Improving safety in radiation oncology

Abstract

As a radiation oncologist, I am proud of the importance our specialty has historically placed on quality assurance and patient safety. Accordingly, I view the events of the last year as a reminder of its importance to our field and an opportunity for us to update our approach to these issues. Dr Marks and his co-authors should be commended for producing such a comprehensive and thoughtful review on the subject.1 In this commentary, I would like to highlight some of the issues that I feel are particularly worthy of future action. The article appropriately starts with a comprehensive review of existing data on error rates in radiation oncology. I found the relative paucity of these data and the nonuniform manner in which they have been collected striking. Contrast these data with the number of reports on the treatment of prostate cancer with radiation therapy using the consensus definition of prostate specific antigen failure published in a single month! If we are going to have a clear understanding of the magnitude of the problem and where we need to intervene (and if the intervention was successful), then we need better error and near-miss reporting data collection and reporting systems at both the national and departmental levels. I agree wholeheartedly with the authors' suggestion that such systems will allow for greater awareness across the specialty of serious, (but sometimes very rare) events, and for local improvements, respectively. It will also greatly facilitate safety-related research in radiation oncology.