LES ACTIVITÉS NUCLÉAIRES : RAYONNEMENTS IONISANTS ET RISQUES POUR LA SANTÉ ET L’ENVIRONNEMENT An improvement is expected in the identification of the barriers to be protected. In 2025, almost two-thirds of the facilities inspected (63%) had defined these barriers, a clear improvement on 2023 (one in five) and 2024 (one in four). Over half of the facilities inspected in 2025 had a maintenance plan for the technical protection systems that is correctly applied (56%). ASNR notes an improvement compared with 2024 (31%), although efforts are still required. The results are detailed in chapter 6. ASNR notes that progressive deployment of the new requirements relative to protecting access to high-activity sources is continuing. The situation is progressing irregularly but cannot yet be considered compliant. 2.2.3.2 Emergency situations and management of malfunctions The malfunctions of brachytherapy devices which can result in jams or incorrect positioning of the source can lead to overexposure of personnel or patients, sometimes with serious consequences (radiation necrosis). Consequently, this type of event underlines the need to comply with the technical requirements concerning the use of these devices, and the obligations to provide training in emergency situation management and to conduct exercises. 2.2.3.3 Radiation protection of medical professionals The occupational radiation protection measures deployed in 2025 by the brachytherapy departments were considered satisfactory in nearly 59% of the departments, compared with three quarters in 2024. Of the 16 centres possessing high-activity sources inspected in 2025, 60% have put in place enhanced training in emergency situations and have organised situational exercises, particularly for managing situations linked to source jamming, whereas 80% had done so in 2024 but only 46% in 2023. ASNR reiterates the importance of providing radiation protection training for the professionals when high-activity sources are possessed in order to be capable of managing jammed source situations. 2.2.3.4 Radiation protection of patients As with external-beam radiotherapy, the radiation protection of brachytherapy patients is assessed through inspections concerning the implementation of the QSMS and care safety. 2.2.3.5 The treatment Quality and Safety Management System The results of the inspections carried out in 2025 showed that most of the brachytherapy departments inspected had implemented a QSMS (see Graph 4). A review of the inspections carried out over the 2022‑2025 period and covering all the departments reveals the following trends: ∙The reporting culture and the organisation for managing event notifications are considered satisfactory for all the departments inspected in recent years, with rates of 100% in 2025 and 90% in 2024. ∙The analysis, definition of corrective actions and building on lessons learned are considered satisfactory in a large majority of the departments, with a situation in 2025 (91%) similar to that of 2024 (90%). ∙The assessment of corrective action effectiveness has been progressing. Thus, while only half of the departments assessed the effectiveness of corrective actions in 2022, 90% of the inspected centres did so in 2025 (70% in 2024). ∙90% of the departments inspected in 2025 have a validation procedure for HDR treatments, this rate having increased, as it ranged between 67% and 80% over the period 2022-2024. ∙The competency sign-off process is being deployed, but there are still disparities between the medical and paramedical personnel, given that it is applied mostly for the paramedical staff. Maintenance and quality controls – The majority of the centres have an inventory of the MDs and a register for recording maintenance operations and quality controls. In the absence of a regulatory baseline reference framework for quality control of brachytherapy devices, the quality controls implemented are based in particular on recommendations from manufacturers or professional organisations: ESTRO (European Society of Radiation Oncology) Guide – Booklet No. 81 and Guide No. 36 from the French Society of Medical Physics (SFPM). Maintenance of the afterloaders (for HDR and PDR applications) – This is ensured by the manufacturers, particularly when replacing sources. The brachytherapy departments rely on these verifications to guarantee correct operation of the devices. The source activity is verified at each delivery, and verifications are also carried out on source removal. ASNR notes that the verifications performed by the departments can sometimes prove insufficient when a new device is received, and draws attention to the need to clearly define these verifications taking into account the manufacturer’s requirements, particularly for 0 2 4 6 8 10 12 14 Bordeaux Caen Châlons-enChampagne Dijon Lille Lyon Marseille Nantes Orléans Paris Strasbourg Licensed centres (legal entities) Including high dose-rate centres New licences or license renewals 10 9 1 1 1 1 1 1 3 3 4 4 3 6 6 3 4 4 3 3 5 2 2 2 1 7 7 2 2 2 13 10 5 GRAPH 3 Breakdown, by ASNR regional division, of the number of brachytherapy centres, of high dose-rate brachytherapy centres and the number of new licenses or license renewals in 2025 ASNR Report on the state of nuclear safety and radiation protection in France in 2025 205 01 05 02 03 04 09 06 10 07 11 13 08 12 A / Z
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