TABLE 9.
Example initial treatment plan (EBRT) check items for radiation therapists
| Recommended | Optional |
|---|---|
| Patient name, MRN, DOB | Enter “custom” for Bolus fields |
| Patient photos and setup photos | DRR approved and associated |
| Consent signed by physician | MUs/daily dose reasonable |
| Rx signed by physician | Peer review signed by physician/physicist |
| Plan laterality matched with Rx in RO‐EMR | Treatment couch inserted in plan |
| Plan used the scheduled treatment unit | Intra‐treatment image method (eg, triggered imaging) in RX |
| Isocenter shifts instruction clear and documented in setup note | Fiducial contoured |
| Rx dose/fractions in RO‐EMR agree with plan | Check corrected images input to the third party image systems |
| Rx Tx technique in RO‐EMR agrees with plan | |
| Rx energy in RO‐EMR agrees with plan | Reference CT/scan sent to third party system |
| Field parameters consistency between plan and RO‐EMR (for third party RO‐EMR) | ROI box drawn appropriately |
| SSD parameters | Bolus field entered |
| Treatment fields approved by physicist | |
| Treatment plan deliverability check (loading reference CT and collision check for non‐coplanar beams) | Physics consult presence |
| Patient setup (immobilization device setup, skin markers) info verified | Dose rate |
| Special alerts/dose actions (position, bolus, in‐vivo measurement, etc.) | Blocks/compensator in Rx and setup note |
| Bolus documented | |
| In‐vivo measurement indicated | |
| Respiratory/IGRT instructions | |
| Third party IGRT data ready | |
| Motion management parameters | |
| Treatment schedule | |
| Boost fields are scheduled/follow‐up | |
| Tx appointment conflicts, concurrent chemo documented | |
| Implanted device presence/document | |
| Second MU check documented | |
| Physics check completed/approved | |
| IMRT/VMAT QA completed/approved | |
| Pre‐RT preparations | |
| For electron fields: | |
| e‐applicator field parameters (energy cone, field size, gantry) | |
| e‐block checked to the template | |
| e‐block code verify (accessory code) |
Abbreviations: DIBH, deep inspiration breath hold; DRR, digitally reconstructed radiograph; EDW, enhanced dynamic wedge; IGRT, image‐guided radiotherapy; KVCBCT, Kilo‐voltage cone beam CT; MU, monitor unit; MVCBCT, Mega‐voltage cone beam CT; QCL, quality‐check‐list; RO‐EMR, Radiation oncology specific electron medical record system; ROIs, regions‐of‐interest; Rx, prescription; SID, source‐imager distance; SSD, source‐skin distance; Tx, treatment.