放射治疗前瞻性危害分析的系统综述

IF 3.2 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Medical physics Pub Date : 2025-09-10 DOI:10.1002/mp.18110
Jonathan Hindmarsh, Sonja Dieterich, Jeremy Booth, Paul Keall
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引用次数: 0

摘要

前瞻性危害分析(PHA)是由2003年美国物理学家协会医学任务小组100的发起而引入到更广泛的医学物理学界的。从那时起,人们对PHA在放疗中的适用性越来越感兴趣,目的是保证患者的安全,并评估整个放疗实践中的风险。本研究的目的是回顾PHA文献,重点是评估了哪些技术和技术,如何评估它们,以及可以学习什么。方法采用通用搜索策略,在5个数据库和3篇重要论文的引文中搜索英文、同行评议的全文文章。根据系统评价和荟萃分析(PRISMA)声明报告标准,采用以下PICOS方法对文章进行整理、过滤和分析:人群:x射线外束放射治疗,干预:前瞻性危害分析,比较:无,结局:患者安全性,研究特征:应用技术的细节。结果共鉴定出689项独特的研究。62人被确定有资格列入。PHA已应用于c型臂治疗系统(17)、立体定向放射外科(8)、TomoTherapy(6)、立体定向体放疗(5)、Ethos(5)、Halcyon(3)、MRIdian(3)、评审活动(3)、调试(2)、unity(1)、体积调节弧治疗(1)、表面引导(1)、射波刀(1)、RefleXion(1)和其他新型软件和硬件系统(6)。参与研究的学科包括物理学家(92%)、内科医生(75%)、放射治疗师或剂量测定师(71%)、外部专家(38%)和辅导员(33%)。75%的研究采用失效模式与影响分析(FMEA), 10%采用FMEA衍生方法,10%采用系统理论过程分析,5%采用其他方法。从FMEA研究中,提取了579种高风险失效模式,涵盖了放疗过程的各个方面,50%应用于患者治疗交付阶段,25%应用于轮廓和治疗计划。研究建议的缓解战略往往会增加部门的工作量。在纳入的研究中,确定了62项使用PHA进行放射治疗的研究:患者旅程是分析最多的过程,物理学家参与研究最多的学科,FMEA是最常见的技术,患者治疗的交付是高风险失败模式的最大来源。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Systematic review of prospective hazard analysis in radiation therapy

Systematic review of prospective hazard analysis in radiation therapy

Systematic review of prospective hazard analysis in radiation therapy

Systematic review of prospective hazard analysis in radiation therapy

Introduction

Prospective hazard analysis (PHA) was introduced to the wider medical physics community by the initiation of American association of physicists in medicine task group 100 in 2003. Since then, there has been increasing interest in the applicability of PHA to radiotherapy for the purpose of keeping patients safe and assessing the risks within the whole practice of radiotherapy. The purpose of this research was to review the PHA literature focusing on which techniques and technologies have been assessed, how they have been assessed, and what can be learnt.

Methods

The search for English language, peer-reviewed, full-text articles was conducted across five databases and the citations of three seminal papers using a common search strategy. The collation, filtration, and analysis of articles was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement reporting standard utilizing the following PICOS approach: Population: x-ray external beam radiation therapy, Intervention: prospective hazard analysis, Comparison: none, Outcome: patient safety, Study characteristics: details of applied technique.

Results

689 unique studies were identified. 62 were determined to be eligible for inclusion. PHA has been applied to C-arm treatment systems (17), stereotactic radiosurgery (8), TomoTherapy (6), stereotactic body radiotherapy (5), Ethos (5), Halcyon (3), MRIdian (3), review activities (3), commissioning (2), unity (1), volumetric modulated arc therapy (1), surface guidance (1), CyberKnife (1), RefleXion (1) and other novel software and hardware systems (6). Disciplines involved in the studies were physicists (92%), physicians (75%), radiation therapists or dosimetrists (71%), external experts (38%), and facilitators (33%). Failure mode and effects analysis (FMEA) was used in 75% of studies, 10% used FMEA derived methods, 10% used system theoretic process analysis, and 5% used other methods. From the FMEA studies, 579 high-risk failure modes were extracted covering all aspects of the radiotherapy process, 50% applied to patient treatment delivery sessions and 25% applied to contouring and treatment planning. The mitigation strategies recommended by studies tended to add to the departmental workload.

Conclusions

62 studies were identified that used PHA in radiotherapy, within the included studies: patient journey was the most analyzed process, of the disciplines physicists were involved in the most studies, FMEA the most common technique, and the delivery of patient treatment was the greatest source of high-risk failure modes.

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来源期刊
Medical physics
Medical physics 医学-核医学
CiteScore
6.80
自引率
15.80%
发文量
660
审稿时长
1.7 months
期刊介绍: Medical Physics publishes original, high impact physics, imaging science, and engineering research that advances patient diagnosis and therapy through contributions in 1) Basic science developments with high potential for clinical translation 2) Clinical applications of cutting edge engineering and physics innovations 3) Broadly applicable and innovative clinical physics developments Medical Physics is a journal of global scope and reach. By publishing in Medical Physics your research will reach an international, multidisciplinary audience including practicing medical physicists as well as physics- and engineering based translational scientists. We work closely with authors of promising articles to improve their quality.
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