Table 2.
Tumour site‐specific radiation quality indicators
| Tumour site | RT Pathway | ROQI | Quality Domain | References |
|---|---|---|---|---|
| PROSTATE | Pre‐treatment and Clinical | Documentation of pre‐treatment PSA | Process, appropriateness of care | Tsiamis 25 , Albert 17 |
| Documentation of clinical stage, TNM and Gleason primary and secondary/tertiary grade | Process, appropriateness of care | Tsiamis 25 , Albert 17 | ||
| Documentation of risk‐specific staging investigations for high risk prostate cancer | Process, appropriateness of care | Tsiamis 25 , Albert 17 | ||
| Different treatment options discussed with patient for localised including active surveillance for low‐risk disease? | Process | Albert 17 UK NPCA 10 , Choosing Wisely 27 | ||
| Treatment | Men with high risk disease receiving local active treatment | Process | Tsiamis 25 | |
| Men undergoing conventionally fractionated should receive at least 74 Gy to the prostate | Process, appropriateness of care | Tsiamis 25 , SEOR 23 , Q‐RRO 36 | ||
| Men undergoing radical RT should receive IMRT/VMAT | Process, technical, safety, patient‐centred | Tsiamis 25 , Albert 17 | ||
| Men receiving EBRT should be treated on high energy lincac>6MV, with DVH calculations for EBRT and post‐implant dosimetry for BT | Process, technical | Q‐RRO 36 , Albert 17 | ||
|
Men undergoing EBRT should have daily IGRT (fiducial markers or CBCT) |
Process, technical, patient‐centred | Tsiamis 25 , Q‐RRO 36 | ||
| Men with intermediate risk disease offered hypofractionation | Process, patient‐centred | UK NPCA 10 , UK RTDS 29 , PCOR‐ANZ 11 | ||
| Men with high risk disease offered RT to pelvic nodes | Process | UK NPCA 10 | ||
| Men with high risk disease should not get LDR brachytherapy | Process, appropriateness of care | Tsiamis 25 | ||
| Men receiving LDR should get over 140/145 Gy Iodine 125 | Process, appropriateness of care | Tsiamis 25 , SEOR 23 | ||
| Men with low‐risk disease receiving EBRT should not get ADT | Process, appropriateness of care | Tsiamis 25 | ||
| Men with high risk disease should have long course ADT >2 years | Process, appropriateness of care | Tsiamis 25 , ACHS 26 , Q‐RRO 36 , Albert 17 | ||
| Salvage | Post‐RP, men without M1 disease should be offered salvage RT | Process, appropriateness of care | Tsiamis 25 | |
| Post‐treatment | Document PSA within 1 year post‐RT | Outcome | Tsiamis 25 | |
| Patient seen in clinic for follow‐up assessment within 1 year | Outcome | Tsiamis 25 | ||
| Assessment of PRO and QoL at 1 year | Outcome, Patient‐centred | Tsiamis 25 , UK NPCA 10 | ||
| Lower GI admissions for toxicity (up to 2 years post‐RT) | Outcome, patient‐centred | NPCA 10 , 32 | ||
| BREAST | Pre‐treatment | Multiple multidisciplinary aspects of care for diagnosis and initial treatment | Process, Structure | Best 24 |
| Receipt of adjuvant RT after surgery (when no SACT) within 12 weeks | Process, timeliness | Best 24 | ||
| RT to LN as well as breast/chest wall when N+ | Process, appropriateness of care | Best 24 | ||
| Delivery of boost to primary when age<50 or when positive margin | Process, appropriateness of care | Best 24 | ||
| Node negative cases receiving adj RT to whole breast after BCS | Process, appropriateness of care | Best 24 | ||
| Use of heart dose constraints, heart DVH, access to DIBH, plans with max point dose‐limited to 110% | Process, Technical | Best 24 | ||
| Treatment | Guidelines for complex cases including LN fractionation, implants, wound healing. Peer review of these and internal mammary inclusion | Structure | Best 24 | |
| Boost to resection cavity 16 Gy/8# or 10 Gy/4‐5# | Process, appropriateness of care | Best 24 | ||
| Use of hypofractionation for adjuvant RT after conservative surgery | Process, value, patient‐centred | Best 24 , SEOR 23 , UK RTDS 29 , Choosing wisely 27 | ||
| Receipt of adjuvant RT within 1 year of conservative surgery | Process, Appropriateness of care | Albert 17 | ||
| Post‐Treatment | Hormone therapy use for stage Ic‐IIIC ER and PR positive cases | Process, Appropriateness of care | Albert 17 | |
| Complete follow‐up documented following RT after breast conservations (including mammography, healthcare provider responsible for surveillance, survivorship plan and referral back to GP | Process, multidisciplinary | Albert 17 , Best 24 | ||
| LUNG | Use of CTPET and brain imaging prior stage III curative intent | Process | UK NLCA 9 , Q‐RRO Komaki 35 | |
| Use of SABR for stage I and II NSCLC | Process, Value, patient‐centred | SEOR 23 , UK NLCA 9 , 30 | ||
| Use of concurrent chemoRT NSCLC | Process, Appropriateness of care | UK NLCA 9 , 31 | ||
| Use of doses over 60 Gy for conventional RT NSCLC | Process, Appropriateness of care | Q‐RRO Komaki 35 | ||
| Use of twice daily RT for L‐SCLC and PCI | Process, Appropriateness of care | Q‐RRO Komaki 35 | ||
| Define at least 2 OAR | Process | Albert 17 | ||
| RECTAL | Patients with locally advanced disease receiving RT within 6 months of diagnosis/ presurgery | Process, Appropriateness of care | Albert 17 | |
| PANCREAS | Use of chemo RT when no surgery and define at least 2 OAR | Process, Appropriateness of care | Albert 17 | |
| Head and Neck | People treated with IMRT | Structure, Technical | SEOR 23 | |
| CERVIX | Use of chemoRT for curative intent treatments | Process, Appropriateness of care | Albert 17 |