Towards Safer Radiotherapy

5.6 Verification and checks of treatment plans
All treatment plans must be subject to a series of well-defined checks and verifications,
documented in protocols. In general, the number of procedures will be greater as the complexity of
a treatment increases. However, even the simplest palliative treatment plans require rigorous if
simple checks.
The planning process usually requires input from more than one operator. In particular, the role of
the prescriber and planner overlap, but are distinct. The term ‘planner’ is used here to cover a
member of a professional group who is entitled by the employer on the basis of assessed
competence to carry out defined treatment planning tasks as an operator.
Radiotherapy protocols generally require that the prescriber signs both the prescription and the
radiotherapy plan to authorise it. However, other staff groups – such as appropriately trained
dosimetrists – can authorise plans according to locally agreed protocols. The precise responsibilities
under IR(ME)R should be specified by the employer. The prescriber is acting as a practitioner
justifying the exposure, and the dosimetrist, if authorising plans, is acting as an operator.
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There are several aspects of treatment plans that must be checked before the planned parameters
are transferred, either manually or electronically through a network, to the treatment machine.
These can be categorised broadly as:
• Verification of input information
• Checks during the planning process
• Verification of the output information.
Examples of checks and verifications are given in Table 5.2. This is not an exhaustive list. Individual
departments need to ensure that their checks and verification procedures are appropriate for their
equipment and practice.
Towards Safer Radiotherapy