RADIATION-THERAPY PORT FILMS - A QUALITY ASSURANCE STUDY

Purpose: The purpose of this study was to assess the port film accepta nce rate in a large community practice setting and to catalog the reas ons for rejection. Methods: Between December 1993 and July 1996, a qua lity assurance monitor log was maintained on 4,150 patients who underw ent a total of 4,450 treatment courses. Port films mere taken at the b eginning and at the half way point in the treatment course, A total of 20,735 port films were compared with the matching simulation films. W e recorded the site being treated, the radiation oncologist who review ed the films and the reason for rejection. Results: The monthly accept ance rate varied from a low of 67% to a high of 83%, with a gradual up ward trend. The single most common reason for rejecting films was a ce ntering problem-12% of all films taken mere rejected for this reason. The next most common problems were block placement or body setup error s that caused 3.4% and 2.7% of the films to be rejected, respectively. Average acceptance rates between 10 different sites (abdomen, brain, breast, chest, extremities, head and neck, pelvis, prostate, rectum an d spine) varied from 68% to 80%. Individual differences between 12 rad iation oncologists reviewing the films varied from 67% to 87%. Conclus ions: A detailed analysis of field localization errors allowed us to i dentify areas where improvement was needed and suggested that specific guidelines for acceptance would help reduce the variability noted in the acceptance rate between sites and physicians. (C) 1998 Elsevier Sc ience Inc.