The ASN reiterates the importance of taking radiotherapy history
Information notice
The longer survival of patients as a result of medical and technological advances and innovations in cancer treatment means that local recurrences or second primary cancers are increasingly being treated. As a result, more and more patients will undergo several courses of radiotherapy in their lives, sometimes many years apart and delivered in different radiation therapy centers.
These situations of re-irradiation raise particular issues, especially when the areas to be treated are identical or adjacent. While each treatment is planned with the preservation of the healthy tissues adjacent to the tumor, known as "at risk" tissues, by limiting their irradiation as far as possible, the accumulation of several treatments in the same area can lead to significant dose of these organs at-risk. The prescription and planning of a radiotherapy treatment must therefore take into account any previous treatments and the cumulative effect of the irradiations so as not to exceed excessively high cumulative doses for organs at risk.
In June 2020, these particular issues led the ASN to publish a report on patient safety in its bulletin on radiotherapy history. This newsletter highlights the major clinical issues involved in the management of patients who have undergone several courses of radiotherapy during their lives, and sets out a number of avenues for progress.
The radiotherapy accident, reported to the ASN in June 2024 and classified at level 4 on the ASN-SFRO scale, related to the failure to take account of a previous radiotherapy treatment, is a reminder of the high stakes involved in radiation protection in this field.
The ASN is therefore once again drawing the attention of professionals and all radiotherapy centers to this growing issue and the need to put in place safety barriers and assess them regularly.
During a patient treatment, particular attention must be paid to identifying any prior radiotherapy, both in the patient’s file and by questioning the patient himself, who is sometimes the only person able to provide this information. In addition, it is essential to ensure that medical and technical records are compiled and complete; these must include the information needed to ensure that the dose provided by the new treatment is not deleterious to organs at risk when added to that delivered previously.
The ASN will pay particular attention to how radiotherapy centers deal with these situations during its inspections.
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Date of last update : 17/07/2024