Radiotherapy practice for paediatric brain tumours across Europe and quality assurance initiatives: Current situation, international survey and future perspectives

Abstract

The aim of the study is to analyse radiotherapy quality assurance (RTQA) processes in the treatment of paediatric central nervous system (CNS) tumours across Europe. Methods: The RTQA aspects of major past and current European trials for paediatric CNS tumours were reviewed based on study protocols and publications. A survey among radiation oncologists and paediatric oncologists about the practices of RTQA in paediatric CNS tumours across European countries was also performed. Results: Several (inter)national initiatives to implement RTQA are being developed across Europe, with an apparent paradigm shift from retrospective to prospective RTQA. Experts from 21 of 29 contacted countries responded to the survey. National consensus guidelines for paediatric CNS tumours are available in 10 of 21 countries. Twenty-one of 33 experts

QUARTET: A SIOP Europe project for quality and excellence in radiotherapy and imaging for children and adolescents with cancer

“…Prospective review of target volume delineation and treatment plans, within and outside the context of clinical trials, is considered best practice to reduce the risk of systematic errors and support ongoing improvement [4,8,26e29]. Unfortunately, uneven distribution of expertise and resources extends to the provision of RTQA initiatives [8,9], which have demonstrated an ability to mitigate planning errors [21e23]. As an independent, centralised platform, QUARTET provides the expertise, infrastructure, and funding for RTQA activities so that it is not dependent on, nor borne by, national providers.…”

“…Once combined with a specialist and everadvancing treatment modality such as radiotherapy, pooling of resources, and knowledge-sharing are essential to maximise the quality and effectiveness of care. Unfortunately, investment and expertise in paediatric radiotherapy is not uniformly distributed in Europe, affecting patients treated within and outside of clinical trials [8,9]. A systematic and centralised mechanism for radiotherapy quality assurance (RTQA) can facilitate a standardised approach to radiotherapy planning requirements and their prospective evaluation in clinical practice, thereby reducing variations in implementation and treatment, and improving patient outcomes.…”