- 作者：Gregory A. Russo ; Muhammad M. Qureshi ; Minh-Tam Truong ; Ariel E. Hirsch ; Lawrence Orlina ; Harry Bohrs ; Pauline Clancy ; John Willins ; Lisa A. Kachnic
- 关键词：Image-guided radiation therapy ; Quality assurance ; Radiation therapy ; Safety
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2012
- 出版时间：1 November, 2012
- 年：2012
- 卷：84
- 期：3
- 页码：596-601
- 全文大小：349 K
Purpose
To determine whether the use of routine image guided radiation therapy (IGRT) using pretreatment on-board imaging (OBI) with orthogonal kilovoltage X-rays reduces treatment delivery errors.Methods and Materials
A retrospective review of documented treatment delivery errors from 2003 to 2009 was performed. Following implementation of IGRT in 2007, patients received daily OBI with orthogonal kV X-rays prior to treatment. The frequency of errors in the pre- and post-IGRT time frames was compared. Treatment errors (TEs) were classified as IGRT-preventable or non-IGRT-preventable.
Results
A total of 71,260 treatment fractions were delivered to 2764 patients. A total of 135 (0.19 % ) TEs occurred in 39 (1.4 % ) patients (3.2 % in 2003, 1.1 % in 2004, 2.5 % in 2005, 2 % in 2006, 0.86 % in 2007, 0.24 % in 2008, and 0.22 % in 2009). In 2007, the TE rate decreased by >50 % and has remained low (P = .00007, compared to before 2007). Errors were classified as being potentially preventable with IGRT (e.g., incorrect site, patient, or isocenter) vs. not. No patients had any IGRT-preventable TEs from 2007 to 2009, whereas there were 9?from 2003 to 2006 (1 in 2003, 2 in 2004, 2 in 2005, and 4 in 2006; P = .0058) before the implementation of IGRT.
Conclusions
IGRT implementation has a patient safety benefit with a significant reduction in treatment delivery errors. As such, we recommend the use of IGRT in routine practice to complement existing quality assurance measures.