Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Sir Peter MacCallum Institute of Oncology, Melbourne University, Melbourne, Victoria, Australia.
J Med Imaging Radiat Oncol. 2022 Mar;66(2):279-290. doi: 10.1111/1754-9485.13348.
Radiation Oncology continues to rely on accurate delivery of radiation, in particular where patients can benefit from more modulated and hypofractioned treatments that can deliver higher dose to the target while optimising dose to normal structures. These deliveries are more complex, and the treatment units are more computerised, leading to a re-evaluation of quality assurance (QA) to test a larger range of options with more stringent criteria without becoming too time and resource consuming. This review explores how modern approaches of risk management and automation can be used to develop and maintain an effective and efficient QA programme. It considers various tools to control and guide radiation delivery including image guidance and motion management. Links with typical maintenance and repair activities are discussed, as well as patient-specific quality control activities. It is demonstrated that a quality management programme applied to treatment delivery can have an impact on individual patients but also on the quality of treatment techniques and future planning. Developing and customising a QA programme for treatment delivery is an important part of radiotherapy. Using modern multidisciplinary approaches can make this also a useful tool for department management.
放射肿瘤学继续依赖于精确的放射治疗，特别是在那些可以从更调制和低分割治疗中受益的患者中，这些治疗可以在优化正常组织剂量的同时向目标部位提供更高的剂量。这些治疗更复杂，治疗设备更电脑化，因此需要重新评估质量保证（QA），以更严格的标准测试更多的选择，而不会过于耗时和资源密集。本文探讨了如何利用现代风险管理和自动化方法来开发和维护有效的 QA 计划。它考虑了控制和指导放射治疗的各种工具，包括图像引导和运动管理。讨论了与典型维护和维修活动的联系，以及针对患者的质量控制活动。事实证明，应用于治疗的质量管理计划不仅可以对个别患者产生影响，还可以对治疗技术和未来规划的质量产生影响。为治疗提供 QA 计划的开发和定制是放射治疗的重要组成部分。使用现代多学科方法也可以使这成为部门管理的有用工具。
