{"product_id":"icrp-publication-97-9780080446585","title":"ICRP Publication 97","description":"\u003ch2\u003eBook Synopsis\u003c\/h2\u003eHigh-dose-rate (HDR) brachytherapy is a rapidly growing technique that has been replacing low-dose-rate (LDR) procedures over the last few years in both industrialised and developing countries. It is estimated that about 500,000 procedures (administrations of treatment) are performed by HDR units annually. LDR equipment has been discontinued by many manufacturers over the last few years, leaving HDR brachytherapy as the major alternative.\u003cbr\u003e\u003cbr\u003eHDR brachytherapy techniques deliver a very high dose, of the order of 1.65.0 Gy\/min, so mistakes can lead to under- or over dosage with the potential for clinical adverse effects. More than 500 HDR accidents (including one death) have been reported along the entire chain of procedures from source packing to delivery of dose. Human error has been the prime cause of radiation events. In the present report, the International Commission on Radiological\u003cbr\u003eProtection concludes that many accidents could have been prevented if staff had had functi\u003cbr\u003e\u003cbr\u003e\u003ch2\u003eTable of Contents\u003c\/h2\u003eCONTENTS ABSTRACT\ti EDITORIAL\t6 PREFACE\t8 1.\tINTRODUCTION\t11 2.\tWhat is the purpose of this report?\t12 2.1.\tWhat is remote high dose rate brachytherapy?\t13 3.\tCurrent Clinical Use of HDR brachytherapy\t15 4.\tInfrastructure and Components of the Remote Afterloading  HDR suite\t16 4.1.\tHDR Suite\t17 4.2.\tHDR Unit\t18 4.2.1.\tHDR source\t18 4.2.2.\tAfterloader device (treatment unit)\t19 4.2.3.\tControl console\t20 4.3.\tApplicators\t20 4.4.\tTreatment Planning System\t21 4.4.1.\tPreplanning\t22 4.4.2.\tIndividualised planning\t22 4.5.\tAssociated safety devices\t22 4.6.\tBuilding\t23 4.6.1.\tInfrastructure required for applicator\/catheter placement (procedure room)\t23 4.6.2.\tInfrastructure required for localisation radiographs\t23 4.6.3.\tInfrastructure required for the treatment planning room\t24 4.6.4.\tInfrastructure required for the treatment room\t24 4.7.\tImaging\t24 4.8.\tEquipment for radiation safety and source handling\t25 5.\tPersonnel Requirements and Training\t26 5.1.\tPersonnel requirements\t26 5.1.1.\tRadiation oncologist\t26 5.1.2.\tMedical physicist\t27 5.1.3.\tTechnician \/ Brachytherapy technologist\t28 5.1.4.\tNurse\t28 5.2.\tIs there need for special training for HDR procedures?\t29 5.2.1.\tRadiation oncologist training\t29 5.2.2.\tPhysicist training\t29 5.2.3.\tTechnician and nurse  training\t30 5.2.4.\tEmergency procedures\t30 6.\tQUALITY ASSURANCE (QA)\t31 6.1.\tClinical QA\t31 6.2.\tPhysical quality assurance\t31 6.3.\tOrganisational quality assurance\t32 6.4.\tSpecific QA related to HDR units\t32 6.5.\tSpecial requirements for interstitial brachytherapy\t32 7.\tEXPOSURES, EVENTS, AND ACCIDENTS\t33 7.1.\tEvents related to packing and transport\t33 7.2.\tExposures to personnel and public\t34 7.3.\tEvents during operation\t34 7.3.1.\tReported mechanical and computer events\t34 7.3.2.\tReported human errors\t35 8.\tExamples of reported events\t37 8.1.\tThe most severe case\t37 8.2.\tTransport and package\t37 8.2.1.\tSource placed outside the transport safe and not secured\t37 8.2.2.\tReturned source not inserted in safe: failure to survey\t38 8.2.3.\tDamage in transit\t38 8.3.\tExposure to personnel and public\t39 8.3.1.\tInadequate shielding of bunker\t39 8.3.2.\tFaulty connection from transport container to HDR safe\t39 8.4.\tMechanical events\t39 8.4.1.\tSource cable separated from drive unit\t39 8.4.2.\tSource stuck (unknown reason)\t40 8.4.3.\tUndersized transfer cable diameter\t40 8.4.4.\tTreatment planning software error \/ or human error\t41 8.4.5.\tKink in the applicator (needle)\t42 8.4.6.\tFailure of retraction system\t43 8.4.7.\tLoss of connection between control  panel and  HDR unit\t43 8.4.8.\tOptical interlock\t43 8.4.9.\tOpen-ended source carrier\t44 8.5.\tHuman errors\t44 8.5.1.\tWrong patient: Identification problem\t44 8.5.2.\tReverse order of entry of dwell positions\t44 8.5.3.\tInadequate default position for start of dwell sites\t45 8.5.4.\tKink in catheter\t46 8.5.5.\tDwell position error\t46 8.5.6.\tWrong catheter\t47 8.5.7.\tWrong length catheter\t47 8.5.8.\tWrong orifice\t47 8.5.9.\tWrong transfer tube\t48 8.5.10.\tFailure to recalibrate\t48 8.5.11.\tDislodged applicator\t49 9.\tRecommendations\t50 9.1.\tGeneral\t50 9.2.\tSpecific\t50 APPENDIX A.\tCLINICAL INDICATIONS\t53 A.1.\tCervical cancer\t53 A.1.1.\tCarcinoma of the endometrium\t54 A.2.\tOesophageal cancer\t54 A.3.\tHead and neck cancer\t55 A.3.1.\tNasopharynx\t55 A.4.\tOther interstitial or mould applications\t55 A.5.\tLung cancer\t55 A.6.\tBreast\t56 A.7.\tProstate\t56 A.8.\tSoft tissue sarcomas\t57 A.8.1.\tSoft tissue sarcomas in children\t58 A.9.\tOther sites\t59 A.10.\tIntraoperative use of HDR brachytherapy\t59 10.\tREFERENCES\t60","brand":"Elsevier Health Sciences","offers":[{"title":"Default Title","offer_id":55534239351127,"sku":"9780080446585","price":141.55,"currency_code":"GBP","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0817\/1739\/5799\/files\/9780080446585.jpg?v=1792586105","url":"https:\/\/bookcurl.com\/products\/icrp-publication-97-9780080446585","provider":"Book Curl","version":"1.0","type":"link"}