[en] Background: Computerized record and verify systems (RVS) have been introduced to improve the precision of radiation treatment delivery. These systems prevent the delivery of ionizing radiations when the settings of the treatment machine do not match the intended parameters within some maximal authorized deviation.
Purpose: To assess the potential alteration of the frequency of errors associated with the use of RVS during radiation treatment delivery.
Materials and methods: The software of the RVS was altered in order to record the settings actually used for radiation treatment delivery whereas the verification function was suppressed. At the end of the study period, the settings used during daily administration of radiation treatment were compared to the parameters recorded in the RVS using the computer. They were also compared with the planned ones written in the patient treatment chart.
Results: Out of the 147 476 parameters examined during the study period, 678 (0.46%) were set erroneously. At least one error occurred in 628 (3.22%) of the 19 512 treated fields. An erroneous parameter was introduced in the RVS memory in 22 (1.17%) of the 1885 fields.
Conclusions: RVS has the potential to improve precision of radiation treatment delivery by detecting a significant number of setting errors. However, excessive confidence in RVS could lead to repeated errors as there is a potential for the entry of erroneous parameters into the RVS memory.
Dutreix A. When and how can we improve precision in radiotherapy? Radiother. Oncol. 2:1984;275-292.
Fraass B.A., Lash K.L., Matrone G.M., et al. The impact of treatment complexity and computer-control delivery technology on treatment delivery errors. Int. J. Radiat. Oncol. Biol. Phys. 42:1998;651-659.
Fredrickson D.H., Karzmark C.J., Rust D.C., Tuschman M. Experience with computer monitoring, verification and record keeping in radiotherapy procedures using a clinac-4. Int. J. Radiat. Oncol. Biol. Phys. 5:1979;415-418.
Green R. The psychology of human error. Atkinson R.S., Adams A.P. Recent advances in anaesthesia and analgesia. 1995;1-15 Churchill Livingstone, Edimburgh.
ICRU 24. International Commission on Radiation Units and Measurements (ICRU), Prescribing, Recording, and Reporting Photon Beam Therapy. ICRU Report 50. Bethesda, Maryland, 1993.
Kartha P.K.I., Chung-Bin A., Wachtor T., Hendrickson F.R. Accuracy in radiotherapy treatment. Int. J. Radiat. Oncol. Biol. Phys. 2:1977;797-799.
Klein E.E., Drzymala R.E., Williams R., Westfall L.A., Purdy J.A. A change in treatment process with a modern record and verify system. Int. J. Radiat. Oncol. Biol. Phys. 42:1998;1163-1168.
Leunens G., Verstraete J., Van den Bogaert W., Van Dam J., Dutreix A., van der Schueren E. Human errors in data transfer during the preparation and delivery of radiation treatment affecting the final result:'garbage in, garbage out'. Radiother. Oncol. 23:1992;217-222.
Macklis R.M., Meier T., Weinhous M.S. Error rates in clinical radiotherapy. J. Clin. Oncol. 16:1998;551-556.
Mohan R., Caley R. Standardization of therapy machine interface for treatment monitoring. Int. J. Radiat. Oncol. Biol. Phys. 9:1983;1225-1229.
Mohan R., Podmaniczky K.C., Caley R., Lapidus A., Laughlin J.S. A computerized record and verify system for radiation treatments. Int. J. Radiat. Oncol. Biol. Phys. 10:1984;1975-1985.
Muller-Runkel R., Watkins S.S. Introducing a computerized record and verify system: its impact on the reduction of treatment errors. Med. Dosim. 16:1991;19-22.
Perez C.A., Gardner P., Glasgow G.P. Radiotherapy quality assurance in clinical trials. Int. J. Radiat. Oncol. Biol. Phys. 10:(Suppl. 1):1984;119-125.
Podmaniczky K.C., Mohan R., Kutcher G.J., Kestler C., Vikram B. Clinical experience with a computerized record and verify system. Int. J. Radiat. Oncol. Biol. Phys. 11:1985;1529-1537.
Rosenbloom M.E., Killick L.J., Bentley R.E. Verification and recording of radiotherapy treatments using a small computer. Br. J. Radiol. 50:1977;637-644.
Valli M.C., Prina M., Bossi A., et al. Evaluation of most frequent errors in daily compilation and use of a radiation treatment chart. Radiother. Oncol. 32:1994;87-89.