Radiation therapy (Radiotherapy) is a speciality in medicine that uses ionising radiation for the treatment or management of cancer. Radiotherapy techniques use high energy x-rays or charged particles to deliver tumoricidal dose that leads to the destruction of cancer cells. The effectiveness of the radiotherapy treatment lies in the accuracy of radiation-dose delivery to the cancer site. Treatments with ionising radiation are regarded as high-risk procedures. The risks associated with radiotherapy are managed through a robust quality assurance programme.
With continuous advancements in radiotherapy technology and increased adoption of more complex treatment techniques, radiotherapy quality audit plays an important role in reducing the likelihood of accidents and errors occurring during patient treatments. This is achieved through independent assessment of the methods and processes used for treatment delivery. There are various levels of dosimetry audits for radiotherapy with varying complexities that have been carefully designed to meet the requirement of a range of clinical needs.
Dosimetry audits are independent peer reviews of the dosimetry practice in the clinic. They pose as an effective tool for quality assurance in clinical dosimetry practice and assist with identifying any anomalies and providing support in their resolution. International organisations such as the International Atomic Energy Agency (IAEA) in collaboration with the World Health Organisation (WHO) have been running dosimetry quality audits in radiotherapy since 1969. This practice has helped improve accuracy and consistency in clinical dosimetry for participating hospitals resulting in high quality treatments.
The National Metrology Institute of South Africa (NMISA) has established a national capability with the assistance of the International Atomic Energy Agency (IAEA). This capability enables radiotherapy centres to have access to audits more frequently for reference dosimetry and technique specific audit. Prior to the use of newly installed treatment machines for clinical practice or implementation of new and advanced treatment techniques, NMISA’s audit team can assist with validation through an assessment process. Participation in peer review audits has been made a requirement for centres wanting to participate in international clinical trials.
NMISA is mandated by Measurement Units and Measurement Standards Act, 2006 (Act No. 18 of 2006) to provide for the accuracy and international recognition of local measurement results. The accuracy of measurement results can be demonstrated by ensuring that these are traceable to the National Measurement Standards (Government Gazette No. 1131,19 October 2018) realised and maintained by NMISA.
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