(A) The radiation oncologist shall establish the doses desired throughout the tumor and set dose limits to critical structures. Treatment deliveries shall meet the specifications of the radiation oncologist.
(B) All treatment applications shall be described in detail and signed by the radiation oncologist. The radiation oncologist shall be notified of any changes that may be necessary in the planned schedule of treatment.
(C) Each freestanding radiation therapy center shall:
(1) Provide or arrange for appropriate radiation treatment localization, simulation and verification;
(2) Provide or arrange for isodose treatment planning with complex analyses generated in appropriate cases;
(3) Provide accurate calculation of doses and dose distribution;
(4) Provide a system for independent checking of initial dose calculations. The check shall be conducted before the third fraction, or before twenty percent of the total dose when the treatment schedule provides less than ten fractions. The independent check includes utilizing another individual or method approved and documented by the medical physicist to verify dose calculations.
(5) Conduct ongoing reviews of accumulating doses;
(6) Conduct a chart and port film review weekly;
(7) Accurately chart treatment doses; and
(8) Maintain records of all data used in planning the specific treatment for a patient in the patient's medical record.
(D) Each freestanding radiation therapy center shall provide devices to aid in positioning and immobilizing the patient. Normal tissue shields, compensating filters, wedges and other aids shall be provided as medically appropriate.
(E) Initial port films shall be reviewed by the radiation oncologist prior to the second treatment and the port films shall be reviewed at least every ten treatments.
(F) Each freestanding radiation therapy center shall establish and maintain procedures for handling medical emergency cardiac care.