Supporting the improvement of quality of radiotherapy treatments, through best medical physics practice in Africa

From the IAEA Division of Human Health, Dosimetry and Medical Radiation Physics Section

In the African continent, critical issues may be encountered when addressing health care related subjects. In particular when the level of technology involved is high, as is the case for radiotherapy facilities for cancer treatment, the challenges increase i.e. keeping pace with technology, lack of medical physics education and training programs, and shortage of structured systems of quality management. All of these elements can negatively affect the quality of radiotherapy treatments.

In the field of radiotherapy, the use of sophisticated machines will not necessarily lead to high quality patient care. If the machine is not emitting the correct quality and quantity of radiation, patient treatment will be compromised.

The medical physicist is the professional who verifies and ensures that this kind of situation does not occur, by developing and implementing quality assurance (QA) programmes as well as routine procedures for accurate dosimetry measurements.

Medical physicist performing quality assurance (QA) of a radiotherapy machine. (photo from IAEA TLD irradiation video tutorial E. Izewski, IAEA)

Course on quality assurance of treatment planning systems held in Algiers. (Photo: A. Meghzifene, IAEA)

In the late nineties, the IAEA launched a regional programme in Africa to strengthen medical physics capabilities and support and/or upgrade the implementation of medical physics QA procedures.

Several regional projects have been set up, with the aim of enhancing patient care through good medical physics practice. These projects support the implementation at the national level of the best practices in radiotherapy, more specifically addressing the problems faced by medical physicists in Africa (i.e. the lack of necessary equipment for QA and of training and education programmes), harmonising the medical physics practice in the region and supporting the creation of strong local groups of well trained and homogeneously educated professionals.

Course on quality assurance of treatment planning systems held in Algiers. (Photo: A. Meghzifene, IAEA)

The projects have already provided tailored and diversified support in the field; suitable dosimetry and quality assurance tools have been distributed to all participants, and expert guidance (15 expert missions) has been facilitated to ensure correct use of treatment machines, treatment planning and instruments. For capacity building, the IAEA has organized 23 workshops and training courses and held 10 meetings to help promote regional cooperation in the field.

The positive impact of these efforts is particularly reflected in the results of the dosimetric checks provided by the IAEA through its IAEA/WHO postal dose audit service, which shows that the quality and accuracy of the radiation used to treat cancer in Africa has visibly improved over the last years.

Cancer patients are the beneficiaries of these projects, which ultimately aim at guaranteeing an improved quality and more effective treatment in every African radiotherapy centre.

Results of TLD dosimetry audits performed by the IAEA Dosimetry Laboratory, AF=Africa, AM=America, EM=Eastern Mediterranean, EU=Europe, SE=South Eastern Asia, WP=West Pacific