I Wayan Juliasa
AKTEK Radiodiagnostik dan Radioterapi Bali

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Analisis Daily Quality Assurance (QA) / Quality Control (QC) pada Pesawat Linac di Unit Onkologi Radiasi RSUD Bali Mandara Anak Agung Ngurah Gede Kusuma Yoga; Kadek Yuda Astina; I Wayan Juliasa
Kappa Journal Vol 9 No 1 (2025): Kappa Journal
Publisher : Universitas Hamzanwadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29408/kpj.v9i1.27443

Abstract

This study focuses on evaluating the Daily Quality Assurance (QA) and Quality Control (QC) of the Linear Accelerator (Linac) machine at the Radiation Oncology Unit of Bali Mandara General Hospital (RSUD Bali Mandara). With the growing complexity of radiotherapy technology, ensuring the accuracy and consistency of radiation doses delivered during treatment is crucial for patient safety and effective cancer treatment. This study aims to evaluate the performance of the Linac Varian CX through a series of Daily checks, including output constancy, laser calibration, Optical Distance Indicator (ODI), and safety interlock systems. The results showed that the output constancy had a maximum error of ±2.5%, laser calibration deviation was within 1-2 mm, and the ODI error was within 1-2 mm, all within the tolerance limits set by the AAPM TG-40 standards. Additionally, the safety interlock and audiovisual systems were fully functional, ensuring that all safety protocols were adhered to. These findings demonstrate that the Daily QA/QC procedures implemented at RSUD Bali Mandara effectively maintain the Linac's performance within the established tolerance limits, ensuring the safety and effectiveness of radiation therapy provided to patients. This study underscores the importance of stringent QA/QC practices in radiotherapy and provides insights for potential improvements in clinical practice.
Teknik Radioterapi Volumetric Modulated Arc Therapy (VMAT) pada Kasus Kanker Parotis di Instalasi Onkologi Radiasi Hermina Bekasi Dwi Cahya Wibowo; I Kadek Sukadana; Ismil B. N.; I Wayan Juliasa
Borneo Nursing Journal (BNJ) Vol. 8 No. 2b (2026)
Publisher : Akademi Keperawatan Yarsi Samarinda

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61878/bnj.v8i2b.1758

Abstract

Latar Belakang: Kompleksitas anatomi daerah kepala dan leher pada kasus kanker parotis menuntut presisi tinggi untuk memberikan dosis terukur pada area target sekaligus melindungi Organ At Risk (OAR) di sekitarnya. Teknik Volumetric Modulated Arc Therapy (VMAT) hadir sebagai solusi radioterapi modern yang efisien. Penelitian ini bertujuan untuk mendeskripsikan penatalaksanaan teknik VMAT pada kasus kanker parotis di Instalasi Onkologi Radiasi RS Hermina Bekasi. Metode: Penelitian ini menggunakan metode kualitatif deskriptif dengan pendekatan studi kasus pada seorang pasien kanker parotis. Pengumpulan data dilakukan melalui observasi alur kerja klinis, dokumentasi hasil perencanaan Treatment Planning System (TPS), wawancara mendalam, dan kendali mutu. Hasil dan Pembahasan: Penatalaksanaan VMAT di RS Hermina Bekasi berjalan secara terintegrasi melalui lima tahapan: edukasi keperawatan (pencegahan dermatitis dan xerostomia), imobilisasi masker termoplastik saat CT Simulasi, optimasi TPS Monaco berkas foton 6.0 MV Single Arc (138 segmen MLC) metode SIB 7000 cGy, pengujian Patient-Specific Quality Assurance (PSQA), serta verifikasi citra harian X-ray Volumetric Imaging (XVI). Pengamatan kualitatif visual pada kurva DVH dan citra Tiga Bidang (Batch Views Report) memperlihatkan sebaran dosis tinggi yang terisolasi ketat pada massa tumor parotis kanan dengan gradien dosis yang tajam. Seluruh struktur OAR kritis (batang otak, medula spinalis, kelenjar parotis sehat kontralateral, dan rongga mulut) terbukti terproteksi di luar area tumpukan dosis tinggi. Keandalan fisik perencanaan VMAT dibuktikan oleh kelulusan uji PSQA analisis 3D Gamma Index (3% / 2 mm mm) dengan passing rate sebesar 99,9%, efisiensi waktu penyinaran harian (2–5 menit per fraksi), serta ambang toleransi pergeseran posisi < 3 mm. Kesimpulan: Penatalaksanaan teknik VMAT pada kasus kanker parotis di RS Hermina Bekasi terbukti presisi, aman, dan efisien secara kualitatif, serta mampu memberikan proteksi optimal terhadap jaringan sehat OAR di sekitar target penyinaran.