Mistakes in Radiation Oncology: A Study of Dosimetric Effects and Pathways

Hossein Kamali^*
*Correspondence: Hossein Kamali, Department of Radiation Oncology, University of Medical Sciences, Mashhad, Iran, Email:

Introduction

Errors are more likely to occur as patient care becomes more complex. Record and Verify (R&V) systems may play a role in error propagation, according to some publications. Direct information move can possibly take out the vast majority of blunders. Furthermore, albeit the dosimetric results might be clear at times, a definite report doesn't exist. We examined potential errors in terms of scenarios, occurrence pathways, and dosimetry in this endeavor. Our objective was to focus on blunder avoidance as indicated by probability of occasion and dosimetric influence. For conventional photon treatments, we investigated geometrical misses caused by incorrect gantry, collimator, or table angle, reversed field settings, and setup errors as well as errors in the Source-To-Surface Distance (SSD), energy, omitted wedge (physical, dynamic, or universal) or compensating filter, incorrect wedge or compensating filter orientation, and improper rotational rate for arc therapy. The investigated errors for electron beam therapy included geometric misses, incorrect SSD, and incorrect energy. Errors in total body irradiation (TBI, incorrect field size, dose rate, and treatment distance) and LINAC radiosurgery (incorrect collimation setting, incorrect rotational parameters) were examined for special procedures. Probability of not entirely settled and along these lines evaluated by our set of experiences of identifying such blunders.

Description

We tracked down mathematical misses to have the most elevated blunder likelihood. Errors in coordinate shifts or incorrect field shaping were the most common causes. The proportion of incorrect fields and mistreated volumes determines the dosimetric impact, which is unique to each instance. Because port films detected these errors quickly, they disappeared quickly. A wedge direction that was in the opposite direction caused the most significant dosimetric error. An incorrect collimator angle or wedge orientation could cause this. In radiation oncology, no one has looked into how global errors affect dosimetry. Errors do and will continue to occur, despite the increased awareness that with increased use of ancillary devices and automation, quality check systems and procedures must also increase. We were able to identify and prioritize potential errors in our clinic based on their frequency and impact on dosimeter thanks to this study. Our clinic, for instance, uses off-axis dosimetry to avoid using an incorrect wedge direction. When setting up fields, we use both the settings for the vertical table and the values for the optical distance indicator to avoid making a treatment distance setup error. As R&V frameworks become more mechanized, more precise and proficient information move will happen [1].

At long last, we have started looking at potential force regulated radiation treatment blunders as indicated by similar models. As the intricacy for arranging and treating radiation oncology patients increments, so does the capability of blunder. This is somewhat because of the expanded interest for auxiliary gadgets and the presentation of new treatment methods and strategies. This headway has not be guaranteed to come all the while with an expansion in confirmation capacity. In point of fact, as the number of daily treatment fields has grown, there has been a simultaneous push to increase automation. Even though the use of Record and Verify (R&V) systems has increased, some authors have suggested that these systems may contribute to the spread of errors because they are often used to improve efficiency rather than quality assurance. However, errors caused by manual data entry and setups will be reduced with the recent introduction of digital data import from treatmentplanning systems and automated treatment setups. As a result, it is essential that radiotherapy department processes and quality assurance procedures adapt to the new electronic environments so that R&V systems reduce rather than increase error propagation. In radiation oncology, no one has looked into how global errors affect dosimeter. Errors do and will continue to occur, despite the increased awareness that automated devices necessitate a parallel increase in quality control systems and procedures [2,3].

Prioritize potential errors in our clinic based on their frequency and impact on dosimetry thanks to this study. For instance, to lessen the utilization of an erroneous wedge course, our facility utilizes off-hub in vivo dosimetry. Incorrect field size, dose rate, and treatment distance were examined in relation to total body irradiatio for special procedures. Using a unique accessory mount, the Varis R&V system locks the field size together. In any case, portion rate isn't interlocked, and there is no functional technique to electronically affirm the lengthy treatment distance on the grounds that the treatment table isn't utilized. We investigated the effects of errors caused by incorrect rotational parameters and collimation settings on LINAC radiosurgery. In this specific study, IMRT was not included. When setting up the fields, we use both the settings for the vertical table and the values for the optical distance indicator to avoid making a treatment distance setup mistake. Clinics should concentrate their CQI efforts on errors with a high frequency and/or high dosimetric impact and longevity, and they should come up with ways to reduce these errors [4,5].

Conclusion

There may be positive or negative effects as the R&V systems become more automated. Autofield sequencing, which automates patient setup and field appropriation, will be welcomed on the one hand. At the same time, these frameworks will likewise have higher levels of availability with treatment arranging and programmatic experience workstations by means of DICOM-RT, in this way working with additional exact and effective information move.

Acknowledgement

None.

Conflict of Interest

No potential conflict of interest was reported by the authors.

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