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Cost analysis of radiation therapy and cost benefit analysis of Co60 versus linear accelerator therapy are useful exercises for radiation therapy departments. Such analysis will show that the costs of radiation therapy are significant. However, the cost benefit is most likely to be seen where survival is increased and morbidity is decreased. In centers where there is a high population of patients treated for palliation, the cost benefit is unlikely to be realized.

We review the various components of quality assurance (QA), including the role of a QA committee, stressing its interdisciplinary nature relative to radiation oncologists, medical physicists, dosimetrists, and radiation therapy technologists. Current standard of QA are reviewed for treatment machines, dosimetry instrumentation, treatment planning, treatment planning computer systems, brachytherapy, and external beam therapy. The latter area includes discussions on the importance of a peer review new patient planning conference, chart checking and film review.