Abstract:
Objective: Brachytherapy is used in 17 radiotherapy facilities In Kazakhstan. Each institution has an individual
quality control (QC) program in place to ensure the safe and accurate delivery of the treatment dose to the patient.
The main objective of this paper is to explore current approaches to quality control of brachytherapy in Kazakhstan
and reduce potential discrepancies in testing frequency and tolerance limits by identifying a set of basic quality
control requirements. Materials and Methods: A detailed brachytherapy quality control questionnaire was provided
to 17 radiotherapy institutions for completion. A separate questionnaire was sent to two institutions associated with
brachytherapy. Questions addressed safety aspects, radiation parameters, total time spent on quality control, and available
imaging systems for dose determination. The results of the survey were compared with the recommendations set found
in international brachytherapy quality control documents. Results: The results of the questionnaires revealed significant
differences in the frequency and methods of testing. For example, only two of the 17 centers have at least some kind
of quality assurance program for brachytherapy treatment. Only five centers have equipment with the help of which
dosimetric control can be performed, and only two centers have local medical physicists performing this control. One
of the centers is checked quarterly, while the other is checked only once a year. In the remaining 15 centers, dosimetric
control is performed by specialists who recharge the source without providing any document or protocol. There were
also significant differences in the amount of time spent on quality control, mostly related to the variety of approaches
to quality control and differences in the availability of resources. Almost all centers (15 of 17) rely only on inspections
from the radionuclide source supplier and do not monitor the dosimetric and mechanical parameters of the facility at
all. Conclusion: Based on the results of the survey and comparison with international recommendations, a set of basic
requirements for brachytherapy quality control is needed.
