Comprehensive Qa for Radiation Oncology

Published by the American Association of Physicists in Medicine DISCLAIMER: This publication is based on sources and information believed to be reliable, but the AAPM and the editors disclaim any warranty or liability based on or relating to the contents of this publication. The AAPM does not endorse any products, manufacturers, or suppliers. Nothing in this publication should be interpreted as implying such endorsement. PREFACE This document is the report of a task group of the Radiation Therapy Committee of the American Association of Physicists in Medicine and supersedes the recommendations of AAPM Report 13 (AAPM, 1984). The purpose of the report is twofold. First, the advances in radiation oncology in the decade since AAPM Report 13 (AAPM, 1984) necessitated a new document on quality assurance (QA). Second, developments in the principles of quality assurance and continuing quality improvement necessitated a report framed in this context. The title " Comprehensive Quality Assurance for Radiation Oncology " may need clarification. While the report emphasizes the physical aspects of QA and does not attempt to discuss issues that are essentially medical (e.g., the decision to treat, the prescription of dose), it by no means neglects issues in which the physical and medical issues intertwine, often in a complex manner. The integrated nature of QA in radiation oncology makes it impossible to consider QA as limited to, for example, checking machine output or calibrating brachytherapy sources. QA activities cover a very broad range, and the work of medical physicists in this regard extends into a number of areas in which the actions of radiation oncologists, radiation therapists, 1 dosimetrists, accelerator engineers, and medical physicists are important. Moreover, this is true for each of the disciplines-each has special knowledge and expertise which affects the quality of treatment , and each discipline overlaps the others in a broad " gray zone. " It is important not only to understand each discipline's role in QA, but to clarify this zone so that errors do not " fall between the cracks. " This report therefore attempts to cover the physical aspects of QA both in a narrow or traditional sense and in a more integrated sense. The report comprises 2 parts: Part A is for administrators, and Part B is a code of practice in six sections. The first section of Part B describes a comprehensive quality assurance program in which the importance of a written procedural …