Table 1.
General requirements
| QI 1: Treatment decisions discussed at a multidisciplinary team meeting | |
| Type | Process indicator |
| Description | The decision for any therapeutic intervention (excluding diagnostic procedure, ie, biopsies or conization performed with a diagnostic intent) has been taken by a multidisciplinary team, including at least a gynecologic oncologist or specialized gynecologic surgeon dedicated to the management of gynecological cancer, a radiologist, a medical or clinical oncologist, a pathologist, and a radiation oncologist specialized in the treatment of gynecological cancers and with expertise in brachytherapy |
| Specifications |
Numerator: number of cervical cancer patients for whom the decision for any therapeutic intervention has been reached within a multidisciplinary team Denominator: all patients with cervical cancer referred to that center |
| Target | ≥95% |
| QI 2: Required pretreatment workup | |
| Type | Outcome indicator |
| Description | The minimal pre-radiotherapy workup for a histologically confirmed cervical cancer includes a clinical examination, pelvic MRI, and 18-FDG PET-CT |
| Specifications |
Numerator: number of patients with histologically confirmed cervical cancer who receive a workup as defined above, before primary radiotherapy treatment (excluding palliative cases) Denominator: all patients with histologically confirmed cervical cancer treated with primary radiotherapy treatment (excluding palliative cases) |
| Target | ≥90%. |
| QI 3: Time to primary radiotherapy | |
| Type | Outcome indicator |
| Description | Time between referral to the center and initiation of primary radiotherapy treatment |
| Specifications |
Numerator: number of cervical cancer patients who start their primary radiotherapy treatment within 6 weeks from the date the patient is referred for the first time to the center Denominator: all patients with cervical cancer treated with primary radiotherapy treatment |
| Targets | Optimal target: ≥90% Minimum required target: ≥75% |
| QI 4: Center participating in clinical trials in gynecological cancers | |
| Type | Structural indicator |
| Description | The center participates in clinical trials in gynecological cancers involving radiotherapy |
| Specifications |
Numerator: not applicable Denominator: not applicable |
| Target | At least one ongoing clinical trial or one clinical trial conducted in the past 5 years in gynecological cancers involving radiotherapy |
| QI 5: Patients are treated with upfront radiotherapy and/or concurrent chemotherapy | |
| Type | Outcome indicator |
| Description | Patients with node negative IB3–IIA2 not treated with surgery and patients with stage IIB–IVa cervical cancer are treated with upfront radiotherapy and/or concurrent chemotherapy |
| Specifications |
Numerator: number of patients with the above criteria treated with upfront radiotherapy and/or concurrent chemotherapy (outside of a clinical trial) Denominator: total number of patients with the above criteria referred to a center (and treated outside of a clinical trial) |
| Target | ≥95% |
| QI 6: Patients are treated with brachytherapy boost | |
| Type | Outcome indicator |
| Description | Patients treated with EBRT (with curative intent) for cervical cancer are treated with a brachytherapy boost |
| Specifications |
Numerator: number of patients treated with EBRT (with curative intent) for cervical cancer treated with a brachytherapy boost Denominator: total number of patients treated with EBRT (with curative intent) for cervical cancer |
| Target | ≥95% |
EBRT, external beam radiotherapy; 18-FDG PET-CT, positron emission tomography–computed tomography with 2-deoxy-2-fluorine-18-fluoro-D-glucose; MRI, magnetic resonance imaging; QI, quality indicator.