Protokół terapeutyczny w dokumentowaniu procesu napromieniania pacjentów w zakładzie radioterapii

SummaryA decision to start radiotherapy should be based on at least two documents:1.Written standards of obligatory clinical procedures which are in fact radiotherapeutic schemes.2.Therapeutic protocols describing all mandatory procedures performed to ensure a safe and proper treatment of the patient.The range of activities described in the therapeutic protocol is very wide.It includes all initial procedures implemented in the simulation room, the CT scanner, in the treatment planning system and the mould- room, and it describes the verification process of the treatment plan, mandatory to start radiotherapy.The therapeutic protocol describes in details what and how should be checked by an internal control system and it qualifies the demands required to sum up the treatment and its’ accordance with the planned radiotherapy scheme.All the activities performed are recorded in a QA protocol, which is an integral part of the therapeutic protocol.In this paper we present the therapeutic protocol in force in the Regional Oncological Hospital in Szczecin and the QA and in-vivo protocols, which assure safe radiotherapy of the patient

A radiotherapy protocol to document the process of irradiation of patients at the radiotherapy department

A decision to start radiotherapy should be based on at least two documents:1.Written standards of obligatory clinical procedures which are in fact radiotherapeutic schemes.2.Therapeutic protocols describing all mandatory procedures performed to ensure a safe and proper treatment of the patient.The range of activities described in the therapeutic protocol is very wide.It includes all initial procedures implemented in the simulation room, the CT scanner, in the treatment planning system and the mould- room, and it describes the verification process of the treatment plan, mandatory to start radiotherapy.The therapeutic protocol describes in details what and how should be checked by an internal control system and it qualifies the demands required to sum up the treatment and its’ accordance with the planned radiotherapy scheme.All the activities performed are recorded in a QA protocol, which is an integral part of the therapeutic protocol.In this paper we present the therapeutic protocol in force in the Regional Oncological Hospital in Szczecin and the QA and in-vivo protocols, which assure safe radiotherapy of the patient

Risk factors for seroma evacuation in breast cancer patients treated with intraoperative radiotherapy

BackgroundNovel techniques in oncology provide new treatment opportunities but also introduce different patterns of side effects. Intraoperative radiotherapy (IORT) allows a shortened overall treatment time for early breast cancer either combined with whole breast radiotherapy (WBRT), or alone. Although the early side effects of IORT are well known, data on clinically important late side effects, which require medical intervention, are scarce.AimIn this study, we analyze risk factors for seroma evacuation more than 6 months after IORT.Materials and methodsWe evaluated 120 patients with a mean follow-up of 27.8 months (range: 7–52 months). Fifty-one patients received IORT only and 69 were additionally treated with WBRT.ResultsSeroma evacuation was performed 6–38 months after IORT. Two (3.9%) events were observed in the IORT group and 14 (20%) in the IORT[[ce:hsp sp="0.25"/]]+[[ce:hsp sp="0.25"/]]WBRT group. Univariate (Kaplan–Meier) analysis showed that addition of WBRT to IORT increased the risk of seroma evacuation [hazard ratio[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]5.5, 95% confidence interval: 2.0–14.7, P[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.011]. In a multivariate analysis (Cox proportional hazards regression), WBRT and axillary lymph node dissection were significant risk factors for seroma evacuation (model P value[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.0025).ConclusionsWBRT applied after IORT is associated with increased risk of seroma evacuation, which might be considered as a late side effect