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Quality Management and Safety in Radiation Oncology

  • James A. Purdy
  • Eric E. Klein
  • Philip Poortmans
  • Coen Hurkmans
Chapter
Part of the Medical Radiology book series (MEDRAD)

Abstract

Today’s treatment planning and delivery processes have become much more complex and much less intuitive. These complexities, coupled with the inadequate informatics infrastructure typically found in radiation oncology department and outdated national QM guidelines, have created enormous QM challenges for modern radiation therapy. Communication among the planning team, including physician, resident, simulation therapist, dosimetrist, physicist, and treating therapist, is often cryptic and complicated by the hybrid charting systems (electronic and paper medical records) now commonly used. Multiple imaging modalities are often used to define target volumes, and 4-D imaging is now emerging in routine practice, all complicating the information processing further. In a typical U.S. clinic, over 40% of patients are now managed with IMRT plans using computer-assisted optimization software. Plan data, transferred over a network to the verify and record system and computer controlled linac systems, carry complex specifications for treatment including precise, accurate positioning of MLC leafs, variable dose rates, gantry angles, and, in some instances, a moving treatment table. In many cases, different vendor software systems are utilized, and interoperability is not always robust. With such complex technology and even newer advanced treatment modalities continuing to be implemented, e.g. volume modulated arc therapy (VMAT), updated national QM guidelines/approaches, and development of an efficient and robust treatment delivery verification system must be given higher priority by the profession. This greater complexity found in today’s radiation therapy requires a far stronger teamwork approach, since no individual has all of the skills necessary to insure its maximum quality. Continued assessment and updating of QM methodologies and procedures are urgently needed. This chapter will address all these issues focusing primarily on the United States and European QM experience. 

Keywords

Stereotactic Body Radiation Therapy Gantry Angle Radiation Therapist Treatment Machine Dynamic Wedge 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg  2011

Authors and Affiliations

  • James A. Purdy
    • 1
  • Eric E. Klein
    • 2
  • Philip Poortmans
    • 3
  • Coen Hurkmans
    • 4
  1. 1.Department of Radiation OncologyUniversity of California Davis Medical CenterSacramentoUSA
  2. 2.Department of Radiation OncologyWashington University School of MedicineSt. LouisUSA
  3. 3.Department of Radiation OncologyInstitute VerbeetenTilburgThe Netherlands
  4. 4.Department of Radiation OncologyCatharina HospitalEindhovenThe Netherlands

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