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EP-1432 MAKING RADIOTHERAPY SAFER: A SURFEIT OF SUGGESTIONS
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provides the service engineer a quick overview of personal service tasks.
Conclusions: The web database for technical errors has become a central tool for effective error correction and systematic preventive maintenance of RT equipment in our department. EP-1432 MAKING RADIOTHERAPY SAFER: A SURFEIT OF SUGGESTIONS P. Dunscombe1 1 Tom Baker Cancer Centre, Medical Physics, Calgary Alberta, Canada Purpose/Objective: Recent years have seen the publication of numerous recommendations, from a variety of organizations, on measures to make radiotherapy safer. With so much advice being offered it is challenging in a resource constrained environment to select, for implementation, those interventions which are most likely to enhance safety and quality. The purpose of this study was to look for commonalities between recommendations made in seven authoritative documents, identify those issues most frequently cited and hence to provide a basis for the allocation of resources in the area of radiotherapy safety and quality. Materials and Methods: Seven authoritative documents addressing safety in radiotherapy have been reviewed. These documents, which include the World Health Organization’s 'Radiotherapy Risk Profile' and the UK’s 'Towards Safer Radiotherapy', contain a total of 116 recommendations. To eliminate duplicates and distil the advice down to those recommendations most frequently endorsed a mapping exercise was undertaken. Using the 37 recommendations in 'Towards Safer Radiotherapy' as the initial base layer, recommendations in the other documents were mapped, adding to the base layer to accommodate all the recommendations from the additional six documents as necessary. This mapping has allowed the elimination of duplicates and the ranking of those general categories of recommendations in the order of the number of documents in which they are identified. Results: The mapping exercise resulted in the distillation of the original 116 recommendations in the seven documents down to 61 unique recommendations. Twelve topics are identified in three or more of the documents as being pertinent to the improvement of patient safety in radiotherapy. They are, in order of most to least cited: training, staffing, documentation, incident learning, communication, check lists, quality control and preventive maintenance, dosimetric audit, accreditation, minimizing interruptions, prospective risk assessment and safety culture. Conclusions: Safety is one dimension of quality and satisfactorily addressing any of the above issues can be expected to enhance the quality of care that radiotherapy patients receive. This analysis provides guidance for the selection of those activities most likely to enhance safety and quality in radiotherapy based on the frequency of citation in selected recent authoritative literature. EP-1433 DEVELOPMENT OF ADVANCED BEAM SCANNING CONTROL SYSTEM FOR PROTON RADIATION THERAPY J. Inoue1, T. Ochi1, T. Morita1, T. Tachikawa1, T. Asaba1, T. Nishio2, R. Kohno2, S. Nishioka2, T. Akimoto2, S. Zenda2 1 Sumitono Heavy IndustriesLtd., Quantum Equipment Division, Niihama, Japan 2 National Cancer Center Hospital East, Particle Therapy Radiation and Oncology Division, Kashiwa, Japan
ESTRO 31
Purpose/Objective: The usage of spot beam scanning for radiation therapy is considered to be increasing in near future. SHI has developed an advanced beam scanning control system for proton radiation therapy in collaboration with NCCHE. In order to secure planned dose distribution, beam current stabilization control and fast beam on/off switching system has been installed. Additionally precise and fast beam position monitoring system has been connected with the beam scanning control system. The purpose of this article is to summarize the design and evaluations of the beam scanning control system for proton radiation therapy from the view point of dosimetry control. Materials and Methods: SHI has adopted the method of continuous line scanning. Under continuous line scanning method, dose distribution is fulfilled by modulated scanning speed and keeping beam current constant. To achieve correct dose distribution, SHI developed advanced beam scanning control system which consists of two main parts. One is a beam current controller which consists of a beam current stabilizer and a fast beam on/off switching system. The other is a scanning controller which includes a scanning control unit and a fast beam position monitor. Results: The performance tests of the beam scanning control system have been conducted. The beam current controller stabilizes the beam current with a mean deviation of less than 1% measured by the dose monitor in the scanning nozzle. The beam current controller also turns on and off by the beam chopper which is located at the center of cyclotron for fast beam switching. The rising and falling time of beam current which is faster than 50m sec has been achieved. The scanning controller detects the beam position within accuracy of 50mm in every 20ms, and evaluates beam position error by comparing the detected position with planned one. When a defect occurs in the operating system and the beam position error exceeds the tolerance of 1mm, the scanning controller stops the beam rapidly. After interruption of the irradiation, if that problem is resolved and system is recovered, the scanning controller resumes the irradiation from the stopped position and completes the planned dose distribution. Conclusions: Development of an advanced beam scanning control system for proton radiation therapy has been conducted and the performance of the system was evaluated. EP-1434 QUALITY ASSURANCE FOR CLINICAL TRIALS IN RADIOTHERAPY C. Melidis1, W.R. Bosch2, J. Izewska3, E. Fidarova4, S. Ishikura5, D. Followill6, J. Galvin7, A. Haworth8, T. Kron8, C.W. Hurkmans9 1 EORTC Headquarters, Quality Assurance in Radiation Therapy, Brussels, Belgium 2 ITC, Radiation Oncology, St Luis, USA; 3 IAEA, Dosimetry Laboratory, Vienna, Austria; 4 IAEA, Applied Radiation Biology and Radiotherapy Section, Vienna, Austria; 5 JCOG, Quality Assurance in Radiation Therapy, Nagoya, Japan; 6 RPC, Radiation Therapy Quality Assurance, Houston, USA; 7 RTOG, Radiation Therapy Quality Assurance, Philadelphia, USA; 8 TROG, Radiation Therapy Quality Assurance, Calvary, Australia; 9 EORTC-ROG, Quality Assurance in Radiation Therapy, Brussels, Belgium Purpose/Objective: Many organizations and cooperative groups performing clinical trials exist worldwide, each performing Quality Assurance (QA) of Radiation Therapy (QART) within their studies to a specific standard. The purpose of this analysis is to present the various procedures of QART within the founding organizations of the global harmonisation of clinical trials radiotherapy QA initiative (ATC, EORTC, IAEA, JCOG, RPC, RTOG and TROG). Materials and Methods: A qualitative description of the established QART procedures used by each of the before mentioned founding organizations has been summarised. Results: Results show that if the trial necessitates advanced, complex planning or treatment radiation techniques, a higher level of QA is required when compared to a trial incorporating standard radiotherapy. The total number of QART procedures ranges between 4 and 6 (see Table), with EORTC and JCOG having 3 procedures before site activation and 2 procedures during and/or after patient accrual, ATC having one procedure before site activation and 5 procedures during and/or after patient accrual and IAEA having 2 procedures before site activation and 2 procedures during and/or after patient accrual. RPC, RTOG and TROG all have 3 procedures before site activation and 3 procedures during and/or after patient accrual. The main differences noted are the names given to each procedure by each group, their frequency of use (periodicity) and the minimum
provides the service engineer a quick overview of personal service tasks.
Conclusions: The web database for technical errors has become a central tool for effective error correction and systematic preventive maintenance of RT equipment in our department. EP-1432 MAKING RADIOTHERAPY SAFER: A SURFEIT OF SUGGESTIONS P. Dunscombe1 1 Tom Baker Cancer Centre, Medical Physics, Calgary Alberta, Canada Purpose/Objective: Recent years have seen the publication of numerous recommendations, from a variety of organizations, on measures to make radiotherapy safer. With so much advice being offered it is challenging in a resource constrained environment to select, for implementation, those interventions which are most likely to enhance safety and quality. The purpose of this study was to look for commonalities between recommendations made in seven authoritative documents, identify those issues most frequently cited and hence to provide a basis for the allocation of resources in the area of radiotherapy safety and quality. Materials and Methods: Seven authoritative documents addressing safety in radiotherapy have been reviewed. These documents, which include the World Health Organization’s 'Radiotherapy Risk Profile' and the UK’s 'Towards Safer Radiotherapy', contain a total of 116 recommendations. To eliminate duplicates and distil the advice down to those recommendations most frequently endorsed a mapping exercise was undertaken. Using the 37 recommendations in 'Towards Safer Radiotherapy' as the initial base layer, recommendations in the other documents were mapped, adding to the base layer to accommodate all the recommendations from the additional six documents as necessary. This mapping has allowed the elimination of duplicates and the ranking of those general categories of recommendations in the order of the number of documents in which they are identified. Results: The mapping exercise resulted in the distillation of the original 116 recommendations in the seven documents down to 61 unique recommendations. Twelve topics are identified in three or more of the documents as being pertinent to the improvement of patient safety in radiotherapy. They are, in order of most to least cited: training, staffing, documentation, incident learning, communication, check lists, quality control and preventive maintenance, dosimetric audit, accreditation, minimizing interruptions, prospective risk assessment and safety culture. Conclusions: Safety is one dimension of quality and satisfactorily addressing any of the above issues can be expected to enhance the quality of care that radiotherapy patients receive. This analysis provides guidance for the selection of those activities most likely to enhance safety and quality in radiotherapy based on the frequency of citation in selected recent authoritative literature. EP-1433 DEVELOPMENT OF ADVANCED BEAM SCANNING CONTROL SYSTEM FOR PROTON RADIATION THERAPY J. Inoue1, T. Ochi1, T. Morita1, T. Tachikawa1, T. Asaba1, T. Nishio2, R. Kohno2, S. Nishioka2, T. Akimoto2, S. Zenda2 1 Sumitono Heavy IndustriesLtd., Quantum Equipment Division, Niihama, Japan 2 National Cancer Center Hospital East, Particle Therapy Radiation and Oncology Division, Kashiwa, Japan
ESTRO 31
Purpose/Objective: The usage of spot beam scanning for radiation therapy is considered to be increasing in near future. SHI has developed an advanced beam scanning control system for proton radiation therapy in collaboration with NCCHE. In order to secure planned dose distribution, beam current stabilization control and fast beam on/off switching system has been installed. Additionally precise and fast beam position monitoring system has been connected with the beam scanning control system. The purpose of this article is to summarize the design and evaluations of the beam scanning control system for proton radiation therapy from the view point of dosimetry control. Materials and Methods: SHI has adopted the method of continuous line scanning. Under continuous line scanning method, dose distribution is fulfilled by modulated scanning speed and keeping beam current constant. To achieve correct dose distribution, SHI developed advanced beam scanning control system which consists of two main parts. One is a beam current controller which consists of a beam current stabilizer and a fast beam on/off switching system. The other is a scanning controller which includes a scanning control unit and a fast beam position monitor. Results: The performance tests of the beam scanning control system have been conducted. The beam current controller stabilizes the beam current with a mean deviation of less than 1% measured by the dose monitor in the scanning nozzle. The beam current controller also turns on and off by the beam chopper which is located at the center of cyclotron for fast beam switching. The rising and falling time of beam current which is faster than 50m sec has been achieved. The scanning controller detects the beam position within accuracy of 50mm in every 20ms, and evaluates beam position error by comparing the detected position with planned one. When a defect occurs in the operating system and the beam position error exceeds the tolerance of 1mm, the scanning controller stops the beam rapidly. After interruption of the irradiation, if that problem is resolved and system is recovered, the scanning controller resumes the irradiation from the stopped position and completes the planned dose distribution. Conclusions: Development of an advanced beam scanning control system for proton radiation therapy has been conducted and the performance of the system was evaluated. EP-1434 QUALITY ASSURANCE FOR CLINICAL TRIALS IN RADIOTHERAPY C. Melidis1, W.R. Bosch2, J. Izewska3, E. Fidarova4, S. Ishikura5, D. Followill6, J. Galvin7, A. Haworth8, T. Kron8, C.W. Hurkmans9 1 EORTC Headquarters, Quality Assurance in Radiation Therapy, Brussels, Belgium 2 ITC, Radiation Oncology, St Luis, USA; 3 IAEA, Dosimetry Laboratory, Vienna, Austria; 4 IAEA, Applied Radiation Biology and Radiotherapy Section, Vienna, Austria; 5 JCOG, Quality Assurance in Radiation Therapy, Nagoya, Japan; 6 RPC, Radiation Therapy Quality Assurance, Houston, USA; 7 RTOG, Radiation Therapy Quality Assurance, Philadelphia, USA; 8 TROG, Radiation Therapy Quality Assurance, Calvary, Australia; 9 EORTC-ROG, Quality Assurance in Radiation Therapy, Brussels, Belgium Purpose/Objective: Many organizations and cooperative groups performing clinical trials exist worldwide, each performing Quality Assurance (QA) of Radiation Therapy (QART) within their studies to a specific standard. The purpose of this analysis is to present the various procedures of QART within the founding organizations of the global harmonisation of clinical trials radiotherapy QA initiative (ATC, EORTC, IAEA, JCOG, RPC, RTOG and TROG). Materials and Methods: A qualitative description of the established QART procedures used by each of the before mentioned founding organizations has been summarised. Results: Results show that if the trial necessitates advanced, complex planning or treatment radiation techniques, a higher level of QA is required when compared to a trial incorporating standard radiotherapy. The total number of QART procedures ranges between 4 and 6 (see Table), with EORTC and JCOG having 3 procedures before site activation and 2 procedures during and/or after patient accrual, ATC having one procedure before site activation and 5 procedures during and/or after patient accrual and IAEA having 2 procedures before site activation and 2 procedures during and/or after patient accrual. RPC, RTOG and TROG all have 3 procedures before site activation and 3 procedures during and/or after patient accrual. The main differences noted are the names given to each procedure by each group, their frequency of use (periodicity) and the minimum