Preoperative Radiotherapy for Rectal Cancer: A Comparative Study of Quality Control Adherence at two Cancer Hospitals in Spain and Poland.

  • Magdalena Fundowicz Greater Poland Cancer Centre
  • Miguel Macia Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain;
  • Susanna Marin Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain;
  • Marta Bogusz-Czerniewiczc Greater Poland Cancer Centre
  • Ewelina Konstanty Greater Poland Cancer Centre
  • Ignaci Modolel Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain;
  • Juluan Malicki Greater Poland Cancer Centre
  • Ferran Guedea Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain;

Abstract

Background and purpose: We performed a clinical audit of preoperative rectal cancer treatment at two European radiotherapy centres (Poland and Spain). The aim was to independently verify adherence to a selection of indicators of treatment quality and to identify any notable inter-institutional differences.

Material and methods: A total of 162 patients (68 ICO, 94 GPCC) diagnosed with locally advanced rectal cancer and treated with preoperative radiotherapy or radiochemotherapy were included in this retrospective study. A total of 7 quality control measures were evaluated: waiting time, multidisciplinary treatment approach, portal verification, in vivo dosimetry, informed consent, guidelines for diagnostics and therapy, and patient monitoring during treatment.

Results: Several differences were observed. Waiting time from pathological diagnosis to initial consultation was 31 (ICO) vs. 8 (GPCC) days. Waiting time from the first visit to the beginning of the treatment was twice as long at the ICO. At the ICO, 82% of patient experienced treatment interruptions. The protocol for portal verification was the same at both institutions. In vivo dosimetry is not used for this treatment localization at the ICO. The ICO utilizes locally-developed guidelines for diagnostics and therapy, while the GPCC is currently developing its own guidelines.

Conclusions: An independent external clinical audit is an excellent approach to identifying and resolving deficiencies in quality control procedures. We identified several procedures amenable to improvement. Both institutions have since implemented changes to improve quality standards. We believe that all radiotherapy centres should perform a comprehensive clinical audit to identify and rectify deficiencies.


Author Biographies

Magdalena Fundowicz, Greater Poland Cancer Centre
Department of Radiotherapy
Miguel Macia, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain;
Department of Radiotherapy
Susanna Marin, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain;
Department of Radiotherapy
Marta Bogusz-Czerniewiczc, Greater Poland Cancer Centre
Department of Training, Scientific Cooperation and Quality Assurance
Ewelina Konstanty, Greater Poland Cancer Centre
Department of Medical Physics
Ignaci Modolel, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain;
Department of Medical Physics
Juluan Malicki, Greater Poland Cancer Centre
Department of Medical Physics, Department of Electroradiology
Ferran Guedea, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain;
Department of Radiotherapy
Published
2014-05-09
How to Cite
Fundowicz, M., Macia, M., Marin, S., Bogusz-Czerniewiczc, M., Konstanty, E., Modolel, I., Malicki, J., & Guedea, F. (2014). Preoperative Radiotherapy for Rectal Cancer: A Comparative Study of Quality Control Adherence at two Cancer Hospitals in Spain and Poland. Radiology and Oncology, 48(2). Retrieved from https://www.radioloncol.com/index.php/ro/article/view/2056
Section
Review