title: A review of safety, quality management, and practice guidelines for high-dose-rate brachytherapy: executive summary.
abstract: This white paper was commissioned by the American Society for Radiation Oncology (ASTRO) Board of Directors to evaluate the status of safety and practice guidance for high-dose-rate (HDR) brachytherapy. Given the maturity of HDR brachytherapy technology, this white paper considers, from a safety point of view, the adequacy of general physics and quality assurance guidance, as well as clinical guidance documents available for the most common treatment sites. The rate of medical events in HDR brachytherapy procedures in the United States in 2009 and 2010 was 0.02%, corresponding to 5-sigma performance. The events were not due to lack of guidance documents but failures to follow those recommendations or human failures in the performance of tasks. The white paper summarized by this Executive Summary reviews current guidance documents and offers recommendations regarding their application to delivery of HDR brachytherapy. It also suggests topics where additional research and guidance is needed.
authors.affiliation: Department of Medical Physics, University of Wisconsin, Madison, Wisconsin. Electronic address: brthomad@wisc.edu.
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Thomadsen
authors.affiliation: Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Erickson
authors.affiliation: Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Eifel
authors.affiliation: Department of Radiation Oncology, University of California San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, California.
authors.forename: I-Chow
authors.initials: IC
authors.lastname: Hsu
authors.affiliation: Western Radiation Oncology, Mountain View, California.
authors.forename: Rakesh R
authors.initials: RR
authors.lastname: Patel
authors.affiliation: Department of Radiation Oncology, John T. Vucurevich Cancer Care Institute, Rapid City Regional Hospital, Rapid City, South Dakota.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Petereit
authors.affiliation: Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Benedick A
authors.initials: BA
authors.lastname: Fraass
authors.affiliation: Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Rivard
mesh_terms: D001918:Brachytherapy / Q000379:methods* / Q000592:standards*; D006801:Humans; D061214:Patient Safety; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care; D018787:Radiation Oncology / Q000379:methods* / Q000592:standards*; D014481:United States