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The Pipeline

Interpreting the Heated Discussion around RT Safety Concerns

By now, most folks have probably read the new series issued by the New York Times, which discusses some serious errors that have been made during radiation therapy treatments for cancer patients. It's an emotional and disturbing read, and one that does justice to the immense importance of standards and quality assurance protocols in the realm of RT.

These articles cast a heavily skeptical eye toward the radiation therapy industry, focusing not just on quality control measures, but also on the pace at which we've seen adoption of new, expensive, and technologically complex RT machines. The point being that these innovative new technologies require increasingly complex quality review due to their reliance on computers and automation to perform much of the treatment planning and delivery functions for each patient.

The lens through which the articles explore these concerns and criticisms is one used to uncover a number of heartwrenching human interest stories. And the gravity of each of these patients' situations intensifies the concerns over radiation therapy safety. However, there are many angles to any one story, some of which don't receive as much focus as others.

It's only fair to highlight a response posted by the American Society for Radiation Oncology, which brings to light some salient statistics on the matter of RT safety. Making no effort to excuse these grave mistakes, ASTRO's chairman brings up the point that the NYT failed to put into context the actual risk of these errors occurring.

There's no question in this response that these errors should not have occurred. But while there may be systemic issues with quality protocols, Dr. Williams' point is that it's unfair to portray the entire field of radiation therapy as systematically unsafe. Looking at the profiles of errors occurring in New York state, the chairman mentions that the actual calculated risk of these grave errors was only 0.0046 percent, given the massive volume of total RT treatments delivered during the time of focus of this article (estimated at 13.6 million treatments delivered during the cited period). Unfortunately, all medical procedures carry risk. Contextual statistics are of no consolation to the families and recipients of such errors, nor should they be used to excuse mistakes made, but in the scientific field of medicine, it's unfair to disregard them all-together.