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As part of a comprehensive approach to quality assurance (QA) in the treatment of cancer by radiation, an independent external audit (peer review) is important to ensure adequate quality of practice and delivery of treatment. Quality audits can be of various types and levels, either reviewing specific critical parts of the radiotherapy process (partial audit) or assessing the whole process (comprehensive audit).

The IAEA has a long history of providing assistance for dosimetry (partial) audits in radiotherapy to its Member States. Together with the World Health Organization (WHO), it has operated postal audit programmes using thermoluminescence dosimeters (TLD) to verify the calibration of radiotherapy beams since 1969.

The IAEA has received numerous requests from developing countries to perform comprehensive audits of radiotherapy programmes to assess the whole process, including aspects such as organization, infrastructure and clinical and medical physics components. The objective of a comprehensive clinical audit is to review and evaluate the quality of all components of the practice of radiotherapy at the institution, including its professional competence, with a view for quality improvement. A multidisciplinary team comprising a radiation oncologist, a medical physicist and a radiotherapy technologist carries out the audit.