Components of quality assurance of radiotherapy process - Setup in the Czech Republic

Full text: Quality assurance (QA) of radiotherapy process consists of many components. It includes a system of internal tests of radiotherapy equipment (acceptance tests, status tests, constancy tests), external tests of radiotherapy equipment (on site audits, TLD postal audits), clinical audits, and inspections. Definitions of these items are presented, as well as description of their aim, content, range, methodology, facture (who performs, how often, budget), acquisition, impact on practice, implementation, etc. Advantages and disadvantages, and related difficulties are described and compared. Legislation, guidelines, recommendations, and standards (international, European, national, ESTRO, IAEA) serve as the bases for QA implementation. According to these documents workplaces introduce QA system, set up QA manual, quality control (QC) procedures, local standards for radiotherapy procedures, and other documents. Particular QA system implementation depends on the national procedures. Actual situation and impact of QA implementation on radiotherapy in the Czech Republic is described as an example. Comparison of all on-site audits of teleradiotherapy equipment performed in 1996-2000 and after 2000 is presented. Selected results of audits of linear accelerators with MLC used for IMRT are given. Experiences from clinical audits of radiotherapy workplaces in the Czech Republic - pilot study - are discussed. (author)