An overview of the use of risk analysis methodologies in radiotherapy facilities in Brazil

The increasing incidence of cancer and rapid advancements in radiotherapy technology have significantly heightened the complexity of treatment processes, necessitating robust infrastructure and safety protocols. This study assessed the implementation of risk analysis methodologies in Brazilian radiotherapy facilities through a nationwide survey of 196 centers, with 111 responses (57%). Results show that the Radiotherapy Risk Assessment System (SEVRRA) is the predominant tool, applied in 86.5% of facilities, while Failure Mode and Effects Analysis (FMEA) remains limited (7.2%), with only a small fraction using both. Adoption has been uneven across regions, with the South and Southeast concentrating the majority of facilities, technological resources, and advanced treatment techniques such as IMRT, VMAT, and SRS, while the North and Central-West report fewer centers and less diversity in methodologies. The peak in implementation occurred between 2017 and 2021, particularly in 2019, influenced by regulatory standards and international recommendations. Medical physicists (69.4%) and Radiation Protection Supervisors (27.9%) are the primary professionals responsible for applying risk analysis, though regulatory compliance issues persist. Despite barriers such as workload constraints and limited training, the integration of risk analysis practices has strengthened safety protocols and quality management, underscoring their importance in minimizing risks and safeguarding patient well-being throughout radiotherapy treatment in Brazil.