Risk assessment deals with processes, accident-initiating events, barriers and risk ratings to unveil the fragility and weakness of some processes; within this study, specifically related to radiation therapy facilities. Barriers are technical or organizational safety measures put in place to avoid, prevent, detect, control, reduce or mitigate the consequences of an accident once an initiating event has occurred. In this work, radiological risk analysis was performed for a set of 20 Brazilian radiotherapy facilities making use of the freeware sevrra risk-management software. The objective of this study was to define parameters that could be useful in creating an overall risk profile. This profile would be helpful for establishing priorities for decision making and support a risk-informed regulatory process. The most relevant missing barriers in facilities were identified according to three parameters: the 'importance index', 'impacted facilities index' and the 'barrier-effectiveness index'. Barriers such as 'in vivo dosimetry in the first treatment session', 'weekly in vivo dosimetry to detect errors in the dose delivering process', 'annual external audit for the control of reference dose rate' and 'independent verification of calibration by various medical physicists with a different dosimetry equipment' were found to be the most effective in reducing the risk level of the facilities. The present investigation reinforces the need to strengthen the mechanisms that guarantee the effectiveness of such barriers in radiation therapy procedures.
Radiation therapy is a complex treatment modality involving several technological and professional resources as well as a large number of attributions of these professionals with a high degree of interdependence. Thus there are many possibilities of failure in the treatment process that may lead to an accidental exposure. So regulatory agencies have established guidelines in their regulations in order to prevent accidental exposures through security analysis planning and risk management. The System of EValuation of Risk in RAdiotherapy, also known as SEVRRA, is based on the risk matrix methodology and allows the risk assessment of radiation therapy facilities in a prescriptive way, highlighting events leading to high-risk levels and severe consequences for individuals. With SEVRRA it is also possible to establish an importance analysis of the barriers proposed to avoid or mitigate such events.This work aimed to demonstrate the application of SEVRRA for the risk management of radiation therapy facilities. The risk profile of the facility was determined by identifying the highest risk level events, and the barriers of greater impact for the overall risk level. After implementing some missing barriers in the original facility profile, it was achieved a reduction from 31% to 8% in the number of events leading to high-risk level, showing the effectiveness of SEVRRA for the risk management in radiation therapy facilities.
Com o crescente uso clínico de técnicas de radioterapia com modulação da intensidade do feixe (IMRT) tem-se exigido mais esforços no controle da qualidade paciente específico. A grande maioria dos centros de radioterapia do país atualmente garante a qualidade de um plano de tratamento comparando o que foi calculado pelo sistema de planejamento com o que se é medido ao irradiar o plano em um fantoma. Essa rotina de verificação pode tornar-se muito onerosa ao físico-médico em função da complexidade do plano, ou principalmente em função da quantidade de pacientes tratados. Este trabalho busca estabelecer, na rotina do Instituto Nacional de Câncer (INCa) no Rio de Janeiro, Brasil, parâmetros que permitam a validação de um software de verificação secundária de dose, IMSure (versão 3.7, Standard Imaging), em planejamentos de radioterapia por intensidade modulada (IMRT). Uma análise retrospectiva conduzida em planos de pacientes tratados nos últimos sete meses no instituto concluiu que, apenas 6% dos planos são reprovados em análise pelo índice gama executada pelo IMSure, segundo critérios de até 4% de diferença de dose e 4 mm de distância para concordância. Isto significa uma redução de cerca de 94% do tempo gasto na execução de controles de qualidade plano-específico. Tais resultados evidenciam, com algumas ressalvas, o potencial de uso do IMSure na rotina de grandes centros, visto sua praticidade, confiabilidade e rápida execução para os casos analisados.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.