Radiotherapy Quality Assurance (RTQA)

Radiotherapy in clinical trials is susceptible to variation at every stage of the patient pathway, from referral and imaging to treatment planning, delivery, and data submission. The EORTC Radiotherapy Quality Assurance (RTQA) programme minimises this variation through structured, trial-specific procedures that support high-quality, reproducible radiotherapy across all participating centres.

The EORTC RTQA team supports trials throughout the study lifecycle by promoting consistent, protocol-compliant planning and delivery. The team works with investigators and participating centres to facilitate accurate implementation of trial guidelines and collaborates with international quality assurance organisations to align RTQA activities with global best practice.

The EORTC RTQA programme is an active member of the Global Harmonization Group, as such it contributes to international efforts to standardise radiotherapy quality assurance.

RTQA involvement accross the study life cycle - Graph

RTQA procedures

As part of the site selection process for trials that include radiotherapy, the RTQA team verifies that all centres wishing to participate i.e., to enrol patients receiving protocol-mandated radiotherapy, meet the minimum human resources and equipment workload requirements.

Centres must complete the RTQA requirements specified in the protocol’s Quality Assurance in Radiotherapy (RTQA) section of the protocol. These may include one or more of the following components.

  • Trial-Specific Facility Questionnaire: Completion of an online questionnaire detailing the centre’s radiotherapy equipment, treatment planning, verification protocols, and patient-specific quality assurance procedures. The link to the trial questionnaire is provided in the trial-specific RTQA guidelines.
  • Beam Output Audit: Submission of a recent external dosimetry audit report providing independent verification of reference dosimetry performance
  • Advanced Credentialing Audit: This involves an independent dosimetric assessment of advanced techniques such as for IMRT and proton deliveries. The credentialing requirements are detailed in the RTQA guidelines and will normally be communicated to interested sites during the feasibility questionnaire.
  • Benchmark Case: The investigator completes the delineation and/or treatment planning for a test patient to demonstrate understanding of trial-specific delineation, planning, and prescription requirements. Case details are provided within the trial-specific RTQA guidelines, when implemented.
  • Individual Case Review (ICR): The radiotherapy treatment plan for enrolled patients is reviewed by an expert panel; components relevant to delineation and planning are reviewed against the protocol to assess compliance. Whether all, or a sub-set of patients are reviewed, and whether this takes prospectively or retrospectively is defined within the protocol. Planning guidance and the submission requirements are detailed within the RTQA guidelines.

More information can be requested directly from the RTQA team at rtqa@eortc.org