• Proceedings of the Korean Society of Medical Physics Conference
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• 2006.08a
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• pp.7-8
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• 2006

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.2829-2834
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• 2013

The objective was to analyze the radiotherapy (RT) practice at the cancer centre of a tertiary academic medical institution in Delhi. This audit from an Indian public institution covered patient care processes related to cancer diagnosis, integration of RT with other anti-cancer modalities, waiting time, overall treatment time, and compliance with RT. Over a period of one year, all consecutively registered patients in radiotherapy were analyzed for the audit cycle. Analysis of 1,030 patients showed median age of 49.6 years, with presentation as stage I and II in 14.2%, stage III and IV in 71.2% and unknown stage in 14.6%. A total of 974 (95%) were advised for RT appointment; 669 (68.6%) for curative intent and 31.4% for palliation. Mean times for diagnostic workup and from registration at cancer centre to radiotherapy referral were 33 and 31 days respectively. Median waiting time to start of RT course was 41 days. Overall RT compliance was 75% and overall duration for a curative RT course ranged from 50 days to 61 days. Non-completion and interruption of RT course were observed in 12% and 13% respectively. Radiotherapy machine burden in a public cancer hospital in India increases the waiting time and 25% of advised patients do not comply with the prescribed treatment. Infrastructure, machine and manpower constraints lead to more patients being treated on cobalt (74%) and by two-dimensional (78%) techniques.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.17-18
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• 2002

Last year, a three-year research program was started in order to establish an external audit system to radiotherapy QA in Japan. It consists of questionnaire surveys, mailed (off-site) dosimetry and visited (on-site) dosimetry at radiotherapy facilities in Japan. The first questionnaire was sent to all Japanese radiotherapy facilities in October 2001, surveying basic QA procedures at each facility. 628 answers were returned with the return rate of 87%. In February 2002, the second questionnaire was sent. Off-site and on-site dosimetry have been tested in several facilities, and will be started soon. We anticipates that this program will gradually grow to a radiotherapy quality control center similar to Radiological Physics Center at MD Anderson Hospital.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2006.08a
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• pp.12-12
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• 2006

• Proceedings of the Korean Society of Medical Physics Conference
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• 2004.11a
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• pp.153-156
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• 2004

Korea Food and Drug Administration(KFDA) has peformed the calibration of therapy level dosimeters for Co-60 radiation since 1979. The reference standard ionization chamber has been calibrated at BIPM in France. The uncertainty on the KFDA calibration coefficients is 0.9 %(k=2) for air kerma and absorbed dose to water. Since 1999 a national quality audit program for ensuring dosimetry accuracy in Korea radiotherapy centers has been performed by the KFDA. The uncertainty associated with the determination of the absorbed dose to water from the TLD readings for high energy x-ray is 1.6 %(k=1). The correction factors for energy, non-linearity dose response, and TLD holder are used in the dose determination. Agreement between the user stated dose and KFDA measured dose within ${\pm}$ 5 % is considered acceptable. KFDA TLD postal dose quality audit program was peformed for 71 beam qualities of 53 domestic radiotherapy centers in 2003. The results for quality assurance showed that 63 out of 71 beam qualifies (89 %) satisfied the acceptance limit. The second audit was carried out for the centers outside the limit and ail of them have been corrected.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.547-552
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• 2013

To investigate patient, cancer and treatment characteristics in females with breast cancer from more remote areas of Australia, to better understand reasons for their poorer outcomes, bi-variable and multivariable analyses were undertaken using the National Breast Cancer Audit database of the Society of Breast Surgeons of Australia and New Zealand. Results indicated that patients from more remote areas were more likely to be of lower socio-economic status and be treated in earlier diagnostic epochs and at inner regional and remote rather than major city centres. They were also more likely to be treated by low case load surgeons, although this finding was only of marginal statistical significance in multivariable analysis (p=0.074). Patients from more remote areas were less likely than those from major cities to be treated by breast conserving surgery, as opposed to mastectomy, and less likely to have adjuvant radiotherapy when having breast conserving surgery. They had a higher rate of adjuvant chemotherapy. Further monitoring will be important to determine whether breast conserving surgery and adjuvant radiotherapy utilization increase in rural patients following the introduction of regional cancer centres recently funded to improve service access in these areas.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1675-1682
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• 2012

Aim: The study aim was to determine the frequency with which women decline clinicians' treatment recommendations and variations in this frequency by age, cancer and service descriptors. Design: The study included 36,775 women diagnosed with early invasive breast cancer in 1998-2005 and attending Australian and New Zealand breast surgeons. Rate ratios for declining treatment were examined by descriptor, using bilateral and multiple logistic regression analyses. Proportional hazards regression was used in exploratory analyses of associations with breast cancer death. Results: 3.4% of women declined a recommended treatment of some type, ranging from 2.6% for women under 40 years to 5.8% for those aged 80 years or more, and with parallel increases by age presenting for declining radiotherapy (p<0.001) and axillary surgery (p=0.006). Multiple regression confirmed that common predictors of declining various treatments included low surgeon case load, treatment outside major city centres, and older age. Histological features suggesting a favourable prognosis were often predictive of declining various treatments, although reverse findings also applied with women with positive nodal status being more likely to decline a mastectomy and those with larger tumours more likely to decline chemotherapy. While survival analyses lacked statistical power due to small numbers, higher risks of breast cancer death were suggested, after adjusting for age and conventional clinical risk factors, (1) for women not receiving breast surgery for unstated reasons (RR=2.29; p<0.001); and (2) although not approaching statistical significance $p{\geq}0.200$), for women declining radiotherapy (RR=1.22), a systemic therapy (RR1.11), and more specifically, chemotherapy (RR=1.41). Conclusions: Women have the right to choose their treatments but reasons for declining recommendations require further study to ensure that choices are well informed and clinical outcomes are optimized.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.4993-4998
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• 2013

Background: A retrospective analysis of all cancer patients attending the radiotherapy outpatient department (OPD) of a single unit during the period of January 2005 till December 2006 was conducted to know the geographical distribution and incidence of the most common cancers, their stage of presentation, treatment compliance among the patients and follow-up. Materials and Methods: A total of 4,484 patients were registered in the Institute of Medical Sciences, Banaras Hindu University during the period of January 2005-December 2006; of which 1,975 registered in an individual unit were included for the retrospective analysis. Results: Most of the patients hailed from the various districts of UP and Bihar. Females outnumbered males with a ratio of 1.33:1. Females mostly belonged to the age group of 40-59 years; whilst males were a decade older. Major cancer sites in females were cervix and breast followed by head and neck. Leading cancer sites in males were head and neck, brain, bone, soft tissue and lung. Most of the cases presented in advanced stage of disease (74%). Squamous cell carcinoma was the most common histopathology (56%). A significant proportion of patients defaulted after undergoing preliminary investigations (16%). Only 53.9% of females and 58.5% of males took treatment out of which 68% and 63% completed the prescribed treatment. Compliance with follow-up was poor. Conclusions: The outcome of this study will significantly help us to define region specific strategies needed for cancer management in eastern Uttar Pradesh.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.19-22
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• 2002

The importance of accurate dose delivery in radiotherapy is well documented. Studies have shown that a mere 5% deviation of the prescribed dose can produce an undesirable treatment outcome. Uncertainties in the dose delivery can arise at different stages of the radiotherapy process. Therefore, a good quality assurance programme will ensure the best possible results and consistency of the radiotherapeutic treatment. Quality assurance in any radiotherapy department involves the responsibility of a multi-disciplinary team of radiation oncologists, medical physicists and radiation technologists. This paper will focus on the physical and technical aspects of QA. The organizational structure and responsibility of the physics QA team is outlined and also included the types and frequencies of QA checks. For a QA program to be effective, action levels should be clearly defined and understood by all staff concerned. Data of the Singapore National Cancer Centre's participation over the last ten years with the IAEA / WHO Postal TLD Dose Inter-comparison programme is presented. The data obtained were within the international criteria. For a QA program to be successfully implemented, there must be a commitment by management to provide adequate staff, test equipment, machine time as well as continual training and education. This is in addition to the positive attitudes of all the staff. A quality audit is also necessary to serve as a check and balance to ensure that the QA is in order.

• Progress in Medical Physics
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• v.32 no.4
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• pp.122-129
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• 2021

Purpose: This study aimed to design a multipurpose dose verification phantom for external audits to secure safe and optimal radiation therapy. Methods: In this study, we used International Atomic Energy Agency (IAEA) LiF powder thermoluminescence dosimeter (TLD), which is generally used in the therapeutic radiation dose assurance project. The newly designed multipurpose phantom (MPP) consists of a container filled with water, a TLD holder, and two water-pressing covers. The size of the phantom was designed to be sufficient (30×30×30 cm³). The water container was filled with water and pressed with the cover for normal incidence to be fixed. The surface of the MPP was devised to maintain the same distance from the source at all times, even in the case of oblique incidence regardless of the water level. The MPP was irradiated with 6, 10, and 15 MV photon beams from Varian Linear Accelerator and measured by a 1.25 cm³ ionization chamber to get the correction factors. Monte Carlo (MC) simulation was also used to compare the measurements. Results: The result obtained by MC had a relatively high uncertainty of 1% at the dosimetry point, but it showed a correction factor value of 1.3% at the 5 cm point. The energy dependence was large at 6 MV and small at 15 MV. Various dosimetric parameters for external audits can be performed within an hour. Conclusions: The results allow an objective comparison of the quality assurance (QA) of individual hospitals. Therefore, this can be employed for external audits or QA systems in radiation therapy institutions.