S1512
Interdisciplinary - Quality assurance and risk management
ESTRO 2026
reviewed. 31% were acceptable. 67 UVs were identified—most frequently involving the small bowel (20.9%) and duodenum (19.4%). Following feedback, all 16 resubmissions were acceptable. Details shown in table 1.During ICR, 44 first submissions from 19 centres were reviewed; 63.6% were acceptable for trial inclusion. 46 UVs were identified, predominantly in the clinical target volume(CTV) and duodenum (both 21.7%).Radiologist involvement (n=29) in contouring resulted in numerically lower ‘unacceptable submission’ rates [(34.5% vs 44.4% (see Table 2)]. Overall UV rates were significantly lower during ICR compared with pre-accrual, particularly for small bowel (p=0.016) and duodenum (p= 0.019). Details shown in Table 1.
clinical and on-trial settings. References:
1. Fokas, E., Clifford, C., Spezi, E., Joseph, G., Branagan, J., Hurt, C., Nixon, L., Abrams, R., Staffurth, J. and Mukherjee, S. (2015). Comparison of investigator- delineated gross tumor volumes and quality assurance in pancreatic cancer: Analysis of the pretrial benchmark case for the SCALOP trial. Radiotherapy and Oncology, 117(3), pp.432– 437. doi:https://doi.org/10.1016/j.radonc.2015.08.026. Keywords: Image segmentation accuracy, protocol compliance Key factors influencing the implementation of Value-Based Health Care in oncology networks: a systematic review Lotte van der Werf 1,2 , Henricus P. Cremers 1 , Maria J.G. Jacobs 1 , Valery E.P.P. Lemmens 2 1 Radiation Oncology, Maastro, Maastricht, Netherlands. 2 Research Institute for Oncology and Reproduction, GROW, Maastricht University, Maastricht, Netherlands Digital Poster 2204 Purpose/Objective: Value-Based Health Care (VBHC) is increasingly adopted to improve patient outcomes and efficiency [1]. While its principles—such as linking outcomes to costs—are widely endorsed, implementation remains challenging, particularly in innovative domains such as radiotherapy (RT) [1]. RT, as a tertiary care service, occupies a unique position within oncology networks: it is central to treatment outcomes yet dependent on upstream coordination and data transparency [2]. This dual role makes RT a compelling lens for VBHC implementation [3]. Successful implementation in RT may positively impact broader healthcare delivery by setting precedents for integrated care.A crucial element is the ability to ‘’speak the same language’’. Shared definitions—particularly of what constitutes ‘’value’’—are essential to ensure alignment across stakeholders and avoid fragmentation in policy and practice.This systematic review aims to identify key determinants for effective VBHC implementation within RT, where integrated care and outcome measurement are essential for delivering patient- centered, value-driven care, with implications for access and equitable introduction of innovations in RT. Material/Methods: A systematic literature search was conducted using PubMed, Scopus, Embase, and Global Health databases. Screening followed the SAFE procedure and was supported by ASReview, which enhances efficiency through machine learning-based
Conclusion: Pre-accrual RTTQA, including detailed feedback significantly improved on-trial contouring performance, demonstrating the benefits of robust, educational programmes in improving RT standards and its importance to future pancreas RT trials. The increasing use of SABR with the associated steep dose gradients may amplify the clinical impact from the improvements seen in GTV, CTV and organ of interest contouring. The observed frequent GTV and duodenum UVs, also seen in the SCALOP-1 trial, suggest further training in these domains may be useful. Increased radiologist involvement, detailed outlining atlases and structured educational programmes may further improve contouring in
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