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IROC Houston QA Center S Independent Peer Review Quality Assurance Program for the Veteran Affairs VA Radiotherapy Facilities

P Alvarez

P Alvarez*, A Molineu , J Lowenstein , P Taylor , S Kry , D Followill , UT MD Anderson Cancer Center, Houston, TX


SU-I-GPD-T-234 (Sunday, July 30, 2017) 3:00 PM - 6:00 PM Room: Exhibit Hall

Purpose: In 2010 the VA Administration implemented a QA program for their radiotherapy facilities in order to provide high quality radiotherapy treatments to all veterans. This work describes the program and its findings after two 3 year cycles.

Methods: IROC-H provides 3 different audit services to VA sites: external beam output checks, anthropomorphic phantoms and on-site dosimetry review visits. Annual external beam output checks are performed following IROC-H’s standard procedures. H&N, prostate, lung, SRS head, spine and liver end-to-end QA phantoms are sent to verify advanced radiotherapy delivery modalities. During on-site visits, basic dose calculation parameters are verified, MLC and IGRT tests are performed and QA programs are evaluated. Anthropomorphic phantoms and on-site visits are performed once during each 3 year cycle.

Results: The VA has 39 radiotherapy facilities. In 2010, 426 beam outputs were verified with an average IROC/VA site ratio of 0.998 ± 0.021 (90% of the beams within 3%) while in 2016 for 499 beams, the average was 1.001 ± 0.016 (95% of the beams within 3%). The number of beams outside the 5% criterion decreased from 4 to 1. During the first cycle, IMRT phantoms were irradiated while during the second cycle, SBRT phantoms were irradiated. 28% of the phantoms in the first cycle were SBRT while during the second cycle it was 85%. The pass rate for phantoms was the same for the 1st and 2nd cycles, but the complexity of the phantom treatment increased. Site visit reports averaged 3 recommendations (parameters outside criteria) per institution and 2 recommendations during the 2nd cycle. In general, RT facilities upgraded their RT equipment, delivery modalities and QA programs between visits.

Conclusion: There were noticeable improvements in the performance even with growing complexity in delivery capability at the VA RT facilities peer reviewed by IROC-H.

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