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QA of treatment delivery equipment: brachytherapy

Introduction

For a safe and accurate dose delivery using brachytherapy many QA issues need to be considered that are different compared to teletherapy such as safety aspects for the patient, the personnel, and the environment. Furthermore, a proper QA programme for brachytherapy consists of tests for both the radioactive sources and the delivery equipment.

Important Principles

A QA programme of brachytherapy should consider all relevant aspects, including verification of prescription, treatment plan, and treatment delivery, as well as radiation safety. Such a QA programme should include a check list describing in detail the methodology with recommended frequencies and tolerances. The methods applied in the tests must be available in the department in written form and the results of the individual checks must be documented in a logbook. The therapeutic goals of a brachytherapy treatment should determine to what extent a QA programme should be developed, taking into account the safety of the patient on the one hand, and the available time and resources on the other. The agreement on such a programme should be a joint decision between all professionals involved in a brachytherapy treatment.

Introduction to References

Many QA aspects of brachytherapy equipment are well covered in a number of textbooks, e.g. the IAEA Handbook and J. Van Dyk's Compendium, as well as in reports of national and international organizations as reviewed in ESTRO Booklet No.8. Some of those textbooks consider radiotherapy in general with brachytherapy as one of the topics. Others such as the GEC ESTRO handbook of brachytherapy, are dedicated more specifically to brachytherapy. The AAPM TG 59 Report discusses QA of high dose rate techniques. The IAEA web site document describes briefly various safety aspects of brachytherapy. More general information can be found in J. Van Dyk's Compendium, in the IAEA Handbook, and in the Handbook of Radiotherapy Physics.