Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48109-5010, USA.
Med Phys. 2011 Sep;38(9):5067-72. doi: 10.1118/1.3600524.
This report on intensity-modulated radiation therapy (IMRT) is part of a series of white papers addressing patient safety commissioned by the American Society for Radiation Oncology's (ASTRO) Target Safely Campaign. The document has been approved by the ASTRO Board of Directors, endorsed by the American Association of Physicists in Medicine (AAPM) and American Association of Medical Dosimetrists (AAMD), and reviewed and accepted by the American College of Radiology's Commission on Radiation Oncology. This report is related to other reports of the ASTRO white paper series on patient safety which are still in preparation, and when appropriate it defers to guidance that will be published by those groups in future white papers. This document takes advantage of the large body of work on quality assurance and quality control principles within radiation oncology whenever possible. IMRT provides increased capability to conform isodose distributions to the shape of the target(s), thereby reducing dose to some adjacent critical structures. This promise of IMRT is one of the reasons for its widespread use. However, the promise of IMRT is counterbalanced by the complexity of the IMRT planning and delivery processes, and the associated risks, some of which have been demonstrated by the New York Times reports on serious accidents involving both IMRT and other radiation treatment modalities. This report provides an opportunity to broadly address safe delivery of IMRT, with a primary focus on recommendations for human error prevention and methods to reduce the occurrence of errors or machine malfunctions that can lead to catastrophic failures or errors.
本报告是美国放射肿瘤学会（ASTRO）目标安全运动委托编写的一系列关于患者安全的白皮书之一，重点介绍调强放射治疗（IMRT）。ASTRO 董事会已批准该文件，美国医学物理学家协会（AAPM）和美国医学剂量师协会（AAMD）也已认可，美国放射肿瘤学会的放射肿瘤委员会已对其进行了审查和接受。本报告与 ASTRO 患者安全白皮书系列中其他仍在编写的报告有关，在适当情况下，本报告将参考这些团体在未来白皮书中发布的指导意见。本文件尽可能利用放射肿瘤学领域内有关质量保证和质量控制原则的大量工作。IMRT 提供了增强的能力，可以使等剂量分布与靶区的形状一致，从而降低相邻关键结构的剂量。这就是 IMRT 得到广泛应用的原因之一。然而，IMRT 的优势被 IMRT 计划和实施过程的复杂性以及相关风险所抵消，其中一些风险已被《纽约时报》关于涉及 IMRT 和其他放射治疗方式的严重事故的报道所证实。本报告为广泛讨论 IMRT 的安全实施提供了一个机会，重点是预防人为错误的建议以及减少导致灾难性故障或错误的错误或机器故障发生的方法。
