S1519
Interdisciplinary - Quality assurance and risk management
ESTRO 2026
The impact of prospective quality assurance on contouring for the TORPEdO trial Chloe Brooks 1,2 , Justine Tyler 1,3 , Luke Gilling 1,2 , Julian Phillips 1,2 , Elizabeth Miles 1,2 , James Price 4 , Robin Prestwich 5 , Nachi Palaniappan 6 , Bernadette Foran 7 , Anna Thompson 8 , Russell Banner 9 , Emma Hall 10 , David Thomson 4 1 National Radiotherapy Trials Quality Assurance Group, RTTQA, London, United Kingdom. 2 Radiotherapy, Mount Vernon Hospital, Northwood, United Kingdom. 3 Radiotherapy, Royal Marsden NHS Foundation Trust, London, United Kingdom. 4 Radiotherapy, The Christie NHS Foundation Trust, Manchester, United Kingdom. 5 Radiotherapy, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom. 6 Radiotherapy, Velindre Cancer Centre, Cardiff, United Kingdom. 7 Radiotherapy, Western Park Cancer Centre, Sheffield, United Kingdom. 8 Radiotherapy, University College London Hospital NHS Foundation Trust, London, United Kingdom. 9 Radiotherapy, Swansea Bay University Health Board, Swansea, United Kingdom. 10 Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, United Kingdom Purpose/Objective: The TORPEdO phase III trial compared intensity- modulated proton therapy (IMPT) with intensity- modulated radiotherapy (IMRT) for reduction of multiple side effects in oropharyngeal cancer (CRUK/18/010). A comprehensive QA programme was implemented for the trial to ensure protocol concordance. We report on the prospective review of all targets and organs-of-interest contours. Material/Methods: The QA programme involved reviewing nine target volumes and 20 organs-of-interest for all enrolled patients against the radiotherapy guidance and trial protocol. Contours were graded as: ‘acceptable-per- protocol’ (complete protocol compliance), ‘acceptable variation’ (adjustment recommended to align with protocol), or ‘unacceptable variation’ (adjustment required for protocol compliance). Feedback, to include details on advised changes, was provided to submitting centres.A retrospective analysis of the prospective contouring review reports and final patient contours was done. Any remaining non- compliant contours were corrected per the protocol, and potential dosimetric impacts assessed. Results:
Conclusion: Transitioning to a cloud-based ILS offers a scalable framework for incident analysis in complex environments, aiming to boost transparency, optimize processes, and improve reporting adherence. This system is crucial for our continuous quality improvement program. Future work will focus on consolidating feedback, implementing systematic follow-up for improvements, and developing targeted training for high-risk workflows to proactively reduce event frequency. References: 1. International Atomic Energy Agency. Safety in Radiation Oncology (SAFRON): A learning system to report and share safety-related events in radiotherapy [Internet]. Vienna: IAEA; 2020. Available from: https://rpop.iaea.org/SAFRON/ 2. International Atomic Energy Agency. SEVRRA: Sistema de Evaluación de Riesgos en Radioterapia [Internet]. Vienna: IAEA; 2016. Available from: https://rpop.iaea.org/SEVRRA/ Keywords: Incident Learning System, Quality, SAFFRON
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