Quality assurance in radiation therapy: clinical and physical aspects. Teletherapy equipment and simulators

A comprehensive Quality Assurance program in a radiation therapy center is desirable regardless of its size, and should cover among others the following areas: physical parameters of the therapy machines, dosimetric standards, preventive maintenance of radiation emitting sources and measuring instruments. In a radiation therapy center, regardless of its size and patient load, it is advisable to have a quality assurance program covering all the treatment planning steps. The following areas should be taken into consideration: physical parameters of the machines; dosimetric standards; radiation safety procedures and preventive maintenance of irradiators and radiation measuring instruments. The minimum instrumentation required and the critical parameters to be observed to establish a quality assurance program are discussed; the suggestions are applicable to the various sizes of radiation therapy centers. It is essential that all the procedures and results obtained are well documented and a critical evaluation of the program be performed periodically. The procedures and frequency suggested are applicable to low, medium and high energy treatment machines and simulators. The fluctuation on physical parameters currently observed in clinical physics practice strongly supports the efforts and costs of a quality assurance program.