ESTRO 2023

Session Item

Quality assurance and auditing

Session Type: Poster (Digital)

Track: Physics

Journey:

Profile of centres participating in paediatric radiotherapy clinical trials: initial QUARTET report

Andrada Turcas, Romania

Presentation Number: PO-1737

Abstract

Abstract Title:

Profile of centres participating in paediatric radiotherapy clinical trials: initial QUARTET report

Authors:

Andrada Turcas^1,2,3, Sarah Kelly^4,5, Enrico Clementel⁶, Mark Gaze⁷, Lorenza Gandola⁸, Gail Horan⁹, Laetitia Padovani¹⁰, Coreen Corning¹¹, Tom Boterberg¹², Henry Mandeville¹³

¹European Organisation for. Research and Treatment of Cancer , (EORTC) Headquarters, Brussels, Belgium; ²The European Society for Paediatric Oncology (SIOPE), QUARTET project, Brussels, Belgium; ³University of Medicine and Pharmacy "Iuliu Hatieganu", Oncology Department, Cluj-Napoca, Romania; ⁴The European Society for Paediatric Oncology, QUARTET project, Brussels, Belgium; ⁵European Organisation for. Research and Treatment of Cancer , (EORTC) Headquarters, Brussels, Belgium; ⁶The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Data Management/RTQA, Brussels, Belgium; ⁷University College London Hospitals NHS Foundation Trust, Department of Oncology, London, United Kingdom; ⁸Fondazione IRCCS-Istituto Nazionale Dei Tumori, Department of Radiation Oncology, Milan, Italy; ⁹Cambridge University Hospitals NHS Trust, Oncology Centre, Cambridge, United Kingdom; ¹⁰Assistance Publique Hoˆpitaux de Marseille, Department of Radiation Oncology, Marseille, France; ¹¹The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Data Management/RTQA , Brussels, Belgium; ¹²Ghent University Hospital, Department of Radiation Oncology, Ghent, Belgium; ¹³The Royal Marsden Hospital and the Institute of Cancer Research, Department of Radiotherapy, Sutton, United Kingdom

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Purpose or Objective

QUARTET is a SIOPE-EORTC collaborative project for radiotherapy quality assurance (RTQA) in paediatric clinical trials. Each participating centre must undergo site RTQA approval procedures, which are streamlined across all EORTC and QUARTET trials. The process includes a Facility Questionnaire (FQ) containing multiple choice and open-ended questions detailing site infrastructure, personnel, workload, radiotherapy techniques and RTQA methods used, as well as paediatric-specific facilities. The aim of this work was to evaluate the profiles of radiotherapy centres participating in QUARTET RTQA.

Material and Methods

We performed a descriptive analysis of the data collected via the QUARTET FQs. Sites that were approved for patient enrolment in EPSSG-FaR-RMS (EUDRACT 2018-000515-24), SIOPEN-VERITAS (EUDRACT 2015-003130-27) SIOPEN-HRNBL2 (EUDRACT 001068-31), SIOP-HRMB (EUDRACT 2018-004250-17) trials between October 2020- August 2022 were included.

Results

Currently 62 centres from 20 countries are approved to participate in QUARTET trials. Most sites are in the UK (16), France (10) and Australia (7). There are 55 photon, 4 proton, and 3 dual modality sites. The median no. of treatment units is 6/centre (range 3-16), and for proton centres a median of 3 treatment rooms (range 2-5). Molecular radiotherapy and brachytherapy are available in 12 and 19 centres, respectively. The majority (93%) are paediatric referral centres: 21 national, 32 regional and 5 international, with 46 centres having designated paediatric radiation oncologists. Table 1 shows the workload and human resources for approved sites. Paediatric MDTs take place in 49 sites, with 40 having access to resources for advice on unusual or rare cases. All centres use advanced techniques (IMRT/VMAT), and all proton centres have pencil beam scanning and IMPT. Deep sedation/general anaesthesia facilities are present in 55 sites. Forty-nine sites have paediatric-adapted protocols for CT simulation and 36 for MRI scanning.

Table 1	Minimum	Median	Maximum
Total no. of patients /year	350	2700	10200
Paediatric patients/year	0	36	272
Radiation Oncologists/centre (FTE)	3	15	63
Designated Paediatric Radiation Oncologists (FTE)	0	1.65	13.5

FTE= full-time equivalent

Figure 1. Map of centres participating in QUARTET

Conclusion

This early data shows high variability in terms of workload and human and technical resources among sites participating in QUARTET-affiliated paediatric radiotherapy clinical trials. Most participants are reference centres for paediatric radiotherapy with the majority having paediatric-specific facilities such as designated clinicians, paediatric MDTs, and adapted imaging protocols. This is the first report from the QUARTET project, and we expect more mature data as trial recruitment increases and new trials open.