly described. The need for an interaction between national and international networks is emphasized. Consensus statements on quality assurance in radiotherapy provided during the January 1993 Geneva meeting conclude this introduction to the detailed reports on the quality assurance programme of the EORTC Cooperative Group of Radiotherapy.
Detection of errors in individual patients in radiotherapy by systematic in vivo dosimetry
Medical Dosimetry, 1995
We report 5 years of systematic measurements of the dose delivered to each patient undergoing radiotherapy treatment with photon beams in order to detect any systematic error that may have escaped the different checks performed at each step of planning and calculation prior to the first treatment session, or may have arisen during the set-up or the treatment delivery. For each patient the target-absorbed dose is derived from the entrance and exit doses measured by silicon diodes, on the beam axis at the patient's skin. Depending on the discrepancies observed between the measured and expected doses we have set decision levels for the corrective actions to be taken. In addition these measurements allow us to obtain information on the overall accuracy or on the quality of a specific treatment. During 5 years, 7519 patients have been measured and 79 errors were detected. Half could have induced a variation of over 10% in the dose delivered. Seventy-eight out of 79 errors were of human origin. As part of an overall quality assurance programme, it is of the utmost importance to check the dose delivered for each patient undergoing radiotherapy treatment in order to avoid systematic underdosing or overdosing.
Radiotherapy and Oncology, 2003
Background and purpose: The IAEA/WHO TLD postal programme for external audits of the calibration of high-energy photon beams used in radiotherapy has been in operation since 1969. This work presents a survey of the 1317 TLD audits carried out during 1998-2001. The TLD results are discussed from the perspective of the dosimetry practices in hospitals in developing countries, based on the information provided by the participants in their TLD data sheets. Materials and methods: A detailed analysis of the TLD data sheets is systematically performed at the IAEA. It helps to trace the source of any discrepancy between the TLD measured dose and the user stated dose, and also provides information on equipment, dosimetry procedures and the use of codes of practice in the countries participating in the IAEA/WHO TLD audits. Result: The TLD results are within the 5% acceptance limit for 84% of the participants. The results for accelerator beams are typically better than for Co-60 units. Approximately 75% of participants reported dosimetry data, including details on their procedure for dose determination from ionisation chamber measurements. For the remaining 25% of hospitals, who did not submit these data, the results are poorer than the global TLD results. Most hospitals have Farmer type ionisation chambers calibrated in terms of air kerma by a standards laboratory. Less than 10% of the hospitals use new codes of practice based on standards of absorbed dose to water. Conclusion: Despite the differences in dosimetry equipment, traceability to different standards laboratories and uncertainties arising from the use of various dosimetry codes of practice, the determination of absorbed dose to water for photon beams typically agrees within 2% among hospitals. Correct implementation of any of the dosimetry protocols should ensure that significant errors in dosimetry are avoided.
A survey of current in vivo radiotherapy dosimetry practice
The British Journal of Radiology, 1997
A questionnaire was sent out to 57 radiotherapy physics departments in the United Kingdom to determine the type of dosemeters used for in vivo measurements inside and outside X-ray treatment fields, and whether any correction is made for energy dependence when the dose to critical organs outside the main beam is estimated. 44 responses were received. 11 centres used a semiconductor for central axis dosimetry compared with only two centres which used thermoluminescent dosimetry (TLD). 37 centres carried out dosimetry measurements outside the main beam; 25 centres used TLD and 12 centres used a semiconductor detector. Of the 16 centres measuring the dose at both sites, 11 used a semiconductor for the central axis measurement, but only four of those 11 changed to TLD for critical organ dosimetry despite the latter's lower variation in energy response. None of the centres stated that they made a correction for the variation in detector energy response when making measurements outside the main beam, indicating a need for a more detailed evaluation of the energy response of these detectors and the energy spectra outside the main beam.