engleski

Potentials for systematic clinical implementation of advanced radiotherapy techniques in Croatian radiotherapy community

Aim and Background. Implementation of advanced radiation therapy techniques, such as intensity modulated radiation therapy (IMRT), in clinical practice can greatly improve tumour control and normal tissue sparing. This makes radiotherapy much more complex making a significant potential for errors. It was already reported, based on audit of IMRT head and neck phantom, that approximately 1/3 of the contributing institutions from USA and EU did not meet the accuracy criteria even though the dose tolerance criteria were not set very strictly. Thus IMRT treatments may not be as accurate as practitioners believe. Concerning this, the comprehensive quality assurance (QA) programme is required to assure treatment outcome and radiation safety of patient. In this work we present recent QA/QC audit results in 4 out of 7 existing Croatian radiotherapy departments performed during 2014 with special emphasis to estimate potential for safe introduction of advanced radiotherapy techniques into clinical use in audited departments. Method. IMRT imposes high demands on the delivery system, the treatment planning system and the users of these systems which are not always met in practice. The audit was separated in two main parts-one dedicated to clinical and quality procedures and the other to different kinds of equipment as well as human resources of respective department. Results.In all departments high level of awareness regarding the QA/QC programme exists. QA/QC is generally performed in main parts of the processes and comprehensive written procedures were found for them as well. Furthermore, the efforts should be made to produce the specific ones, both in clinical and quality assurance part of the system. Experimental part of the audit included evaluation of the respective treatment machine’s parameters. It shows that quality of vital parameters of treatment machines is well assured in all audited departments. The shortage of medical physics staff in two departments is noted as well. Conclusions.Results show significantly higher awareness regarding QA/QC comparing to audit performed in 2008. when even existence of machine QC written procedures were often missing. Following advances in radiotherapy treatment, the complexity of QA/QC programs also increased. Regarding this, prerequisites for the clinical use of the IMRT are fulfilled in some departments while others have to improve QA programme if IMRT will be introduced in a safe way.

radiotherapy; quality control; advanced technique

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