Educational requirements and quality assurance in modern radiotherapy delivery

The delivery of modern radiotherapy is a complex interactive process requiring coordination of many mutually dependent processes. It is essential therefore that it is seen to be delivered as a team process with co-dependent members trained in their specific areas of expertise recognizing the roles of different skills and their integration into the whole process. Few radiation errors are due to machine failure; the majority are due to human error. The weakest component of the quality assurance pathway is often the clinician. This must be addressed by rigorous attention to competency based training and the development of clear clinical guidelines and protocols. The processes involved in the delivery of modern radiotherapy can be broken down into several steps each requiring different skills and levels of expertise and quality assurance. 1. Cancer diagnosis, staging, patient selection and treatment intent. 2. Radiotherapy planning for the specific site of tumour and treatment intent. 3. Target localization. 4. Dosimetry. 5. Implementation of treatment requires transfer of the planning processes and dosimetry to the treatment setting, often involving transfer of complex data from the planning calculations to the treatment machines. 6. Verification