Patient Safety in Radiotherapy: Human Factors and Error Prevention Systems

Radiotherapy is a cornerstone of modern cancer treatment, offering high precision in tumor targeting while minimizing damage to surrounding healthy tissues. Due to the use of high-energy ionizing radiation and highly complex planning and delivery workflows, patient safety represents a critical aspect of radiotherapy practice. This review provides an overview of patient safety in radiotherapy with a particular focus on human factors, sources of error, and system-based error prevention strategies. A narrative literature review was conducted using peer-reviewed articles, international guidelines, and reports on incident learning systems and quality assurance in external beam radiotherapy. The radiotherapy process consists of multiple interdependent stages, including simulation, target delineation, treatment planning, verification, and treatment delivery, each of which carries specific safety risks. Evidence shows that most radiotherapy incidents arise from human and organizational factors such as communication failures, workload, inadequate supervision, and system design issues rather than isolated technical faults. Quality assurance programs, incident reporting systems, patient safety indicators, and international frameworks such as Safety in Radiation Oncology (SAFRON) represent key mechanisms for preventing errors. The integration of technical quality assurance with a strong safety culture and attention to human factors is essential for reducing risk and improving patient outcomes. A systembased approach that emphasizes learning, supervision, and continuous improvement is crucial for maintaining safe radiotherapy practice as treatment technologies continue to evolve.