Quality and safety considerations in intensity modulated radiation therapy: An ASTRO safety white paper update Journal Article


Authors: Moran, J. M.; Bazan, J. G.; Dawes, S. L.; Kujundzic, K.; Napolitano, B.; Redmond, K. J.; Xiao, Y.; Yamada, Y.; Burmeister, J.
Article Title: Quality and safety considerations in intensity modulated radiation therapy: An ASTRO safety white paper update
Abstract: Purpose: This updated report on intensity modulated radiation therapy (IMRT) is part of a series of consensus-based white papers previously published by the American Society for Radiation Oncology (ASTRO) addressing patient safety. Since the first white papers were published, IMRT went from widespread use to now being the main delivery technique for many treatment sites. IMRT enables higher radiation doses to be delivered to more precise targets while minimizing the dose to uninvolved normal tissue. Due to the associated complexity, IMRT requires additional planning and safety checks before treatment begins and, therefore, quality and safety considerations for this technique remain important areas of focus. Methods and Materials: ASTRO convened an interdisciplinary task force to assess the original IMRT white paper and update content where appropriate. Recommendations were created using a consensus-building methodology, and task force members indicated their level of agreement based on a 5-point Likert scale, from “strongly agree” to “strongly disagree.” A prespecified threshold of ≥75% of raters who select “strongly agree” or “agree” indicated consensus. Conclusions: This IMRT white paper primarily focuses on quality and safety processes in planning and delivery. Building on the prior version, this consensus paper incorporates revised and new guidance documents and technology updates. IMRT requires an interdisciplinary team-based approach, staffed by appropriately trained individuals as well as significant personnel resources, specialized technology, and implementation time. A comprehensive quality assurance program must be developed, using established guidance, to ensure IMRT is performed in a safe and effective manner. Patient safety in the delivery of IMRT is everyone's responsibility, and professional organizations, regulators, vendors, and end-users must work together to ensure the highest levels of safety. © 2022 American Society for Radiation Oncology
Keywords: adult; intensity modulated radiation therapy; drug safety; united states; quality control; consensus; radiation oncology; radiotherapy, intensity-modulated; patient safety; medical society; organization; radiotherapy planning, computer-assisted; responsibility; procedures; societies; humans; human; article; likert scale; multidisciplinary team
Journal Title: Practical Radiation Oncology
Volume: 13
Issue: 3
ISSN: 1879-8519
Publisher: Elsevier Inc.  
Date Published: 2023-05-01
Start Page: 203
End Page: 216
Language: English
DOI: 10.1016/j.prro.2022.11.006
PUBMED: 36710210
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 1 May 2023 -- Source: Scopus
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  1. Yoshiya Yamada
    479 Yamada
  2. Jean Marie Moran
    48 Moran