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放射治疗中的医学物理:保留临床职责以及扩大该专业在研究、教育和质量控制方面作用的重要性。

Medical physics in radiotherapy: The importance of preserving clinical responsibilities and expanding the profession's role in research, education, and quality control.

作者信息

Malicki Julian

机构信息

University of Medical Sciences, Electroradiology Department, Garbary 15, 61-866 Poznan, Poland ; Greater Poland Cancer Centre, Medical Physics Department, Garbary 15, 61-866 Poznan, Poland ; Adam Mickiewicz University, Medical Physics Department, Umultowska 85, 61-614 Poznan, Poland.

出版信息

Rep Pract Oncol Radiother. 2015 May-Jun;20(3):161-9. doi: 10.1016/j.rpor.2015.01.001. Epub 2015 Feb 19.

Abstract

Medical physicists have long had an integral role in radiotherapy. In recent decades, medical physicists have slowly but surely stepped back from direct clinical responsibilities in planning radiotherapy treatments while medical dosimetrists have assumed more responsibility. In this article, I argue against this gradual withdrawal from routine therapy planning. It is essential that physicists be involved, at least to some extent, in treatment planning and clinical dosimetry for each and every patient; otherwise, physicists can no longer be considered clinical specialists. More importantly, this withdrawal could negatively impact treatment quality and patient safety. Medical physicists must have a sound understanding of human anatomy and physiology in order to be competent partners to radiation oncologists. In addition, they must possess a thorough knowledge of the physics of radiation as it interacts with body tissues, and also understand the limitations of the algorithms used in radiotherapy. Medical physicists should also take the lead in evaluating emerging challenges in quality and safety of radiotherapy. In this sense, the input of physicists in clinical audits and risk assessment is crucial. The way forward is to proactively take the necessary steps to maintain and advance our important role in clinical medicine.

摘要

长期以来,医学物理师在放射治疗中一直发挥着不可或缺的作用。近几十年来,医学物理师从直接负责放射治疗计划的临床工作中逐渐但明确地退了出来,而医学剂量师承担了更多责任。在本文中,我反对这种从常规治疗计划中逐渐退出的做法。至关重要的是,物理师至少在一定程度上要参与每个患者的治疗计划和临床剂量测定;否则,物理师就不能再被视为临床专家。更重要的是,这种退出可能会对治疗质量和患者安全产生负面影响。医学物理师必须对人体解剖学和生理学有扎实的理解,才能成为放射肿瘤学家称职的合作伙伴。此外,他们必须对辐射与身体组织相互作用的物理原理有透彻的了解,还要理解放射治疗中使用的算法的局限性。医学物理师还应带头评估放射治疗质量和安全方面新出现的挑战。从这个意义上说,物理师在临床审核和风险评估中的投入至关重要。前进的方向是积极采取必要措施,在临床医学中保持并提升我们的重要作用。

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