S2989
Invited Speaker
ESTRO 2026
5277 B-QUATRO Aude Vaandering 1 , Anitha Batamuriza-Almasi 2 , Dylan Callens 3 , Nicolas Christian 4 , Séverine Cucchiaro 5 , Antoine Delor 1 , Nathalie Deman 6 , Sylvie Derycke 7 , Leen Geuens 8 , Els Goemaere 9 , Nadine Linthout 10 , Catherine Meunier 11 , Daan Nevens 12 , Vincent Remouchamps 11 , Lorenzo Verellen 16 , Ann Vermeylen 16 , Caroline Weltens 3 1 Department of Radiation Oncology, Cliniques Universitaires St Luc, Brussels, Belgium. 2 Department of Radiation Oncology, EpiCURA, Baudour, Belgium. 3 Department of Radiation Oncology, UZ Leuven, Leuven, Belgium. 4 Department of Radiation Oncology, CHIREC, Brussels, Belgium. 5 Department of Radiation Oncology, CHU de Liège, Liège, Belgium. 6 Department of Radiation Oncology, AZ St Lucas, Gent, Belgium. 7 Department of Radiation Oncology, AZ Groeninge, Kortijk, Belgium. 8 Department of Radiation Oncology, AZ Sint Maarten, Mechelen, Belgium. 9 Department of Radiation Oncology, AZ Delta, Roeselare, Staelens 9 , Pieternel Thysebaert 13 , Milan Tomsej 14 , Barbara Vanderstraeten 15 , Dirk Belgium. 10 Department of Radiation Oncology, Onze- Lieve-Vrouwziekenhuis, Aalst, Belgium. 11 Department of Radiation Oncology, CHU-UCL Namur, Namur, Belgium. 12 Department of Radiation Oncology, AZ Groeninge, Kortrijk, Belgium. 13 Department Medical Imaging and Radiotherapy, Odisee Hogeschool, Brussels, Belgium. 14 Department of Radiation Oncology, CHU Vésale, Charleroi, Belgium. 15 Department of Radiation Oncology, UZ Gent, Gent, Belgium. 16 Department of Radiation Oncology, Iridium Netwerk, Antwerpen, Belgium Clinical audits are structured and systematic evaluations designed to enhance the quality and safety of clinical practice. In Belgium, the B QUATRO clinical audits represents a national adaptation of the IAEA QUATRO audit model and provides a comprehensive peer-review framework for assessing radiotherapy departments. Built on multidisciplinary collaboration rather than regulation, B QUATRO offers an in-depth appraisal of departmental processes, organizational structures, infrastructure and quality governance [1,2]. Supported by the National Cancer Plan, the B-QUATRO audits have been rolled out in all Belgian radiotherapy departments, facilitated by the allocation of funding for dedicated quality managers. Since its initial rollout in 2010, two audit cycles have been completed and a third has now begun, each supported by ongoing refinement of the B QUATRO manual and its quality criteria. The audits have had a demonstrable impact on radiotherapy practice in Belgium. They have driven
concrete corrective and enhancement actions at the departmental level and enabled nationwide quality mapping, fostering benchmarking, shared learning, and targeted interventions such as the identification of RTT training needs. The deployment of quality managers has further reinforced national quality governance initiatives, contributing to platforms such as QMRT.be and PRISMA RT. Beyond operational outcomes, B QUATRO has supported cultural transformation within and between radiotherapy centres—strengthening team cohesion, highlighting departmental strengths, and developing cross-functional expertise among both auditors and auditees [3]. Together, these elements have cultivated deeper internal engagement and stronger inter-centre collaboration, underscoring the enduring value of the peer-review audits within Belgian radiotherapy. References: [1] Vaandering A, Lievens Y, Scalliet P. Feasibility and impact of national peer reviewed clinical audits in radiotherapy departments. Radiotherapy and Oncology 2020;144:218–23. https://doi.org/10.1016/j.radonc.2020.01.012. [2] International Atomic Energy Agency. Comprehensive Audits of Radiotherapy Practices: A Tool for Quality Improvement Quality Assurance Team for Radiation Oncology (QUATRO) - second edition. 2022. [3] Vaandering A, Cucchiaro S. BQUATRO audits in radiotherapy: Crossperspectives between auditors and audited departments. Cancer Radiother. 2025 Sep- Oct;29(5-6):104679. doi: 10.1016/j.canrad.2025.104679.
5279 National clinical audits clinical outcomes Joanna Dodkins
National Cancer Audit Collaborating Centre, Royal College of Surgeons of England, London, United Kingdom. Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom National clinical audits play a central role in improving cancer care through systematic measurement, benchmarking and feedback. In England and Wales, the National Cancer Audit Collaborating Centre (NATCAN) coordinates the world’s largest cancer audit programme, delivering over 100 indicators across the full spectrum of care for ten major cancers. These audits encompass surgery, radiotherapy and systemic therapy across all NHS hospitals, using linked national datasets, including cancer registry data and patient reported outcome measures (PROMs), to produce robust, risk adjusted outcome reporting. The National Prostate Cancer Audit (NPCA) provides a leading example of how national audit can directly influence oncology practice. Through comprehensive
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