111 / 1082
S98
ESTRO 36 2017
_______________________________________________________________________________________________
With the development of advanced radiotherapy
technologies resulting in greater complexity of radiation
treatments, it was necessary to extend basic dosimetry
audits. More complex audit programmes involve tests of
different beam parameters, machine performance
characteristics and treatment delivery techniques.
Examples include audits of small beam dosimetry,
complex irradiations, combined beams, audits of
treatment planning, and ‘end-to-end’ methodologies.
Although the accurate clinical dosimetry is essential for
the effective radiation treatment, the desired patient
outcome cannot be achieved without the adequate quality
of clinical, physical and technical processes. A
comprehensive IAEA audit methodology called the Quality
Assurance Team for Radiation Oncology (QUATRO) was
developed to review the entire radiotherapy chain and
infrastructure. Since 2005 QUATRO audits have been
conducted in approximately 90 radiotherapy centres in
various world regions.
The experiences above demonstrate that quality audits
improve dosimetry and clinical practices. Audits have
been effective in identifying discrepancies in dosimetry
and in providing support to participating centres in
resolving them. Audits can lessen the likelihood of major
dosimetry errors and the resulting consequences for
patient outcomes. Audits also address smaller errors and
help in reducing uncertainties in the dose delivery thus
improving the treatment quality for many patients. Audits
can provide support and confidence when introducing new
technologies and complex processes in radiotherapy.
Audits verify the consistency of dosimetry practices among
centres in different countries and world regions. They
strengthen the confidence in clinical dosimetry both for
physicists and clinicians who obtain assurance that their
patients are given accurate doses in accordance with
medical prescription.
The significance of quality audits in radiotherapy and their
impact on dosimetry and clinical practices have been
widely recognized. Still, a large number of radiotherapy
centres do not participate in such audit programmes. Due
to obvious benefits, all centres should be encouraged to
take part in quality audits in radiotherapy.