Abstract
The Brazilian Institute of Radiation Protection and Dosimetry (IRD/CNEN) carried out quality assurance regulatory audits in Brazilian radiotherapy facilities from 1995 to 2007. In this work, the set of data collected from 195 radiotherapy facilities that use high‐energy photon beams are analyzed. They include results from audits in linear electron accelerators and/or Co‐60 units. The inspectors of IRD/CNEN performed the dosimetry of high‐energy radiotherapy photon beams according to the IAEA dosimetry protocols TRS 277 and TRS 398, and the values of measurements were compared to stated values. Other aspects of radiological protection were checked during on‐site audits such as calibration certification of clinical dosimeters and portable monitors, existence and use of check source, use of barometer and thermometer, individual dose registry and training of staff. It was verified that no check source was available in 38% of the visited facilities; the training of personnel was not adequate in 9% of the facilities and the registry of accumulated individual doses was not being done in 6% of the facilities. Measurements of absorbed dose have indicated deviations in the range ± 3% for 67.6% of the cobalt‐60 units and 79.6% of medical linear accelerators; 18.5% of Co‐60 irradiators and 9.6% of linear accelerators presented deviations in the range 3% <δ≤ 5%. Finally, 13.9% of Co‐60 facilities and 10.8% of linear accelerator facilities presented dosimetry deviations above 5%. The effort in dosimetric quality control performed by IRD/CNEN audits has yielded positive changes that make radiation treatment facilities more reliable.PACS number: 87.55.Qr
Highlights
Quality assurance in radiotherapy is broad in scope, encompassing all activities needed to ensure the safe, accurate and consistent implementation of the physician’s prescription
Another item taken into account was the validity of the calibration factor of survey monitors and clinical dosimeters employed by the radiation safety officers and the medical physics staff working in the radiotherapy facility
IRD/Commission of Nuclear Energy (CNEN) audits in radiotherapy facilities were very effective during the 13 years analyzed in this investigation, helping to identify different kinds of nocompliances and contributing to more accurate and consistent radiotherapy in Brazil
Summary
Quality assurance in radiotherapy is broad in scope, encompassing all activities needed to ensure the safe, accurate and consistent implementation of the physician’s prescription. One very important part of overall quality assurance is quality control. Quality control is the regulatory process used to measure actual quality performance, based on existing national standards and international recommendations, and the actions necessary to keep or to recuperate conformance with those standards and recommendations. The quality control process should be carried out by the radiotherapy facility staff, at a very important fundamental stage, and by the regulatory authority. The regulatory authority executes that task through quality audits. A quality audit is a systematic and independent examination to determine whether quality activities and results comply with planned arrangements, and whether the arrangements are effectively implemented and suitable to achieve the stated objectives. Quality audits should be performed by personnel not directly responsible for the areas being audited, preferably in cooperation with the incumbent staff
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