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          To Investigate the Relationship Between end to end Accuracy and Quality Assurance Extent and Depth in Radiotherapy

          Closed for proposals

          Project Type

          Coordinated Research Project

          Project Code

          E24017

          CRP

          1963

          Approved Date

          17 September 2012

          Status

          Closed

          Start Date

          4 June 2013

          Expected End Date

          10 June 2017

          Completed Date

          23 March 2018

          Description

          Institutional protocols that quantify accuracy in Radiotherapy are becoming more important because technological advances have facilitated reduced treatment margins and higher dose gradients. More precise treatment delivery in turn limits the tolerance for error. This approach has resulted in concomitant increases in the amount, extent and depth of quality assurance and professional review points that are needed to ensure safe and effective treatment. Rapid advances in technology do not necessarily enable adequate systematic reflection on the impact of improved quality assurance on the accuracy achievable. It is also known that there is no cost benefit associated with the advanced techniques that demand improved quality assurance (Van de Werf, E. et al, The cost of radiotherapy in a decade of technology evolution. Radioth Oncol (102) 2012 148-153). ?This study aims to establish whether there is a link between the quality assurance effort and the accuracy achievable, as measured by independent end to end phantom tests. A future phase could then confirm whether more accurate radiotherapy translates into improved clinical outcomes.

          Specific objectives

          1. Quantify end-to-end accuracy for 3D conformal radiotherapy with point dose measurements in an anthropomorphic phantom for a range of clinical radiotherapy departments
          2. Quantify end-to-end accuracy for intensity modulated radiotherapy with 1D and 2D dosimetric measurements in an anthropomorphic phantom for a range of clinical radiotherapy departments
          3. Determine the extent and depth of quality assurance activities in radiotherapy departments and correlate with end-to-end accuracy.

          Impact

          1. Providing guidance to the radiotherapy community on the factors influencing quality assurance extent and depth in radiotherapy including staffing levels, patient workload, and complexity of radiotherapy techniques.
          2. Providing guidance to the radiotherapy community on the level of accuracy achievable in radiotherapy through end-to-end testing, particularly in LMI countries, and its link to quality assurance extent and depth.

          Relevance

          The results of the CRP are highly relevant to the current practice of radiotherapy, particularly in LMI countries. The CRP demonstrates that high levels of accuracy in radiotherapy are achievable in LMI countries with associated levels of quality activities dependent on patient workload, staffing levels and complexity of treatment techniques.

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