QA of data transfer from planning to delivery
The patient treatment chart is accompanying the patient during the entire process of radiotherapy. Any mistake made at the data entry of the patient treatment chart is likely to be carried through the whole treatment. QA of the patient treatment chart is therefore essential. An independent dose (MU) calculation at one or more points, which is often recognised as an appropriate QA tool for 3D conformal radiotherapy, may also be adequate for IMRT verification in combination with a comprehensive QA programme of linac performance.
Treatment charts should be reviewed regularly, and signed and dated by the reviewer. A QA team should define which items are to be reviewed, who is to review them, when are they to be reviewed, the definition of minor and major errors, and what actions are to be taken in the event of errors. Basic components of a patient treatment chart that should be checked include patient name and ID, photograph, treatment summary and treatment planning data. All planning data, as well as modifications entered during the planning and treatment delivery process, should be independently checked. These checks concern verification of plan integrity, and all irradiation parameters including the MU calculation.
Introduction to References
QA of treatment planning and independent MU calculations are discussed in the Handbook of Radiotherapy Physics and in the IAEA Handbook. Guidelines under Acceptance testing, Commissioning and Quality Control of Record and Verify Systems are published in the IAEA Human Health Report No. 7. ESTRO Booklet 3 is a comprehensive formalism for independent MU calculations of photon beams.