Аннотация
Relevance: The development of high-tech radiation therapy techniques, such as Intensity-Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT), requires strict standardization of all pre-treatment stages to ensure safety and improve treatment efficacy. International guidelines (TG-100, ICRU Report 83) emphasize the need for process-oriented quality control, yet implementing these approaches in clinical practice necessitates adaptation to local conditions.The study aimed to systematize the stages of pre-treatment preparation within the framework of SOP-115-RS-02 implementation and describe the organizational and technical algorithm for quality assurance at the Kazakh Institute of Oncology and Radiology (KazIOR, Almaty, Kazakhstan).Materials and Methods: A retrospective-practical analysis of pre-treatment preparation for External Beam Radiation Therapy was conducted following the implementation of Standard Operating Procedure SOP-115-RS-02 at KazIOR. The analysis covered all preparation stages: from multidisciplinary team (MDT) decision-making and topometry to physical-dosimetric planning and quality assurance. Organizational changes, roles of MDT members, and improvements in immobilization, computed tomography (CT) simulation, target and organ-at-risk delineation, dose distribution planning, and quality control were studied. Compliance with international requirements was assessed by comparison with AAPM TG-100 and ICRU recommendations.Results: The implementation of SOP-115-RS-02 standardized patient routing and improved continuity of care by adhering to the “single radiation oncologist” principle, thereby reducing the risk of data loss. Enhanced immobilization requirements and the transition to tattoo marks ensured increased positioning accuracy. A standardized approach to CT simulation improved image quality and eliminated data transfer errors. Integration of ICRU recommendations for GTV, CTV, and PTV determination reduced interobserver variability in contouring. Calculated plans underwent multi-stage verification, including double dosimetric control and a first-day check, which enhanced radiation safety.Conclusion: Standardization of pre-treatment preparation based on SOP-115-RS-02 improves treatment quality, enhances team organization, and ensures compliance with international safety standards in modern radiation oncology. The acquired experience demonstrates the importance of regulating every stage as a key tool for preventing clinical and technical errors.