IAEA E-learning Program Safety and Quality in Radiotherapy

Safety and Quality in Radiotherapy MODULE 1: INTRODUCTION MODULE 1: INTRODUCTION Sections: 1.1 Aim and Structure of the Program 1.2 Quality and Safety – the connection 1.3 Statistics on Incidents in Radiotherapy 1.4 Review of Key Publications In the first of 12 modules we will set the scene for this e-learning program: explore the relationship between safety and quality; briefly review the limited statistics we have on incidents in radiotherapy and conclude with an overview of some of the recent literature.

Safety and Quality in Radiotherapy MODULE 1: INTRODUCTION MODULE 1: INTRODUCTION Sections: 1.1 Aim and Structure of the Program 1.2 Quality and Safety – the connection 1.3 Statistics on Incidents in Radiotherapy 1.4 Review of Key Publications First, let us frame the issue.

Safety and Quality in Radiotherapy MODULE 1: INTRODUCTION Section 1: Aim and Structure of the program OBJECTIVES To appreciate the scope of the cancer problem worldwide To review the role of radiotherapy. To share information on radiotherapy incident. To state the purpose of this Program. So the objectives are to appreciate the scope of the cancer problem worldwide, to review the role of radiotherapy, to remind ourselves that there have been radiotherapy incidents, to state the purpose of this Program.

Safety and Quality in Radiotherapy MODULE 1: INTRODUCTION Section 1: Aim and Structure of the program There were approximately 14,000,000 new cancer cases worldwide in 20121. This number will only increase as populations all over the world continue to live longer. The three most widely used treatment modalities for this potentially lethal disease are surgery, chemotherapy (systemic therapy) and radiotherapy. It is estimated that approximately 50% of cancer patients would benefit from radiotherapy at some stage in the course of their therapy2. There were approximately 14,000,000 new cancer cases worldwide in 2012. This number will only increase as populations in the developed and developing countries continue to live longer. The three most widely used treatment modalities for this potentially lethal disease are surgery, chemotherapy and radiotherapy. It is estimated that approximately 50% of cancer patients would benefit from radiotherapy at some stage in the course of their disease.

Safety and Quality in Radiotherapy MODULE 1: INTRODUCTION Section 1: Aim and Structure of the program For radiotherapy to be maximally effective it must generally be delivered very close to a patient’s tolerance, thus maximizing the probability of cure/palliation while minimizing unacceptable side effects. Small deviations from optimum, evidence based prescription and delivery can compromise the clinical outcome for the patient either through unnecessarily reduced life expectancy and/or unnecessary morbidity3. For radiotherapy to be maximally effective it must generally be delivered very close to a patient’s tolerance, thus maximizing the probability of cure or palliation whilst minimizing unacceptable side effects. Small deviations from optimum, evidence based prescription and delivery can compromise the clinical outcome for the patient either through unnecessarily reduced life expectancy and/or unnecessary morbidity. Accuracy in radiotherapy is critical if the patient is to benefit from the best outcome. The radiation dose must generally be delivered to within a few percent of that prescribed and to within a few millimeters of the location determined by the radiation oncologist.

Safety and Quality in Radiotherapy MODULE 1: INTRODUCTION Section 1: Aim and Structure of the program While radiotherapy is safely and effectively delivered to the vast majority of the patients treated worldwide with this modality, there are certainly opportunities to improve our service to cancer patients. The last two decades have seen an increased awareness of the hazards faced by patients entering the health care system, including radiotherapy. Although the number of reported incidents in radiotherapy is small compared with the number of patients treated everyday with this modality, when incidents do occur, the results can be catastrophic. While radiotherapy is safely and effectively delivered to the vast majority of the patients treated worldwide with this modality, there are certainly opportunities to improve our service to cancer patients. The last two decades have seen an increased awareness of the hazards faced by patients entering the health care system, including radiotherapy. Although the number of reported incidents in radiotherapy is small compared with the number of patients treated everyday with this modality, when incidents do occur, the results can be catastrophic. In the next module we will discuss three recent serious incidents and then use these three incidents as the basis for later discussions.

Safety and Quality in Radiotherapy MODULE 1: INTRODUCTION Section 1: Aim and Structure of the program This e-Learning Program is designed to equip radiotherapy professionals with the knowledge to enhance the safety and quality of their practice and hence to provide patients with optimum outcomes. So here is the purpose of this program. This e-Learning Program is designed to equip radiotherapy professionals with the knowledge to enhance the safety and quality of their practice and hence to provide patients with optimum outcomes. In the next section we will establish the connection between quality and safety in a general way. Once this connection is established, it will follow that the tools and techniques to be discussed later in this e-learning program have the potential not just to make radiotherapy safer but to enhance quality across all clinical activities to the benefit of every patient.

Safety and Quality in Radiotherapy MODULE 1: INTRODUCTION Section 1: Aim and Structure of the program SUMMARY We have: Estimated the scope of the cancer problem worldwide Reviewed the role of radiotherapy. Reminded ourselves that there have been radiotherapy incidents. Stated the purpose of this Program. So just to summarize, we have estimated the scope of the cancer problem worldwide, reviewed the role of radiotherapy, reminded ourselves that there have been radiotherapy incidents, and stated the purpose of this Program.

Safety and Quality in Radiotherapy MODULE 1: INTRODUCTION Section 1: Aim and Structure of the program References and additional resources Globocan. http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx Barton MB, Jacob S, Schafiq J, et al. Estimating the demand for radiotherapy from the evidence: A review of changes from 2003 to 2012. Radiother Oncol 2014;112(1):140 -144. Radiation Biology: A Handbook for Students and Teachers. http://www-pub.iaea.org/MTCD/publications/PDF/TCS-42_web.pdf If you want more information on any of the topics we’ve discussed these references will be useful. As the list shows, there’s a wealth of valuable information on the IAEA website.