Radiation Protection and Safety Program
Department of Radiological Sciences- Radiation Oncology Section
AREA CLASSIFICATION
1. Controlled Area
“A defined area in which specific protection measures and safety provisions are or could be required
for controlling exposures or preventing the spread of contamination in normal working conditions, and
preventing or limiting the extent of potential exposures.” (IAEA General Safety Requirements Part 3)
The treatment room and other areas near the treatment room are designated as controlled areas. Only
radiation health works (radiation oncologist, medical physicist, radiologic technologist) who are
specifically trained in the use of medical radiation therapy equipment and sealed radioactive sources are
allowed to stay in these areas.
2. Supervised Area
“A defined area not designated as a controlled area but for which occupational exposure conditions are
kept under review, even though no specific protection measures or safety provisions are not normally
needed.” (IAEA General Safety Requirements Part 3)
3. Uncontrolled Area
An area not designated as controlled or supervised areas, and is generally open and accessible to
members of the public.
Uncontrolled areas are those occupied by individuals such as patients, visitors to the facility, and
employees who do not work routinely with or around radiation sources. Areas adjacent to but not part of
the X-ray facility is also uncontrolled areas.
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Radiation Protection and Safety Program
Department of Radiological Sciences- Radiation Oncology Section
RADIOLOGICAL EMERGENCY PROCEDURES
The important goals of emergency preparedness are: (1) to prevent the occurrence of
deterministic effects, and (2) to prevent the occurrence of stochastic effects.
A. IN CASE SOURCE DID NOT RETURN TO OFF POSITION
1. Press the interrupt button on the console unit. If the source is still stuck, press the emergency button
on the console unit.
2. Open the treatment room door to allow the console unit to activate the door interlock.
3. Enter the treatment room and turn on the key for the source cable lock located on top of afterloader.
4. Turn the emergency gold crank in the direction of the arrow to retract the source in the safe position.
5. If source is still stuck, disconnect the applicator from the transfer tube, cut the guide wire, use the
thong to retrieve the source and place it in the emergency container located near the treatment
machine.
6. Remove the applicator from the patient and re-survey the patient. Seal the treatment room door and
radioactivity warning label.
B. POWER FAILURE
1. DO NOT TURN the key to off position. Source train will automatically return to the intermediate
safe.
2. Open the treatment room door. Inform the patient that treatment will be interrupted.
3. Disconnect the transfer tubes from the applicators.
4. Bring the patient out of the room.
5. The printer will automatically print the machine status.
C. IN CASE OF FIRE
1. The equipment is fire resistant.
2. The technologist on duty must:
Immediately turn off the machine.
Put out the fire using a fire extinguisher.
Check the source using a survey meter to ensure that the source is completely retracted.
Disconnect the guide tubes and transfer the patient to a stretcher.
Bring out the patient from the treatment room to a safe place.
Lock the room and notify the RSO and the service engineer.
3. The RSO will in turn notify the RSC who will in turn inform management and PNRI.
4. The RSO will investigate and record the incident.
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Department of Radiological Sciences- Radiation Oncology Section
5. Treatment shall only be resumed upon clearance of the equipment by the service engineer, the RSO
and the hospital engineer.
D. IN CASE OF EARTHQUAKE
1. Push the interrupt button and open the treatment room door.
2. Inform the patient of the situation.
3. When quake subsides, remove the patient form the treatment room and call the RSO.
4. The service engineer will evaluate the machine, and the treatment room shielding will be evaluated
by the RSO.
5. Treatment will not resume until the structural stability of the treatment room and the machine has
been evaluated.
E. IN CASE OF LOSS OR PILFERAGE
1. Notify the RSC and the RSO immediately upon discovery of the loss or pilferage.
2. The RSC will in turn inform the PNRI, the management and the police.
3. The RSO will perform radiation survey in the treatment room, nearby rooms, and possible locations
where the source might be hidden or dropped.
4. The RSC, together with authorities, must exhaust all possibilities to recover the source.
5. Once recovered, the service engineer and the medical physicist must conduct all tests before putting
the machine back into use.
6. Safety and security measures to prevent the repeat of the same incident will be reinforced by the
RSC and the management, in cooperation with the Chief Security.
7. Records of the investigations conducted will be kept on secured file.
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Radiation Protection and Safety Program
Department of Radiological Sciences- Radiation Oncology Section
RADIATION PROTECTION AND SAFETY PROGRAM
A. Machine Details/ Technical Data
SagiNova HDR Brachytherapy Machine
Dimensions: (W x D x H) 552 x 654 x 1000 mm
Weight: 267 kg
Voltage Range: 100V -240V, 50/60 Hz, 1/N/PE
Classification: Class 1, Type B equipment according to IEC 60601-1, Section 6
Dose Rate at 5 cm distance: <0.1 mSv/hr (Radiation shielding fulfill IEC 60601-2-17)
Radioactive Source: ≤81.4 GBq Co-60 Ø 1.0 mm
Active Source Component: Ø 0.5 x 3.5 mm Co-60
B. General Safety Procedures
1. HDR brachytherapy treatments shall only be given according to the signed, written prescription
of attending physician.
2. The Prescription shall include at least the patient’s name, age, gender, treatment site,
dose/fraction, location of the dose prescription, number of fractions, and the total dose.
3. HDR brachytherapy treatments shall not be administered unless there is a signed, witnessed
consent of the patient or legally responsible party.
4. The radiation oncologist and the medical physicist shall be physically present, within a distance
of a normal speaking voice, during the treatment.
5. The radiation oncologist/medical physicist/radiologic technologist on duty shall perform a visual
and mechanical test of the applicator before insertion into the patient. Broken applicators shall
not be used.
6. The radiation oncologist shall approve the treatment plan before the treatment.
7. The medical physicist shall approve the technical aspects of the treatment plan before treatment.
8. The patient shall be visually and aurally monitored by the radiologic technologist and the nurse
on duty with an intercom system during the treatment. Treatment shall not be administered if
these monitoring systems are not functional.
9. Only the patient shall be in the treatment room when the source is exposed during the treatment.
No workers or visitors shall stay inside the treatment room during treatment.
10. After the treatment, the medical physicist shall survey the patient and the treatment room using a
survey meter to verify that the source has retracted into the HDR unit. This shall be documented
in the treatment chart.
11. If the source has not retracted into the HDR unit, the posted Emergency Procedures shall be
followed.
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Radiation Protection and Safety Program
Department of Radiological Sciences- Radiation Oncology Section
12. The medical physicist shall complete the treatment sheet in the chart after the treatment fraction
has been completed.
13. The medical physicist shall check the treatment plan, calculation, and delivery prior to every
fraction. If discrepancy is found, it will be reviewed with the radiation oncologist prior to the
next fraction.
14. The medical physicist shall perform a final chart check at the completion of the treatment course
C. Quality Assurance
1. Before first clinical use after: initial installation, source replacements, and software
upgrades. The medical physicist shall perform the following before first clinical use:
1.1. The medical physicist shall review the treatment planning system.
2. Prior to first treatment each treatment day. The medical physicist shall perform the
following before a treatment is given:
2.1. The day-of-use checks shall be carried out successfully by the medical physicist
and the radiologic technologist on-duty before a treatment is given.
3. Prior to each patient treatment. The medical physicist, together with the radiation
oncology and radiologic technologist on-duty, shall perform the following checks before
each patient’s treatment:
3.1. The radiation oncologist/ medical physicist/ radiologic technologist on-duty shall
perform a visual and mechanical test of the applicator before insertion into the
patient. Broken applicators shall not be used.
4. At source change (or quarterly). The medical physicist shall perform the following before a
treatment is given:
4.1. The source-exchange checks shall be carried out successfully by a medical
physicist before the treatment is given with a new source.
5. Annual check. The medical physicist and the radiologic technologist shall perform the
following quality assurance tests following the report of the AAPM Radiation Therapy
Committee Task Group No. 56.
5.1. Remote Afterloader QA Test
5.2. QA for Treatment Planning and Evaluation Systems
5.3. Brachytherapy Computer Planning System QA
5.4. Source and Applicator QA
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Radiation Protection and Safety Program
Department of Radiological Sciences- Radiation Oncology Section
D. Maintenance
1. Maintenance shall only be performed by the supplier of the equipment. This includes
installation, repair, preventive maintenance inspection, and source exchange.
2. The HDR brachytherapy unit shall be fully inspected and maintained during each source
exchange.
3. The RSO or the medical physicist shall be physically present during the maintenance on
the HDR brachytherapy unit.
4. Records of all maintenance and repair work shall be kept by the RSO for reference.
E. Personnel Monitoring
1. Each radiation health personnel shall wear an Optically Stimulated Luminescence (OSL)
dosimeter or badge provided by the PNRI while working with radiation.
2. The OSL dosimeter shall be collected and processed every two (2) months pursuant to
PNRI’s guidelines.
3. Personal dose monitoring report shall be reviewed by the RSO and the medical physicist.
4. All personal dose monitoring reports shall be kept by the RSO for reference and shall be
made available to regulatory during inspection.
5. It is the personnel’s responsibility to ensure that his/her OSL dosimeter is safe from
unnecessary exposure to any source of radiation.
6. In case of loss or damage, notify the RSO immediately.
7. The personnel shall surrender his/her OSL dosimeter to the RSO after his/her duty.
8. The RSO shall keep all the RSO dosimeters in a box away from the source of radiation when
not in use.
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Radiation Protection and Safety Program
Department of Radiological Sciences- Radiation Oncology Section
RECORDS MANAGEMENT
The following records shall be kept and maintained by the facility following the necessary requirements
in Section V of Code of PNRI Regulations Part 14 entitled “Licenses for Medical Use of Radioactive Sources in
Brachytherapy”:
1. Records of Radiation Surveys;
2. Records of Inventory of Sealed Sources and Brachytherapy Sources;
3. Records of Use of Brachytherapy Sources;
4. Records of Calibration Measurements of Brachytherapy sources;
5. Records of Safety Instructions;
6. Records of Periodic Spot-Checks for Remote Afterloader Units;
7. Records of Calibration of Survey Instruments;
8. Records of Installation, Maintenance, Adjustment, and Repair;
9. Records of Leak Test;
10. Records of Personnel Monitoring;
11. Records of Disposal of Radioactive Wastes and Disused Sealed Resources; and
12. Report of Exposure of Persons Who Have Worked in the Facility.
REFERENCES
1. Code of PNRI Regulations Part 14 entitled “Licenses for Medical Use of Radioactive Sources in
Brachytherapy
2. Report of the AAPM Radiation Therapy Committee Task Group No. 56
3. Eckert & Ziegler Brochure on SagiNova HDR Brachytherapy
*** Note: This manual shall be reviewed and updated once the facility is already operating
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