Radiation Therapy Physics Quality Assurance and Management Practices in Low- and Middle-Income Countries: An Initial Pilot Survey in Six Countries and Validation Through a Site Visit

• DOI: 10.1016/j.adro.2023.101335
• Publication Date: 2023-08-08T00:54:39Z
• Authors: Afua A. Yorke; Vonetta M. Williams; Shekinah Elmore; Kellie Alleyne-Mike; Eric Addison; Philip Oppong Kye...; Samuel Nii Adu Tagoe; Christoph Jon Tra...; Graeme L. Lazarus; Eric C. Ford

PurposeTo assess physics quality assurance (PQA) practices in less resourced RT-centers to improve of care.MethodsA preliminary study was conducted 2020 thirteen select RT centers six countries and 2021, our team onsite visits all the Ghana, one from initial survey. The included private, two public institutions (denoted Public-1- –2). Follow-up surveys were sent 17 medical physicists site visit. Questions centered on topic equipment, institutional practice, assurance, management, safety practices. Qualitative descriptive methods used for data analysis. regarding operational challenges (machine downtime, patient-related issues, power outage staffing) asked a 5-point Likert scale.ResultsThe survey had 92% response rate. One key result showed that lower GNIpc country there direct correlation between QA needs country. identified film/array detectors, independent dose calculation software, calibration ion chambers, diodes, TLDs, phantoms verification, TPS test phantoms, imaging film dosimeters, education, training. For post after visit we received 100% private Public-1 each have CT simulators located their RT-center. average daily patient external beam workload clinic LINAC was: Private = 25, 55, Public-2 Co- 60 45, 25 (there no Co-60 at hospital). and-2 lacked equipment necessary conform best TG-142 198. reported significant challenges. Notably peer review chart rounds which are attended by clinical oncologists, physicists, physicians, trainees. All who responded indicated they system documenting, tracking, trending related incidents but only physicist using IAEA SAFRON.ConclusionThe development index follow up examines clinics surveyed. This will form basis planned continent-wide Africa intended spotlight LMICs, faced, lessons learned help understand gaps support local PQA management programs. Audits during show education training remains most important need operating successful