Original articleSafety in Radiation Oncology: The Role of International Initiatives by the International Atomic Energy Agency
Section snippets
Personnel-Related Initiatives
Insufficient numbers of radiotherapy professionals and a lack of adequate training of existing staff members have been found to be among the main causative factors behind radiotherapy incidents and accidents [3, 4, 5]. Several IAEA programs help rectify these problems in its member states.
Radiation Safety Education and Training
A program for education and training in radiation safety for radiation protection officers, regulators, and radiation therapy staff members has been developed, and supporting publications are available [18]. In addition, publications containing information important to safety in radiotherapy (http://www.iaea.org) and standardized training materials on various topics such as the prevention of accidental exposure in radiotherapy are also available at the Web site of the IAEA's Radiation
QA
Most severe accidental exposures have occurred in radiation therapy departments in which QA programs either were not in place or were not fully implemented or monitored [22]. Effective implementation of a radiotherapy QA program requires the support, training, and commitment of every staff member [23, 24]. Training becomes particularly critical when introducing new equipment technology or changing procedures.
Example of Implementation of IAEA Initiatives in a Single Country
The country we describe is on a continent that has scarce radiation oncology facilities. The only available facilities are concentrated mainly in countries in the northern and southern areas of the continent. This limited the technical expertise and support available in radiation oncology and radiation physics in the area. However, the need for radiation oncology services was evident, with 10,000 new cancer patients annually in a population of approximately 12 million. Young patients with
Discussion
Patient safety in radiation therapy can be influenced by many factors. The human error component of these errors can be due to one or more contributing factors. First is the situation in which the professionals involved were not certified or did not have updated training. This can be addressed by training, education, and national certification and benchmarking. An appropriate system of education and training (in the country or abroad) and a process of certification must be in place. In
Conclusions
A comprehensive program that addresses all of these areas of concern, including reporting, analysis, and learning from incidents, is possible and is available through the IAEA. Such programs contribute to the national and international efforts to make radiation therapy safer in all settings, including resource-limited settings. Advance government and professional association planning to prevent shortages of staff members with key roles in safety is encouraged and made possible through
References (32)
- et al.
Radiotherapy with or without mitomycin C in the treatment of locally advanced head and neck cancer: results of the IAEA multicentre randomised trial
Radiother Oncol
(2003) - et al.
Improving patient safety in radiation oncology
Pract Radiat Oncol
(2011) - et al.
Quality assurance in radiotherapyEuropean Society for Therapeutic Radiology and Oncology Advisory report to the Commission of the European Union for the “Europe Against Cancer Programme.”
Radiother Oncol
(1995) - et al.
Integrating the Healthcare Enterprise in Radiation Oncology—IHE-RO
Int J Radiat Oncol Biol Phys
(2010) - et al.
Improving safety in radiation oncology through the development and testing of IHE radiation oncology integration profiles
Int J Radiat Oncol Biol Phys
(2010) - et al.
The IAEA/WHO TLD postal program for radiotherapy hospitals
Radiother Oncol
(2000) - et al.
Preventing accidental exposures from new external beam radiation therapy technologies (ICRP Publication 112)
Ann ICRP
(2009) Radiotherapy risk profile—technical manual
Accidental overexposure of radiotherapy patients in San Jose, Costa Rica
(1998)Investigation of an accidental exposure of radiotherapy patients in Panama
(2001)
Radiation offers new cures, and ways to do harmThe New York Times
Future trends in the supply and demand for radiation oncology physicists
J Appl Clin Med Phys
A syllabus for the education and training of RTTs (radiation therapists/therapy radiographers)
A syllabus for the education and training of radiation oncology nurses (Training Course Series 28)
IAEA syllabus for the education and training of radiation oncologists (Training Course Series 36)
Clinical training of medical physicists specializing in radiation oncology
Cited by (28)
The role of surface-guided radiation therapy for improving patient safety
2021, Radiotherapy and OncologyCore elements of national cancer control plans: a tool to support plan development and review
2019, The Lancet OncologyWorldwide Access to Stereotactic Radiosurgery
2019, World NeurosurgeryCitation Excerpt :The organization assists in obtaining necessary staff and diagnostic, therapeutic, and treatment-planning equipment. Through regional coordination meetings, the IAEA assists existing programs in improving their training and facilities, and through IAEA involvement, several countries have acquired radiotherapy capabilities.1,13,31-33 Projects to implement radiosurgery have also been undertaken by the IAEA, for instance in Uruguay (https://www.iaea.org/projects/tc/uru6038) and Malta (https://www.iaea.org/projects/tc/mat6009).
Assessment of cancer control capacity and readiness: the role of the International Atomic Energy Agency
2017, The Lancet OncologyCitation Excerpt :This mechanism has empowered many member states to offer diagnostic imaging and radiotherapy, thus providing safe, effective, and quality care to patients with cancer.8–10 Safety and quality are key elements to consider when designing support programmes in the field of radiation medicine.11 The IAEA has several quality assurance initiatives, such as the Quality Assurance Team in Radiation Oncology, Quality Assurance in Nuclear Medicine, and Quality Assurance in Diagnostic Radiology, which intend to improve the practice of radiation medicine around the world.8,12