title: The ESTRO-QUALity assurance network (EQUAL).
abstract: OBJECTIVE
  ESTRO has set up a Quality Assurance network (EQUAL) to check the dose delivered on axis in reference and non-reference conditions for external radiotherapy. The external audits covered by the network are based on measurements made with mailed thermoluminescent dosimeters (TLD).
  
  
  METHODS
  The TLD consist of LiF powder type DTL 937 read with a PCL 3 automatic TLD reader. The participating centres are instructed to deliver to the TLDs absorbed doses of 2 Gy calculated with the Treatment Planning System used in clinical routine. A maximum of three photon energies by participating centre have been checked with 10 on-axis points per beam. The quantities checked include the reference beam output, beam output variation with collimator opening, depth dose data and wedge transmission factor.
  
  
  RESULTS
  During the 1998 EQUAL programme 102 centres have been checked corresponding to 235 beams (28 (60)Co beams and 207 X-ray beams). About 3% of the outputs in reference conditions show deviations outside tolerance level (>+/-5%). A similar rate of deviation is noted for the percentage depth doses. A rate of deviation (6%) has been observed for the beam output variation (open and wedged beams) and the wedge transmission factor. The analysis of the results shows that for 24 out of the 102 centres, a deviation outside tolerance level is observed at least in one point, mainly for the large and rectangular field sizes and for the wedged beams.
  
  
  CONCLUSIONS
  The results for the EQUAL programme show the importance of a quality assurance network in Radiotherapy especially for the non reference points even if they are only located on the beam axis (In order to participate in this network, please contact EQUAL secretariat or download the attached application form ESTRO web site: Dr I.H. Ferreira or Mrs Aline Mechet, EQUAL-ESTRO, Physics Department, Institut Gustave-Roussy 39 Rue Camille Desmoulins, F-94805 Villejuif Cedex, France. e-mail:equal@igr.fr or http://www.estro.be/).
authors.affiliation: EQUAL Measuring Laboratory, Service de Physique, Institut Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif, France. equal@igr.fr
authors.forename: I H
authors.initials: IH
authors.lastname: Ferreira
authors.forename: A
authors.initials: A
authors.lastname: Dutreix
authors.forename: A
authors.initials: A
authors.lastname: Bridier
authors.forename: J
authors.initials: J
authors.lastname: Chavaudra
authors.forename: H
authors.initials: H
authors.lastname: Svensson
mesh_terms: D006801:Humans; D015588:Observer Variation; D011785:Quality Assurance, Health Care; D011829:Radiation Dosage; D011874:Radiometry / Q000592:standards*; D011878:Radiotherapy / Q000592:standards*; D012189:Retrospective Studies