Towards Safer Radiotherapy

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Radiotherapy The treatment of disease, usually cancer, using high-energy electromagnetic radiation or particles Radiotherapy error See Section 3.1.2 Radiotherapy treatment pathway The route that a patient will take to the completion of their treatment Radiation incident See Section 3.1.2 Record and verify system (R&V) Computerised system into which planning data is entered and transferred to LinAc and used each fraction to set up the field size and dose to be delivered Reportable radiation incident See Section 3.1.2 Simulator Specialist registrar Therapeutic radiographer Thermoluminescent dosimetry (TLD) Transit dosimetry Treatment parameters Treatment planning system (TPS) Underdose Verification Wedge Yellow Card scheme X-ray device used in radiotherapy to plan the radiotherapy and provide geometric verification of treatment position and set-up A doctor who is receiving advanced training in a specialist field of medicine to become a consultant An individual trained to plan and deliver radiotherapy and all aspects of associated patient care along the radiotherapy treatment pathway A small chip of a special absorbent material (eg, lithium fluoride) is placed in the radiation beam to measure the dose delivered The process to calculate the actual dose delivered to a patient by measuring the dose entering and exiting from the patient Size of treatment fields, use of wedge, angles of beam, number of monitor units etc used to deliver the required radiation dose Computers and specialised software which enables planners to design treatment plans When less radiation has been delivered than was intended The process by which data is confirmed to be correct. For example, confirming data entry or acquiring images to ensure correct patient set-up Used to vary the radiation intensity across a treatment field. Can be used in a treatment plan to ensure an even dose distribution A British scheme for reporting information on adverse events by healthcare professionals and patients to the MHRA 81 Towards Safer Radiotherapy
Abbreviations 82 BIR BSI CNS CPD CT CTV DRR DVH EPIDs ESR e-KSF FSD GP GTV HPA HSE ICRP ICRU IMRT IPEM British Institute of Radiology British Standards Institution Central nervous system Continuous professional development Computer tomography Clinical target volume Digitally reconstructed radiograph Dose volume histogram Electronic portal imaging devices Electronic staff record Electronic Knowledge and Skills Framework Focus-skin distance General Practitioner Gross tumour volume Health Protection Agency Health Services Executive International Commission on Radiological Protection International Commission on Radiation Units and Measurements Intensity modulated radiotherapy Institute of Physics and Engineering in Medicine IR(ME)R Ionising Radiation (Medical Exposure) Regulations 2000 ISO IVD MHRA NATCANSAT NHS NPL International Organisation for Standardisation In vivo dosimetry Medicines and Healthcare products Regulatory Agency National Cancer Services Analysis Team National Health Service National Physical Laboratory Towards Safer Radiotherapy
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IPEM Patient Safety Division The Ro
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Foreword In my Annual Report on the
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• This report contains detailed r
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Chapter 2: Nature and frequency of
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technology tends to impair individu
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Table 2.1. Examples of radiation in
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2.3.3 There was an average of 30 in
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Table 2.5. Errors with > 10 Gy than
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Chapter 3: Defining and classifying
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Near miss Other non-conformance A p
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22 Table 3.1. Examples of classific
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Chapter 4: Prerequisites for safe d
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• The multidisciplinary team of p
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Recommendation All procedures shoul
Page 29 and 30: The audit process should ideally:
Page 31 and 32: tendering process in which the radi
Page 33 and 34: In addition to these scientific and
Page 35 and 36: Recommendation The precise details
Page 37 and 38: 5.6 Verification and checks of trea
Page 39 and 40: known discrepancies between clinici
Page 41 and 42: However, at the present time and in
Page 43 and 44: Staff should be provided with some
Page 45 and 46: Recommendation Each radiotherapy ce
Page 47 and 48: Chapter 6: Learning from errors Tho
Page 49 and 50: 6.2.1.b Voluntary reporting systems
Page 51 and 52: To avoid incorrect speculation and
Page 53 and 54: 7.1.4 Some errors may require a ret
Page 55 and 56: • Externally: Patients should use
Page 57 and 58: Summary of recommendations Departme
Page 59 and 60: 28. Commissioning of radiotherapy e
Page 61 and 62: 62 3b 3c 3d 3e 3f 3g 3h 3i 3j 3k 3l
Page 63 and 64: 9 Mould room/workshop activities 64
Page 65 and 66: 13 Treatment unit process 66 13a 13
Page 67 and 68: 16f 16g Communication of follow-up
Page 69 and 70: Appendix 6.1. Care delivery problem
Page 71 and 72: 15. Girinsky T, van der Maazen R, S
Page 73 and 74: 52. Society and College of Radiogra
Page 75 and 76: 88. Appleyard R, Ball K, Hughes FE
Page 77 and 78: Glossary of terms 78 Anthropomorphi
Page 79: 80 In vivo dosimetry Isocentric Iso
Page 83 and 84: Membership of Working Party Ms Geri
Page 85: The Royal College of Radiologists 3
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Towards Safer Radiotherapy

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