ESTRO 36 Abstract Book

S124 ESTRO 36 2017 _______________________________________________________________________________________________

largely attributable to the methods used to motivate change and promote a culture of sharing and trust. CPQR was described as: ‘… the first successful example in the Canadian health care system where professionals from different disciplines work together as a team to improve the quality and safety of their practice’. Looking forward, CPQR will capitalize on these successes and the momentum within the Canadian radiation treatment community to advance new quality and safety initiatives, working with ESTRO and other international partners. This will include a renewed focus on equitable access to radiation treatment in Canada and the collection and sharing of radiation treatment patient reported outcomes, integrating improvements in the care of individual patients with higher-level improvements in pan- Canadian health system performance. SP-0248 Radiotherapy Quality Management and Improvement across Europe: variable approaches, united view N. Jornet 1 1 Hospital de la Santa Creu i Sant Pau, Medical Physics, Barcelona, Spain ESTRO vision states that “ Every cancer patient in Europe will have access to State of Art Radiotherapy as part of a multidisciplinary approach were treatment is individualized for the specific patient’s cancer, taking into account the particular patients’ circumstances”. Different studies show that access to radiotherapy in European Countries is far from being homogeneous and also the quality management strategies and initiatives at national level are not aligned. Quality and Safety are key elements to demonstrate that Radiotherapy is a key player in cancer cure. Therefore, to fulfill the vision, ESTRO, as an overarching organization, has to find a way to align European quality management strategies and quality indicators and standards– guiding and supporting- without overruling. This is challenging due to the diversity on cultural and economic backgrounds of European Countries. But this diversity is also an opportunity as we can learn from different countries experiences. The results of a survey on the actions being developed at a national level in Quality Management and Patient Safety show that the approaches differ. Some National Radiation Oncology Societies are active in the definition of quality indicators and standards while others focus on incident and accident reporting and analysis or in the implementation of clinical audits. On ESTRO side, ACROP committee is publishing consensus guidelines which together with ESTRO School are pillars to promote that good practice in RT departments across Europe and beyond. Furthermore, ESTRO is in a unique position to put together existing initiatives and propose a set of quality indicators and standards that could be used by the different countries. In addition, whether ESTRO should embark on accreditation of departments through Clinical Audits has been discussed in the Physics Committee strategy meeting in 2015, it is now under discussion at ESTRO board. Wrapping up, while the approaches differ, the vision is unique “Equal access, high quality and safe radiation therapy”. However, there is still a long way to harmonize Quality Management practice through Europe and ESTRO can play an important role to facilitate this harmonization. SP-0249 An Overview of Two Radiotherapy Quality Initiatives in Canada M.D. Brundage 1 1 Cancer Centre of Southeastern Ontario, Kingston, Canada This presentation will review two specific quality improvement initiatives for the practice of radiation

Figure 1. Comparison of T2 W after Gd injection MRI sequences in the case of standard PT (left) and in pMBRT (right). The images were acquired 7 months after irradiation. Important lesions (hematomas, edemas) are observed in the T2 W images, as well as an extensive BBB breakdown in the standard PT case. The images corresponding to the pMBRT irradiation showed no significant damage. Conclusion Conclusion: pMBRT leads to an increase in normal tissue resistance. This net gain in normal tissue sparing can foster one of the main applications of proton therapy, paediatric oncology, as well as open the door to an efficient treatment of very radioresistant tumors, which are currently mostly treated palliatively. The next step will be to perform studies to unravel the biological mechanisms involved in normal tissue sparing. [1] Prezado et al. Med. Phys. 40, 031712, 1–8 (2013). [2] Prezado et al., Rad. Research. 184, 314-21 (2015). [3] Peucelle et al., Med. Phys. 42 7108-13 (2015). and T1 W SP-0247 Driving Radiotherapy Quality Improvement: The Canadian Experience M. Milosevic 1,2 1 Princess Margaret Cancer Centre and University Health Network, Radiation Medicine Program, Toronto, Canada 2 University of Toronto, Department of Radiation Oncology, Toronto, Canada The success of radiotherapy as an indispensible part of a cancer control strategy depends on a wide range of programmatic and system-level factors, including effective quality management. Treatment delivered in a suboptimal manner without appropriate oversight can lead to poor clinical outcomes or, in extreme cases, severe patient injury and death. In Canada, radiation treatment quality and safety activities have largely evolved independently in programs across the country with no over-arching coordination. The Canadian Partnership for Quality in Radiotherapy (CPQR) was formed in 2000 as a catalyst to harmonize quality and safety on a national scale. CPQR utilized a bottom-up and top-down engagement model to motivate pan-Canadian harmonization of radiation treatment quality and safety. Guiding principles included involvement of the three primary disciplines involved in the delivery of radiation treatment, equal representations from all regions of Canada, impactful objectives aligned with the needs of the radiation treatment community, broad engagement of front-line practitioners and a person-centered focus with meaningful patient involvement. As well, CPQR engaged key stakeholder groups including Accreditation Canada, the Canadian Institute for Health Information (CIHI) and the provincial cancer agencies. CPQR developed and validated practice guidelines and quality/safety indicators relating to program performance, equipment performance and patients engagement, as well as pan-Canadian radiation treatment accreditation standards and a national system for radiation treatment incident reporting. An independent review found that CPQR initiatives produced substantial and measurable improvements in the quality and safety performance of Canadian radiation treatment programs, Joint Symposium: ESTRO-CARO: Waiting times and QA