In all establishments holding authorisation for cancer treatment using radiotherapy, as provided for in article R.6123-87 of the French Public Health Code (CSP), the following quality of care criteria are met:
1) At least one doctor practising radiotherapy, with the qualifications mentioned in article D. 6124-133 of the CSP, takes part, either physically or by videoconference, in the multidisciplinary consultation meeting during which the file of a patient likely to receive irradiation is presented.
2) The files of patients receiving irradiation as an emergency or as part of palliative treatment are not presented at the RCP prior to application.
3) Before any treatment is started, the centre has the patient's file, including in particular the minutes of the multidisciplinary consultation meeting and all the information required to draw up the treatment plan.
4) A doctor specialising in radiotherapy and a person specialising in medical radiophysics are present in the centre while treatment is being applied to patients.
5) The treatment of each patient is carried out by two manipulators at the treatment station.
6) The report at the end of radiotherapy must include at least the following information:
7) A multi-year training plan including training in the use of equipment is put in place for all radiotherapy team professionals.
8) The radiotherapy centre keeps an up-to-date list of personnel trained in the use of its radiotherapy equipment.
9) A self-assessment of radiotherapy practices is carried out annually in the establishment, using indicators defined by the National Cancer Institute, and as part of the monitoring of the quality of practice provided for in article R. 6123-95 of the Public Health Code. These data, which are anonymised, are sent to the National Cancer Institute for a national summary.
10) The radiotherapy centre uses three-dimensional imaging to prepare treatments. For this purpose, it has a dedicated scanner or, failing that, access to
time slots dedicated to treatment preparation.
11) Dose calculation and planning software systematically takes into account beam measurements validated in the centre.
12) The number of monitor units is checked by a second calculation system for each beam before treatment.
13) Treatment parameters are recorded and checked by a dedicated computer system.
14) All the geometric characteristics of each new beam are checked when it is first used.
15) In vivo dosimetry is carried out for each technically measurable beam during the first or second irradiation session, as well as each time the treatment is modified.
16) For the same treatment sequence, all the beams are used at each session.
17) Patient positioning is checked at least once a week by imaging performed on the treatment machine.
18) The follow-up of each patient treated by irradiation and the traceability of this follow-up are organised, in agreement with the patient. An annual radiotherapy consultation will be scheduled for a minimum of 5 years; this frequency may be modified on the basis of the patient's clinical condition and/or monitoring data, or as part of a clinical research programme. Late toxicity is assessed according to the Common Toxicity Criteria classification currently used by the US National Cancer Institute.
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