Aubrie Rice

DOS 516
Radiation Safety

Radiation Safety
Aubrie Rice
rice.aubrie@uwlax.edu
The University of Wisconsin - La Crosse

Aubrie Rice
DOS 516
Radiation Safety
The field of radiation therapy has recently stirred some anxiety when it comes to the

general public. Due to many different reasons, fears and misconceptions have arisen that include
fear for their own safety as well as the safety of the patients in which we are treating. The media

is one major contributing factor when it comes to the publics concern about the field of radiation
therapy.1 The New York Times featured stories of serious, some fatal, radiation overdoses in

2010 in an article titled, Radiation offers new cures, and ways to do harm. 2 This article, along
with other media attention on radiation therapy errors sparked a major concern with the public. 1
What might ease the fears and clear up the misconceptions that the public have is more

knowledge on what radiation therapy departments do in order to ensure the safety of their

patients. Radiation therapy departments take many precautions in order to ensure that patients are
safe and that they are receiving accurate treatments. These precautions include multiple quality
assurance (QA) testing for not only the equipment being used but also for each patients

treatment plan.3 Radiation therapy departments most often require certification of their radiation
therapists and take steps to ensure their competency in ways such as continued education and
skills assessments.1

When it comes to the publics fear of their own safety when it comes to radiation therapy,

knowledge of the shielding of rooms containing linear accelerators may ease this anxiety. As
Khan states, protective barriers for radiation therapy rooms are designed so that the dose

equivalent received by any person does not exceed the maximum permissible value. 4 The

calculations that solve for how much shielding is needed are complex calculations that involve

multiple aspects including whether the area falls within the primary beam, energy of the beam,
occupancy, distance, and workload.4,5 A radiation protection survey is also performed by a

physicist as soon as the first beam is generated after machine installation. 5 An ion chamber
survey meter is used to check all barriers and ensure that the dose in areas near the linear
accelerator does not exceed the limits.5

Knowledge about the quality assurance testing measures that radiation therapy

departments take in order to ensure proper machine function would be another way to ease fears
or misconceptions held by the public. The AAPM Task Group 142 report outlines the various
quality assurance testing recommendations that many radiation therapy departments follow. 6
Certain QA checks are performed daily, monthly and yearly and according to the procedure

Aubrie Rice
DOS 516
Radiation Safety
(non-IMRT, IMRT, SBRT) they must pass these QA tests within a certain tolerance. For

example, a daily check that must be performed is for x-ray output constancy. This test must pass
within a 3% tolerance for all procedures. Another check, which is performed monthly, is the

light/radiation field coincidence test which must pass within a 2mm or 1% tolerance per side. 6
Due to the multiple quality assurance tests that radiation departments perform, accuracy and
safety of treatments is ensured.

Radiation therapy departments also take measures to ensure patient safety by

recommending certification as well as continued education and skills assessments of their

radiation therapists.1 Although some states do not have licensing regulations for radiation

therapists, many do and those who do not are still encouraged by accreditation programs to hire
ARRT certified radiation therapists.1 In order to maintain their certification status, radiation
therapists must sustain a level of expertise and remain aware of changes and advances in

radiation therapy practice which requires them to complete 24 hours of continued education

requirements every two years.1 Accreditation programs also recommend two therapists per linear
accelerator for patient safety due to the increasing demands of QA policies and procedures. 1

Many administrators also require skills competency tests in areas such as in CT simulation and
IMRT procedures.1

Radiation therapy can be a dangerous field if the correct steps are not taken to ensure

patient and public safety. Although, due to the multiple precautions that a radiation therapy
department takes, radiation therapy is overall a pretty safe field. These precautions include

shielding of the linear accelerator room, preforming a radiation protection survey, completing
quality assurance testing procedures, and hiring certified and education radiation therapists to

carry out the treatments. In addition to ensuring safety, these measures also allow for precise and
accurate treatment of patients. Quality assurance testing works to ensure that the dose delivered
to the patient does not deviate significantly from the prescribed dose by assuring that the

machine characteristics do not deviate more than 5% from the values acquired at the time of

commision.6 In testing these characteristics, we can warrant more accurate treatments for our
patients.

Aubrie Rice
DOS 516
Radiation Safety
References
1. Odle T, Rosier N. Radiation Therapy Safety: The Critical Role of the Radiation Therapist.

ASRT. https://www.asrt.org/docs/default-source/whitepapers/rt-safety---the-critical-role-ofthe-rad-therapist.pdf?sfvrsn=2. Accessed October 25, 2016.

2. Bogdanich W. Radiation offers new cures, and ways to do harm. The New York Times.

January 23, 2010. www.nytimes.com/2010/01/24/health/24radiation.html?ref=radiation

_boom. Accessed October 25, 2016.

3. Ishikura S. Quality assurance of radiotherapy in cancer treatment: toward improvement of

patient safety and quality of care. Jpn J Clin Oncol. 2008;38(11):723-9.

4. Khan, FM. The Physics of Radiation Therapy. 5th ed. Philadelphia, PA: Lippincott Williams
& Wilkins; 2014. Chapter 16.

5. McDermott PN, Orton CG. The Physics & Technology of Radiation Therapy. Madison, WI:
Medical Physics Publishing; 2010. Chapter 17.

6. Klein EE, Hanley J, Bayouth J, et al. Task Group 142 report: quality assurance of medical
accelerators. Med Phys. 2009;36(9):4197-212.