Radiation Protection of Patients in External Beam Radiotherapy: Introduction of the topic

The benefits of radiotherapy can be summarized in the following statement: radiotherapy saves lives, prolongs lives and improves quality of life. On the other hand, to achieve these benefits, normal tissue often receives radiation doses that are on the upper edge of tolerable doses, as a result of which, accidental overdosage has sometimes had devastating consequences; in addition, underdosage, which may not always be detected timely, can also lead to severe consequences. A step-by-step approach is suggested for the prevention of accidental exposures in radiation therapy: (i) design and implementation of a quality and safety programme in accordance with safety standards and quality protocols; (ii) use of lessons from accidental exposures to test whether the quality and safety programme has some gaps or vulnerable aspects; and (iii) use of an anticipative approach to find other latent risks by posing the question 'What else could go wrong?' in all steps of the radiotherapy process and evaluating the list of potential events according to a combination of likelihood and severity of outcome. This rational approach facilitates focusing the efforts on a limited number of higher risk events. (author)