ESTRO 2025 - Abstract Book

S4302

RTT - Service evaluation, quality assurance and risk management

ESTRO 2025

2797

Proffered Paper A decade of peer-reviewed clinical audits in Belgian radiotherapy: insights from B-QUATRO Aude Vaandering 1 , Vincent Remouchamps 2 , Anitha Batamuriza-Almasi 3 , Ann Vermylen 4 , Barbara Vanderstraeten 5 , Caroline Weltens 6 , Nathalie Deman 7 , Dirk Verellen 8 , Els Goemaere 9 , Catherine Meunier 2 , Michel Van Dycke 10 , Nadine Linthout 11 , Pieternel Thysebaert 12 , Séverine Cucchiaro 13 , Sylvie Derycke 14 , Milan Tomsej 15 , Stefaan Vynckier 16 , Pierre Scalliet 16 , Paul Van Houtte 17 , Frederik Vanhoutte 5 , Katia Vandeputte 18 1 Radiation Oncology department, Cliniques Universitaires St Luc, Brussels, Belgium. 2 Department of Radiation Oncology, CHU UCL Namur, Site Sainte Elisabeth, Namur, Belgium. 3 Department of Radiation Oncology, Centre Hospitalier EpiCURA, Baudour, Belgium. 4 Department of Radiation Oncology, Iridium Network, Wilrijk (Antwerp), Belgium. 5 Department of Radiation Oncology, Ghent University Hospital, Gent, Belgium. 6 Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium. 7 Department of Physics, AZ St Lucas, Gent, Belgium. 8 Department of Radiation Oncology, Iridium Network, Antwerp, Belgium. 9 Department of Radiation Oncology, AZ Delta, Roeselare, Belgium. 10 Department of Radiation Oncology, Clinique St Jean, Brussels, Belgium. 11 Department of Radiation Oncology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium. 12 Department Medical Imaging and Radiotherapy, Odisee Hogeschool, Brussels, Belgium. 13 Department of Radiation Oncology, CHU Liège, Liège, Belgium. 14 Department of Radiation Oncology, AZ Groeninge, Kortrijk, Belgium. 15 Service de Radiophysique Médicale- CHU Charleroi – Chimay, Humani, Charleroi, Belgium. 16 Center of Molecular Imaging, Radiotherapy and Oncology, Université catholique de Louvain, Brussels, Belgium. 17 Department of Radiation Oncology, Institut Jules Bordet, Brussels, Belgium. 18 Radiation Oncology department, CH Mouscron, Mouscron, Belgium Purpose/Objective: Clinical audits offer numerous benefits, primarily aiming to encourage continuous quality improvement through the implementation of corrective actions based on audit recommendations. In Belgium, peer-reviewed clinical audits of all radiotherapy (RT) departments have been conducted since 2010, resulting in each department being audited twice. Post the second audit cycle, the reports were analyzed to identify areas needing improvement on a national scale. Material/Methods: Following the completion of the initial audit cycle in 2015, which utilized the IAEA QUATRO (Quality Assurance Team for Radiation Oncology) methodology, a second cycle of audits was conducted using B-QUATRO, a modified version of the IAEA QUATRO [1,2]. This cycle concluded in 2023, after a brief interruption due to the COVID-19 pandemic. The resulting B-QUATRO audit reports were subsequently analyzed, and issued recommendations were categorized according to the coding key proposed by Izewska et al. classifying the recommendations into four primary categories: staffing, infrastructure, process, or organizational factors, further subdivided into a three-level categorization code [3]. Results: As shown in FIG 1, 481 recommendations were identified from the audit reports, with the majority (32%) addressing organizational issues, attributed to the B-QUATRO manual's focus on quality management systems. A significant portion highlighted challenges in systematically implementing proactive risk assessments, despite it being a legal requirement for new equipment or procedures. Additionally, 29% of recommendations focused on optimizing clinical processes, including improving geriatric assessments, formalizing IGRT protocols, and ensuring proper patient follow-up. Recommendations also emphasized the need for end-to-end QC development of equipment and TPS. Infrastructure-related recommendations accounted for 20%, highlighting the necessity of upgrading RT facilities and equipment in several departments. Finally, 22% of recommendations addressed RTT staff, citing limited staffing levels and the need to expand the RTT scope of practice in certain departments. The analysis also revealed that most recommendations from the first audit cycle had been addressed by the second audit cycle.