Paragraph 3: Conditions specific to the modality: "external radiotherapy, brachytherapy".

I.-The holder of the authorisation must have a qualified team on the site comprising at least the following professions: 1° Qualified radiotherapists specialising in oncology with the option of radiotherapy, or in radiotherapy or in radiology with the option of radiodiagnosis and radiotherapy, or in radiology with the option of radiotherapy; 2° Medical physicists; 3° Medical electroradiology technicians. At least one member of the team must be a dosimetrist. II…

At least one doctor practising radiotherapy or brachytherapy, with the qualifications mentioned in article D. 6124-133, takes part, physically or by videoconference, in the multidisciplinary consultation meeting dealing with the file of a patient likely to receive external radiotherapy or brachytherapy treatment.

The authorisation holder must ensure that a radiotherapist with the qualifications listed in Article D. 6124-133 and a medical physicist are present on the authorised site throughout the period of treatment. The radiotherapist and the medical physicist must intervene at all times in the radiotherapy unit within a timeframe compatible with the imperative of safety during the application of the treatments.

Outside the operating hours of the radiotherapy unit and by way of derogation from article D. 6124-133-2, the holder of the brachytherapy authorisation practising brachytherapy continuously over more than twelve hours has an organisation enabling him to ensure continuity of this treatment in the hospital sector by providing in particular for an operational on-call radiotherapist with the qualifications listed in article D. 6124-133.

The holder of the radiotherapy or brachytherapy authorisation makes the necessary arrangements with the professionals concerned for : 1° The final validation of the delineation of target volumes and organs at risk, which is the responsibility of a radiotherapist with the qualifications listed in article D. 6124-133 of the team ; 2° The preparation of each treatment validated by a radiotherapist with the qualifications listed in article D. 6124-133 and…

The authorisation holder ensures that each patient’s external radiotherapy treatment is carried out by two medical radiation technologists present at the treatment station in the radiotherapy unit.

The licence holder practising radiotherapy in stereotactic conditions has the appropriate technique for monitoring anatomical structures in real time and for acquiring anatomical data with a view to planning the irradiation of moving targets.

Where the licensee has a particle accelerator with on-board magnetic resonance imaging equipment, it has a pre-established protocol drawn up by the radiotherapy team, involving qualified doctors specialising in radiology and medical imaging.

Any referral of a patient to another radiotherapy authorisation holder for cancer treatment by proton therapy is recorded in writing to ensure traceability.

The holder of the external radiotherapy authorisation is organised in such a way as to be able to provide unscheduled palliative symptomatic irradiation within a timeframe compatible with the patient’s situation.