Bogusz-Czerniewicz Marta, Kaźmierczak Daniel
Greater Poland Cancer Centre, 15th Garbary Str., 61-866 Poznań, Poland ; University of Medical Sciences, Poznań, Poland.
Greater Poland Cancer Centre, 15th Garbary Str., 61-866 Poznań, Poland.
Rep Pract Oncol Radiother. 2012 Jun 3;17(4):190-9. doi: 10.1016/j.rpor.2012.05.001.
Indisputably, radiotherapy has become an entirely interdisciplinary specialty. This situation requires efficient planning, verification, monitoring, quality control and constant improvement of all aspects of service delivery, referring both to patients' (including diagnosis, prescription and method of treatment, its justification, realization and follow up) and organizational, technical and physics matters.
The aim of this work was to develop technical, physics and clinical quality standards for radiotherapy. This paper presents chosen standards for each of the aforementioned category.
For the development of quality standards the comparison analysis of EU and Polish acts of law passed between 1980 and 2010 was conducted, the universal industrial ISO norm 9001:2008 referring to quality management system was reviewed. Recommendations of this norm were completed with detailed quality standards based on the author's 11 year work experience and the review of articles on quality assurance and quality control standards for radiotherapy published between 1984 and 2009 and the review of current recommendations and guidelines of American, International, European and National bodies (associations, societies, agencies such as AAPM, ESTRO, IAEA, and OECI) for quality assurance and quality management in radiotherapy.
As a result 352 quality standards for radiotherapy were developed and categorized into the following three groups: (1) organizational standards, (2) physics and technical standards and (3) clinical standards.
Proposed quality standards for radiotherapy, can be used by any institution using ionizing radiation for medical procedures. Nevertheless standards are only of value if they are implemented, reviewed, audited and improved and if there is a clear mechanism in place to monitor and address failure to meet agreed standards.
毫无疑问,放射治疗已成为一门完全跨学科的专业。这种情况要求对服务提供的各个方面进行高效规划、验证、监测、质量控制并持续改进,这涉及患者相关事宜(包括诊断、治疗处方和方法、其合理性、实施及随访)以及组织、技术和物理方面的问题。
本研究的目的是制定放射治疗的技术、物理和临床质量标准。本文介绍了上述每个类别的部分选定标准。
为制定质量标准,对1980年至2010年间通过的欧盟和波兰法律进行了比较分析,回顾了通用的工业ISO质量管理体系标准9001:2008。基于作者11年的工作经验,以及对1984年至2009年间发表的关于放射治疗质量保证和质量控制标准的文章的回顾,以及对美国、国际、欧洲和国家机构(协会、学会、机构,如美国医学物理学会、欧洲放射肿瘤学会、国际原子能机构和欧洲癌症治疗研究与信息组织)当前关于放射治疗质量保证和质量管理的建议及指南的回顾,对该标准的建议进行了补充,制定了详细的质量标准。
最终制定了352项放射治疗质量标准,并分为以下三组:(1)组织标准;(2)物理和技术标准;(3)临床标准。
所提出的放射治疗质量标准可供任何使用电离辐射进行医疗程序的机构使用。然而,只有当这些标准得到实施、审查、审核和改进,并且有明确的机制来监测和处理未能达到商定标准的情况时,它们才具有价值。