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{"work":{"id":127086719,"created_at":"2025-01-17T06:34:04.131-08:00","from_world_paper_id":262675942,"updated_at":"2025-02-04T06:44:50.642-08:00","_data":{"publisher":"EDP Sciences","grobid_abstract":"À la suite de la survenue des accidents d'Épinal (détecté en 2006) et de Toulouse (détecté en 2007), la radioprotection des patients a été remise en avant dans le travail de tous les acteurs concernés et s'est imposée de fait comme incontournable. En conséquence, la réglementation concernant la gestion des risques en radiothérapie a évolué en France. En l'absence de méthode propre pour analyser les risques médicaux, des méthodes d'analyse des risques issues des sciences de l'ingénieur ont été transposées en 2009 en radiothérapie. Il s'agit notamment de la méthode d'analyse des modes de défaillance et de leurs effets (AMDEC) adoptée par l'Autorité de sûreté nucléaire dans son guide méthodologique. Mais l'application de l'AMDEC en radiothérapie a révélé des difficultés d'utilisation qui entrent en résonance avec certaines difficultés décrites dans la littérature internationale. Cet article, issu d'une recherche en ergonomie conduite dans le domaine de la gestion des risques et de la sécurité des patients en radiothérapie, fait le point sur les forces et faiblesses de la méthode AMDEC. Mots clés : radiothérapie / gestion des risques / analyse des risques a priori / AMDEC / sécurité des patients Abstract -Risk analysis in radiotherapy. Part 1: Strengths and weaknesses of the FMEA method. As a consequence of the Épinal and Toulouse accidents detected in 2006 and 2007 respectively, radiological protection became a major and critical concern for all actors. Thus, the regulation regarding the management of risk in radiation therapy was updated. In the absence of a specific method of analysis of medical risks, methods developed by engineers were transposed in radiotherapy. The FMEA method (failure mode and effects analysis) has been adopted by the French nuclear safety authority (ASN) for the risk evaluation in external radiotherapy. But the application of FMEA to radiation therapy has shown intrinsic difficulties similar to those encountered in other domains. This article, resulting from a research in ergonomics in the domain of risk management and patient security, makes the point on the strengths and weaknesses of FMEA.","publication_date":"2019,,","publication_name":"Radioprotection","grobid_abstract_attachment_id":"120872166"},"document_type":"paper","pre_hit_view_count_baseline":null,"quality":"high","language":"fr","title":"Analyse des risques en radiothérapie","broadcastable":true,"draft":null,"has_indexable_attachment":true,"indexable":true}}["work"]; window.loswp.workCoauthors = [60526180]; window.loswp.locale = "en"; window.loswp.countryCode = "SG"; window.loswp.cwvAbTestBucket = ""; window.loswp.designVariant = "ds_vanilla"; window.loswp.fullPageMobileSutdModalVariant = "full_page_mobile_sutd_modal"; window.loswp.useOptimizedScribd4genScript = false; window.loginModal = {}; window.loginModal.appleClientId = 'edu.academia.applesignon'; window.userInChina = "false";</script><script defer="" src="https://accounts.google.com/gsi/client"></script><div class="ds-loswp-container"><div class="ds-work-card--grid-container"><div class="ds-work-card--container js-loswp-work-card"><div class="ds-work-card--cover"><div class="ds-work-cover--wrapper"><div class="ds-work-cover--container"><button class="ds-work-cover--clickable js-swp-download-button" data-signup-modal="{"location":"swp-splash-paper-cover","attachmentId":120872166,"attachmentType":"pdf"}"><img alt="First page of “Analyse des risques en radiothérapie”" class="ds-work-cover--cover-thumbnail" src="https://0.academia-photos.com/attachment_thumbnails/120872166/mini_magick20250117-1-5kxykq.png?1737124527" /><img alt="PDF Icon" class="ds-work-cover--file-icon" src="//a.academia-assets.com/images/single_work_splash/adobe_icon.svg" /><div class="ds-work-cover--hover-container"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span><p>Download Free PDF</p></div><div class="ds-work-cover--ribbon-container">Download Free PDF</div><div class="ds-work-cover--ribbon-triangle"></div></button></div></div></div><div class="ds-work-card--work-information"><h1 class="ds-work-card--work-title">Analyse des risques en radiothérapie</h1><div class="ds-work-card--work-authors ds-work-card--detail"><a class="ds-work-card--author js-wsj-grid-card-author ds2-5-body-md ds2-5-body-link" data-author-id="60526180" href="https://independent.academia.edu/SylvieThellier"><img alt="Profile image of Sylvie Thellier" class="ds-work-card--author-avatar" src="//a.academia-assets.com/images/s65_no_pic.png" />Sylvie Thellier</a></div><div class="ds-work-card--detail"><p class="ds-work-card--detail ds2-5-body-sm">2019, Radioprotection</p><div class="ds-work-card--work-metadata"><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">visibility</span><p class="ds2-5-body-sm" id="work-metadata-view-count">…</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">description</span><p class="ds2-5-body-sm">9 pages</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">link</span><p class="ds2-5-body-sm">1 file</p></div></div><script>(async () => { const workId = 127086719; 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if (!viewCountBody) { throw new Error('Failed to find work views element'); } viewCountBody.textContent = `${commaizedViewCount} views`; } catch (error) { // Remove the whole views element if there was some issue parsing. document.getElementById('work-metadata-view-count')?.parentNode?.remove(); throw new Error(`Failed to parse view count: ${viewCount}`, error); } }; // If the DOM is still loading, wait for it to be ready before updating the view count. if (document.readyState === "loading") { document.addEventListener('DOMContentLoaded', () => { updateViewCount(viewCount); }); // Otherwise, just update it immediately. } else { updateViewCount(viewCount); } })();</script></div><p class="ds-work-card--work-abstract ds-work-card--detail ds2-5-body-md">À la suite de la survenue des accidents d'Épinal (détecté en 2006) et de Toulouse (détecté en 2007), la radioprotection des patients a été remise en avant dans le travail de tous les acteurs concernés et s'est imposée de fait comme incontournable. En conséquence, la réglementation concernant la gestion des risques en radiothérapie a évolué en France. En l'absence de méthode propre pour analyser les risques médicaux, des méthodes d'analyse des risques issues des sciences de l'ingénieur ont été transposées en 2009 en radiothérapie. Il s'agit notamment de la méthode d'analyse des modes de défaillance et de leurs effets (AMDEC) adoptée par l'Autorité de sûreté nucléaire dans son guide méthodologique. Mais l'application de l'AMDEC en radiothérapie a révélé des difficultés d'utilisation qui entrent en résonance avec certaines difficultés décrites dans la littérature internationale. Cet article, issu d'une recherche en ergonomie conduite dans le domaine de la gestion des risques et de la sécurité des patients en radiothérapie, fait le point sur les forces et faiblesses de la méthode AMDEC. Mots clés : radiothérapie / gestion des risques / analyse des risques a priori / AMDEC / sécurité des patients Abstract -Risk analysis in radiotherapy. Part 1: Strengths and weaknesses of the FMEA method. As a consequence of the Épinal and Toulouse accidents detected in 2006 and 2007 respectively, radiological protection became a major and critical concern for all actors. Thus, the regulation regarding the management of risk in radiation therapy was updated. In the absence of a specific method of analysis of medical risks, methods developed by engineers were transposed in radiotherapy. The FMEA method (failure mode and effects analysis) has been adopted by the French nuclear safety authority (ASN) for the risk evaluation in external radiotherapy. But the application of FMEA to radiation therapy has shown intrinsic difficulties similar to those encountered in other domains. 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data-client_id="331998490334-rsn3chp12mbkiqhl6e7lu2q0mlbu0f1b" data-doc_id="120872166" data-landing_url="https://www.academia.edu/127086719/Analyse_des_risques_en_radioth%C3%A9rapie" data-login_uri="https://www.academia.edu/registrations/google_one_tap" data-moment_callback="onGoogleOneTapEvent" id="g_id_onload"></div><div class="ds-top-related-works--grid-container"><div class="ds-related-content--container ds-top-related-works--container"><h2 class="ds-related-content--heading">Related papers</h2><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="0" data-entity-id="31591313" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/31591313/L_analyse_de_la_complexit%C3%A9_de_l_activit%C3%A9_pour_identifier_les_risques_encourus_par_les_patients_en_radioth%C3%A9rapie">L’analyse de la complexité de l’activité pour identifier les risques encourus par les patients en 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translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/31591313/L_analyse_de_la_complexit%C3%A9_de_l_activit%C3%A9_pour_identifier_les_risques_encourus_par_les_patients_en_radioth%C3%A9rapie"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="1" data-entity-id="127086705" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/127086705/Penser_diff%C3%A9remment_les_risques_en_radioth%C3%A9rapie_apr%C3%A8s_les_accidents_d_Epinal_et_de_Toulouse">Penser différemment les risques en radiothérapie après les accidents d’Epinal et de Toulouse</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="60526180" href="https://independent.academia.edu/SylvieThellier">Sylvie Thellier</a></div><p class="ds-related-work--metadata ds2-5-body-xs">2019</p><p class="ds-related-work--abstract ds2-5-body-sm">Les accidents en RT interrogent la sécurité des patients Journée SFEN -6 juin 2019 3 ▌ Feuille de route en radiothérapie  Référentiel en assurance qualité (ASN) :  Article 8 : analyse des risques encourus par les patients  Article 11: analyse des dysfonctionnements, des événements</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Penser différemment les risques en radiothérapie après les accidents d’Epinal et de Toulouse","attachmentId":120872144,"attachmentType":"pdf","work_url":"https://www.academia.edu/127086705/Penser_diff%C3%A9remment_les_risques_en_radioth%C3%A9rapie_apr%C3%A8s_les_accidents_d_Epinal_et_de_Toulouse","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/127086705/Penser_diff%C3%A9remment_les_risques_en_radioth%C3%A9rapie_apr%C3%A8s_les_accidents_d_Epinal_et_de_Toulouse"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="2" data-entity-id="88163891" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/88163891/Lanalyse_des_risques_en_radioth%C3%A9rapie_quelle_alternative_%C3%A0_lAMDEC">L'analyse des risques en radiothérapie : quelle alternative à l'AMDEC?</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="33646691" href="https://independent.academia.edu/LucieCuvelier">Lucie Cuvelier</a></div><p class="ds-related-work--metadata ds2-5-body-xs">2018</p><p class="ds-related-work--abstract ds2-5-body-sm">The present research falls within the fields of risk management and patient safety. It focuses exclusively on the implementation of the prospective approach through the Failure Mode Effects Analysis (FMEA). The FMEA method has been controversial. Its effectiveness in minimizing accident risk in a human and complex sociotechnical system is called into question by its methodological limits in radiation therapy. This work proposes an alternative method which provides a link between the daily work of a medical team and the patient risks. The risk is thought differently in "Spaces for Sharing and Exploring the Complexity of Work". The aim of this space of discussion is to analyze the weakening process of success modes which are mobilized to deal with the complexity of work.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"L'analyse des risques en radiothérapie : quelle alternative à l'AMDEC?","attachmentId":92191770,"attachmentType":"pdf","work_url":"https://www.academia.edu/88163891/Lanalyse_des_risques_en_radioth%C3%A9rapie_quelle_alternative_%C3%A0_lAMDEC","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/88163891/Lanalyse_des_risques_en_radioth%C3%A9rapie_quelle_alternative_%C3%A0_lAMDEC"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="3" data-entity-id="66919493" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/66919493/Approche_ergonomique_de_l_analyse_des_risques_en_radioth%C3%A9rapie_de_l_analyse_des_modes_de_d%C3%A9faillances_%C3%A0_la_mise_en_discussion_des_modes_de_r%C3%A9ussite">Approche ergonomique de l’analyse des risques en radiothérapie : de l’analyse des modes de défaillances à la mise en discussion des modes de réussite</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="60526180" href="https://independent.academia.edu/SylvieThellier">Sylvie Thellier</a></div><p class="ds-related-work--metadata ds2-5-body-xs">2017</p><p class="ds-related-work--abstract ds2-5-body-sm">Cette recherche s’inscrit dans le domaine de la gestion des risques et de la securite des patients, et vise a developper une methode d’analyse de la fragilisation de l’activite pour faire face aux difficultes methodologiques rencontrees par les centres de radiotherapie pour mener une analyse des risques encourus par les patients a partir de la methode AMDEC. Cette these est une contribution empirique et theorique sur la « securite en reflexion » dans des espaces de discussion (regulation froide) que l’on distingue ici de la « securite en action » (regulation chaude). Ce travail cherche a determiner de nouveaux liens entre la securite et la gestion des risques – relation eminemment connectee mais egalement chargee d’ambiguites – en donnant une place preponderante a une etape methodologique souvent delaissee, l’identification des risques. La securite des soins dependant principalement des pratiques quotidiennes exercees par le personnel soignant, il s’agirait pour les analystes de fai...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Approche ergonomique de l’analyse des risques en radiothérapie : de l’analyse des modes de défaillances à la mise en discussion des modes de réussite","attachmentId":77932009,"attachmentType":"pdf","work_url":"https://www.academia.edu/66919493/Approche_ergonomique_de_l_analyse_des_risques_en_radioth%C3%A9rapie_de_l_analyse_des_modes_de_d%C3%A9faillances_%C3%A0_la_mise_en_discussion_des_modes_de_r%C3%A9ussite","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/66919493/Approche_ergonomique_de_l_analyse_des_risques_en_radioth%C3%A9rapie_de_l_analyse_des_modes_de_d%C3%A9faillances_%C3%A0_la_mise_en_discussion_des_modes_de_r%C3%A9ussite"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="4" data-entity-id="127086688" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/127086688/L_analyse_des_risques_d_un_syst%C3%A8me_sociotechnique_complexe_le_cas_de_la_radioth%C3%A9rapie">L’analyse des risques d’un système sociotechnique complexe : le cas de la radiothérapie</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="60526180" href="https://independent.academia.edu/SylvieThellier">Sylvie Thellier</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Cancer/Radiothérapie, 2019</p><p class="ds-related-work--abstract ds2-5-body-sm">en Français La complexité croissante des situations de travail en radiothérapie (évolutions des technologies, dynamique de changement, accroissement des contraintes, évolution de l'action collective, des métiers, des interfaces entre les Hommes, des Interfaces Homme-Machine, etc.) et les limites des méthodes classiques de type AMDEC (Analyse des Modes de Défaillances, de leurs Effets et de leur Criticité) pour analyser les risques encourus par les patients en radiothérapie génèrent des difficultés pour identifier comment les situations de travail d'une équipe soignante peuvent conduire à des situations risquées pour les patients. Ce constat nous a amené à développer une nouvelle méthode d'analyse des risques : les Espaces de Partage et d'Exploration de la Complexité du Travail (EPECT). L'objectif de cet article est de présenter cette démarche visant à mieux sécuriser un processus de soin (fiabilisation des pratiques, mise à jour du travail prescrit, définition de mesures de prévention et de correction, poursuite des réflexions) à partir d'une compréhension de la complexité des situations de travail en radiothérapie et d'une modification de notre manière de penser les risques. The increasing complexity of radiotherapy work situations (technological developments, dynamics of change, increased constraints, evolution of collective actions, of professions, of interfaces between people, of humanmachine interfaces, etc.) and the limits of traditional FMEA method (Failure Mode and Effects Analysis) for analysing the risks incurred by radiotherapy patients generate difficulties in identifying how the work situations of a healthcare team can generate risky situations for patients. This observation has led us to develop a new method of risk analysis: the Work Complexity Sharing and Exploration Spaces (EPECT in French). The objective of this article is to better secure a care process (making practices more reliable, updating prescribed work, defining preventive and corrective measures, continuing reflections) based on an understanding of the complexity of radiotherapy work situations and a change in our way of thinking about risks.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"L’analyse des risques d’un système sociotechnique complexe : le cas de la radiothérapie","attachmentId":120872119,"attachmentType":"pdf","work_url":"https://www.academia.edu/127086688/L_analyse_des_risques_d_un_syst%C3%A8me_sociotechnique_complexe_le_cas_de_la_radioth%C3%A9rapie","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/127086688/L_analyse_des_risques_d_un_syst%C3%A8me_sociotechnique_complexe_le_cas_de_la_radioth%C3%A9rapie"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="5" data-entity-id="20266788" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/20266788/Prise_en_charge_du_risque_h%C3%A9mostatique_au_cours_des_actes_de_radiologie_interventionnelle">Prise en charge du risque hémostatique au cours des actes de radiologie interventionnelle</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="41483470" href="https://independent.academia.edu/ChristopheTeriitehau">Christophe Teriitehau</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal de Radiologie, 2011</p><p class="ds-related-work--abstract ds2-5-body-sm">Periprocedural management of hemostasis risk in interventional radiology</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Prise en charge du risque hémostatique au cours des actes de radiologie interventionnelle","attachmentId":41169884,"attachmentType":"pdf","work_url":"https://www.academia.edu/20266788/Prise_en_charge_du_risque_h%C3%A9mostatique_au_cours_des_actes_de_radiologie_interventionnelle","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/20266788/Prise_en_charge_du_risque_h%C3%A9mostatique_au_cours_des_actes_de_radiologie_interventionnelle"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="6" data-entity-id="113220670" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/113220670/Proc%C3%A9dure_d%C3%A9valuation_du_risque_radiotoxique">Procédure d'évaluation du risque radiotoxique</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="282677861" href="https://independent.academia.edu/NathaliePaquet4">Nathalie Paquet</a></div><p class="ds-related-work--abstract ds2-5-body-sm">La Procédure d’évaluation du risque radiotoxique a pour objectif d’estimer les probabilités d’effets néfastes chez des récepteurs écologiques exposés à des rayonnements ionisants. Elle est complémentaire à la Procédure d’évaluation du risque écotoxicologique pour la réhabilitation des terrains contaminés (PERE; CEAEQ, 1998) utilisée pour évaluer les risques associés à la toxicité chimique des contaminants. La caractérisation du risque radiotoxique consiste à comparer les doses d’exposition estimées pour chacun des récepteurs écologiques retenus (débit de dose total, toutes voies d’exposition et tous radionucléides confondus) à des valeurs de référence radiotoxiques. Ces valeurs correspondent au niveau qui n’induit pas de changement structurel ou fonctionnel excédant la variabilité naturelle chez l’organisme concerné. La procédure d’évaluation du risque radiotoxique peut être utilisée dans tous les cas où des radionucléides peuvent se retrouver dans l’environnement, incluant la gesti...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Procédure d'évaluation du risque radiotoxique","attachmentId":110289540,"attachmentType":"pdf","work_url":"https://www.academia.edu/113220670/Proc%C3%A9dure_d%C3%A9valuation_du_risque_radiotoxique","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/113220670/Proc%C3%A9dure_d%C3%A9valuation_du_risque_radiotoxique"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="7" data-entity-id="18490889" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/18490889/Analyses_des_risque">Analyses des risque</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="38512386" href="https://independent.academia.edu/chikiessaadia">chiki essaadia</a></div><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Analyses des risque","attachmentId":40091956,"attachmentType":"pdf","work_url":"https://www.academia.edu/18490889/Analyses_des_risque","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/18490889/Analyses_des_risque"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="8" data-entity-id="78943625" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/78943625/1324_Risques_et_responsabilite_en_radiologie_diagnostique_et_interventionnelle_aspects_ethiques_et_medico_legaux">1324 Risques et responsabilite en radiologie diagnostique et interventionnelle : aspects ethiques et medico-legaux</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="42308712" href="https://independent.academia.edu/StephanosFinitsis">Stephanos Finitsis</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal de Radiologie, 2004</p><p class="ds-related-work--abstract ds2-5-body-sm">Risks and responsibilities in diagnostic and interventional radiology. Ethical and medicolegal considerations.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"1324 Risques et responsabilite en radiologie diagnostique et interventionnelle : aspects ethiques et medico-legaux","attachmentId":85826209,"attachmentType":"pdf","work_url":"https://www.academia.edu/78943625/1324_Risques_et_responsabilite_en_radiologie_diagnostique_et_interventionnelle_aspects_ethiques_et_medico_legaux","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/78943625/1324_Risques_et_responsabilite_en_radiologie_diagnostique_et_interventionnelle_aspects_ethiques_et_medico_legaux"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="9" data-entity-id="61097508" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/61097508/Qualit%C3%A9_s%C3%A9curit%C3%A9_en_radioth%C3%A9rapie_pour_une_strat%C3%A9gie_professionnelle">Qualité - sécurité en radiothérapie : pour une stratégie professionnelle</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="145294136" href="https://independent.academia.edu/ParmentierG%C3%A9rard">Gérard Parmentier</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Cancer/Radiothérapie</p><p class="ds-related-work--abstract ds2-5-body-sm">En médecine, en radiothérapie oncologique, comme ailleurs, le principe de qualité n'a de sens que s'il est défini. En France comme partout, la radiothérapie a ses forces et ses faiblesses. Comme dans tous les pays, son avenir semble assuré par ses performances en termes de coût/efficacité comme par sa capacité à évoluer du triple point de vue de ses équipements, de ses métiers et de son organisation. Pourtant, la radiothérapie française est en crise. Les professionnels ont vu clair. Depuis plus de dix ans ils rappellent les autorités sanitaires à leurs responsabilités concernant les évolutions démographiques des radiothérapeutes et des physiciens, la rénovation des plateaux techniques, la modernisation des organisations, la promotion de l'évaluation des procédures et des résultats et le développement d'une plus grande équité dans les financements. Mais le retard pris, la mise sous pression des professionnels par l'État, ses services, ses agences et les médias à la suite des récents accidents, sont source de nombreux effets pervers et d'une grande inquiétude. L'accident d'Épinal a été l'initiateur d'un effort de professionnalisation de la gestion des risques, mais aussi d'une période troublée propice à une certaine confusion des esprits, au découragement et aux comportements protecteurs. Les risques ressentis par les professionnels semblent alors surtout provenir des autorités et des médias. Il apparaît que le thème de la qualité est au centre de tous les discours. Sous ce vocable, c'est en fait le respect des procédures liées à l'impératif de sécurité qui est privilégié par l'État et ses représentants. La sécurité apparente semble l'emporter sur la qualité réelle des pratiques. Le temps est donc venu d'une clarification des concepts de qualité et de sécurité, des organisations qui y concourent et de l'élaboration d'une stratégie claire rassemblant l'interprofession. Dans ce contexte, l'implication des sociétés savantes et en particulier de la Société française de radiothérapie oncologique est une nécessité.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Qualité - sécurité en radiothérapie : pour une stratégie professionnelle","attachmentId":74258800,"attachmentType":"pdf","work_url":"https://www.academia.edu/61097508/Qualit%C3%A9_s%C3%A9curit%C3%A9_en_radioth%C3%A9rapie_pour_une_strat%C3%A9gie_professionnelle","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/61097508/Qualit%C3%A9_s%C3%A9curit%C3%A9_en_radioth%C3%A9rapie_pour_une_strat%C3%A9gie_professionnelle"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div></div></div><div class="ds-sticky-ctas--wrapper js-loswp-sticky-ctas hidden"><div class="ds-sticky-ctas--grid-container"><div class="ds-sticky-ctas--container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--sticky-ctas","attachmentId":120872166,"attachmentType":"pdf","workUrl":null}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--sticky-ctas","attachmentId":120872166,"attachmentType":"pdf","workUrl":null}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div></div></div><div class="ds-below-fold--grid-container"><div class="ds-work--container js-loswp-embedded-document"><div class="attachment_preview" data-attachment="Attachment_120872166" style="display: none"><div class="js-scribd-document-container"><div class="scribd--document-loading js-scribd-document-loader" style="display: block;"><img alt="Loading..." src="//a.academia-assets.com/images/loaders/paper-load.gif" /><p>Loading Preview</p></div></div><div style="text-align: center;"><div class="scribd--no-preview-alert js-preview-unavailable"><p>Sorry, preview is currently unavailable. 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class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/54217029/IRM_Interventionnelle_Risques_de_br%C3%BBlure_du_patient_et_du_radiologue">IRM Interventionnelle : Risques de brûlure du patient et du radiologue</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="38905299" href="https://independent.academia.edu/MArmenean">M. Armenean</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal de Radiologie, 2007</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"IRM Interventionnelle : Risques de brûlure du patient et du radiologue","attachmentId":70687595,"attachmentType":"pdf","work_url":"https://www.academia.edu/54217029/IRM_Interventionnelle_Risques_de_br%C3%BBlure_du_patient_et_du_radiologue","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/54217029/IRM_Interventionnelle_Risques_de_br%C3%BBlure_du_patient_et_du_radiologue"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="6" data-entity-id="30815436" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/30815436/Gestion_du_risque_radioactif_associ%C3%A9_au_d%C3%A9c%C3%A8s_d_un_patient_12heures_apr%C3%A8s_injection_de_Quadramet_">Gestion du risque radioactif associé au décès d’un patient 12heures après injection de Quadramet®</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="58658392" href="https://independent.academia.edu/FBonichon">F. Bonichon</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Médecine Nucléaire, 2009</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Gestion du risque radioactif associé au décès d’un patient 12heures après injection de Quadramet®","attachmentId":51248655,"attachmentType":"pdf","work_url":"https://www.academia.edu/30815436/Gestion_du_risque_radioactif_associ%C3%A9_au_d%C3%A9c%C3%A8s_d_un_patient_12heures_apr%C3%A8s_injection_de_Quadramet_","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/30815436/Gestion_du_risque_radioactif_associ%C3%A9_au_d%C3%A9c%C3%A8s_d_un_patient_12heures_apr%C3%A8s_injection_de_Quadramet_"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="7" data-entity-id="55864465" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/55864465/Progr%C3%A8s_r%C3%A9cents_en_radioth%C3%A9rapie">Progrès récents en radiothérapie</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="39036755" href="https://independent.academia.edu/BeyP">P. Bey</a></div><p class="ds-related-work--metadata ds2-5-body-xs">La Revue de Médecine Interne, 1996</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Progrès récents en radiothérapie","attachmentId":71532163,"attachmentType":"pdf","work_url":"https://www.academia.edu/55864465/Progr%C3%A8s_r%C3%A9cents_en_radioth%C3%A9rapie","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/55864465/Progr%C3%A8s_r%C3%A9cents_en_radioth%C3%A9rapie"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="8" data-entity-id="16958882" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/16958882/Les_accidents_lors_d_explorations_radiologiques">Les accidents lors d’explorations radiologiques</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="36464003" href="https://independent.academia.edu/PhilippejeanBousquet">Philippe-jean Bousquet</a></div><p class="ds-related-work--metadata ds2-5-body-xs">2009</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Les accidents lors d’explorations radiologiques","attachmentId":42368862,"attachmentType":"pdf","work_url":"https://www.academia.edu/16958882/Les_accidents_lors_d_explorations_radiologiques","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/16958882/Les_accidents_lors_d_explorations_radiologiques"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="9" data-entity-id="93614731" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/93614731/Pr%C3%A9vention_des_cancers_radio_induits">Prévention des cancers radio-induits</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="45337217" href="https://independent.academia.edu/MazalA">A. 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ds2-5-body-xs">Radioprotection, 2009</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Évaluation et Gestion Du Risque Radioactif Suite Au Décès D’Un Patient Ayant Reçu Une Dose Thérapeutique D’IODE-131 Dans Le Cadre D’Un Traitement en Radiothérapie Métabolique","attachmentId":89978826,"attachmentType":"pdf","work_url":"https://www.academia.edu/85210748/%C3%89valuation_et_Gestion_Du_Risque_Radioactif_Suite_Au_D%C3%A9c%C3%A8s_D_Un_Patient_Ayant_Re%C3%A7u_Une_Dose_Th%C3%A9rapeutique_D_IODE_131_Dans_Le_Cadre_D_Un_Traitement_en_Radioth%C3%A9rapie_M%C3%A9tabolique","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/85210748/%C3%89valuation_et_Gestion_Du_Risque_Radioactif_Suite_Au_D%C3%A9c%C3%A8s_D_Un_Patient_Ayant_Re%C3%A7u_Une_Dose_Th%C3%A9rapeutique_D_IODE_131_Dans_Le_Cadre_D_Un_Traitement_en_Radioth%C3%A9rapie_M%C3%A9tabolique"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="11" data-entity-id="127086711" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/127086711/Appropriation_dun_nouveau_syst%C3%A8me_dimagerie_m%C3%A9dicale_en_radioth%C3%A9rapie_externe_et_risques_%C3%A9mergents">Appropriation d'un nouveau système d'imagerie médicale en radiothérapie externe et risques émergents</a><div class="ds-related-work--metadata"><a 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