Background
For intensity modulated treatments, most radiotherapy facilities undertake detailed checks for each individual patient plan, known as Patient Specific Quality Assurance (PSQA). PSQA has been found to miss problematic plans[1]. A new approach to assess the ability of a facility’s clinical PSQA to detect errors (SEAFARER) has been introduced[2].
Aims
This work discusses a new phase of the SEAFARER project offering improved and extended sensitivity PSQA checks to facilities in Australia.
Methods
For different treatment sites, universal treatment plans are created that are similar in dose distribution and robustness towards delivery errors across a range of linear accelerators. This is achieved using the fallback planning feature of RayStation(Raysearch Laboratories, Sweden) and representative beam model parameters[3]. Twelve copies of each plan are made, and small but clinically significant treatment delivery errors are introduced. Error significance is assessed through dose volume histogram parameters of the planning target volume and a suitable organ at risk, e.g. the dose to 90% of PTV and the near maximum spinal cord dose. Communication is handled through TROG and with the help of online surveys.
Results
Treatment plans with similar dose distribution and robustness towards errors have been created for different linear accelerators for head and neck treatment as a first site. Fallback planning options have been explored for optimal results. Facilities have started to sign up for SEAFARER Australia and are providing their system information.
Conclusions
Going beyond the traditional audit approach to test a facility’s ability to deliver selected test cases, SEAFARER evaluates local clinically used PSQA procedures. Its impact continues for ongoing PSQA, thus improving quality and impacting many patients. SEAFARER is administered fully remotely. This provides advantages in cost, environmental impact, and logistics. The study will help finding a suitable place for SEAFARER in the portfolio of audit tools.
[1]doi.org/10.1016/j.ijrobp.2014.08.334
[2]doi.org/10.1016/j.radonc.2022.04.019
[3]doi.org/10.1002/mp.13892