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Table 6 Recommended steps for improvement and/or harmonization for selected indicators/processes

From: Multicentre clinical radiotherapy audit in rectal cancer: results of the IROCA project

PROCESS OR INDICATOR

FINDING

RECOMMENDED ACTION

DIAGNOSTIC AND PRE-TREATMENT PHASE

Presentation to MTB

75.6% of cases presented to MTB (range, 50–95%).

Present all cases to MTB

Implement quality control measures to ensure registration of data in 100% of cases

Presentation at departmental clinical session

63.8% of cases presented

Establish clear criteria for presenting cases to clinical sessions

Consider using mini-tumour boards comprised of radiation oncologists specialising in the specific tumour type/location

Staging MRI

67.0% of cases (range, 10.3 to 95%)

Implement measures to raise MRI-based staging to 100%

Participation in clinical trial

6.3% (range, 0 to 25%)

At centres with low rates, seek to increase the percentage of patients participating in clinical trials

TREATMENT PHASE

Median time between biopsy and first visit to RT

37.6 days (range, 21.6–58.6)

Implement measures to reduce this time interval

Median time elapsed between first visit and start of radiotherapy

22 days (range, 15.1–38.8)

Implement measures to reduce this time interval

Treatment interruptions

43.9% of cases (EBRT), range 2.5–90%

Implement measures to reduce interruptions at centres with a high percentage of treatment interruptions

Consider working on Saturdays and holidays

Treatment compensation rates

2.1% of cases compensated (range, 0 to 100%)

Data not registered in some cases

Implement measures to increase compensation rates

Apply quality control measures to ensure registration of data in 100% of cases

Treatment completed in prescribed time

55.7% of treatments completed in prescribed time ± 4 days (range, 10–97.5%)

Apply procedures to raise rate to 100%

Consider working on Saturdays and holidays

FOLLOW-UP PHASE

Registration of AEs missing

Data missing in 11.2% of cases

Implement quality control measures to ensure registration of data in 100% of cases

  1. Abbreviations: MTB, multidisciplinary tumour board; MRI, magnetic resonance imaging; AE, adverse events; RT, radiotherapy