Strategies for effective physics plan and chart review in radiation therapy: Report of AAPM Task Group 275.
Strategies for effective physics plan and chart review in radiation therapy: Report of AAPM Task Group 275.
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虽然医学物理学家对放射治疗计划和图表的审查是安全、高质量护理的关键组成部分，但目前对这项任务的具体建议很少。TG-275的目标是为放射治疗的物理计划和图表审查提供实用的、基于证据的建议。虽然这份报告主要针对医学物理学家，但其他人也可能受益，包括剂量学家、放射治疗师、内科医生和其他对质量管理感兴趣的专业人员。该报告的范围包括光子/电子束外放射治疗(EBRT)、质子放射治疗以及妇科应用的高剂量率(HDR)近距离放射治疗(目前是大多数实践中容量最大的近距离放射治疗服务)。考虑以下评审时间点：治疗前的初始评审、每周评审和治疗结束评审。工作组采取了解风险的方法来制定建议。进行了故障模式和影响分析(FMEA)，以确定每个过程的最高风险方面。在光子/电子EBRT的情况下，还对美国医学物理学家协会(AAPM)的所有成员进行了调查，以确定当前的做法。这些数据被用来提供建议。失败风险最高的模式包括光子/电子EBRT初始回顾中的112个失败模式，每周和治疗结束回顾中的55个失败模式，质子治疗的初始回顾中的24个失败模式，以及HDR近距离治疗中的48个失败模式。文中列出了建议的检查表，并讨论了最佳实践的建议。文中还对软件供应商提出了建议。本报告草稿已通过为期三周的公开评议期提供给AAPM正式成员征求意见，并根据这些意见对报告进行了修订。TG-275为物理计划和图表审查提供了具体的建议，这应该会提高接受放射治疗的患者的安全和护理质量。
While the review of radiotherapy treatment plans and charts by a medical physicist is a key component of safe, high-quality care, very few specific recommendations currently exist for this task. The goal of TG-275 is to provide practical, evidence-based recommendations on physics plan and chart review for radiation therapy. While this report is aimed mainly at medical physicists, others may benefit including dosimetrists, radiation therapists, physicians and other professionals interested in quality management. The scope of the report includes photon/electron external beam radiotherapy (EBRT), proton radiotherapy, as well as high-dose rate (HDR) brachytherapy for gynecological applications (currently the highest volume brachytherapy service in most practices). The following review time points are considered: initial review prior to treatment, weekly review, and end-of-treatment review. The Task Group takes a risk-informed approach to developing recommendations. A failure mode and effects analysis (FMEA) was performed to determine the highest-risk aspects of each process. In the case of photon/electron EBRT, a survey of all American Association of Physicists in Medicine (AAPM) members was also conducted to determine current practices. These data were used to inform recommendations. The highest-risk failure modes included 112 failure modes in photon/electron EBRT initial review, 55 in weekly and end-of-treatment review, 24 for initial review specific to proton therapy, and 48 in HDR brachytherapy. Tables of recommended checks are presented and recommendations for best practice are discussed. Suggestions to software vendors are also provided. A draft of this report was provided to the full AAPM membership for comment through a three-week open-comment period, and the report was revised in response to these comments. TG-275 provides specific recommendations for physics plan and chart review which should enhance the safety and quality of care for patients receiving radiation treatments.
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作者：
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