Radiation therapy quality-of-care indicators for locally advanced cervical cancer: A consensus guideline.
OBJECTIVE
Radiation therapy plays an important curative role for patients with locally advanced cervical cancer (LACC). There are no standards to define best practice. The purpose of this study was to develop a suite of radiation therapy key quality-of-care indicators (KQIs) for the curative management of LACC based on expert consensus.


METHODS
A modified Delphi method was used after identifying candidate KQIs. Round 1 involved surveying all Canadian gynecology radiation oncologists. The current and anticipated future (5 years) importance and current achievability of each KQI was ranked. Round 2 consisted of a facilitated face-to-face meeting with a smaller expert panel to discuss, revise, and develop consensus on the KQIs.


RESULTS
The literature review identified 83 candidate KQIs. Survey response was 71%. Round 2 yielded a final suite of 40 KQIs in the following categories: pretreatment assessment, external beam radiation therapy, brachytherapy, follow-up, and expertise/workload. A prominent theme was the importance of having KQIs to measure the current state, evolution, and future uptake of magnetic resonance-guided brachytherapy.


CONCLUSIONS
To our knowledge, this is the first study establishing radiation therapy KQIs in LACC based on expert consensus. These KQIs should be used to guide programmatic direction and resource allocation to assure consistent and optimal patient care.
Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada. Electronic address: jennifer.croke@rmp.uhn.ca.
Jennifer
J
Croke
Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
Anthony
A
Fyles
Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Department of Radiation Oncology, Odette Cancer Center, Toronto, ON, Canada.
Lisa
L
Barbera
Department of Radiation Oncology, London Health Sciences Centre, London, ON, Canada.
David
D
D'Souza
Department of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada.
Robert
R
Pearcey
Department of Radiation Oncology, Dr. H. Bliss Murphy Cancer Centre, St. John's, Newfoundland, Canada.
Teri
T
Stuckless
Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, ON, Canada.
Brenda
B
Bass
Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, ON, Canada; Department of Oncology, Queen's University, Kingston, ON, Canada.
Michael
M
Brundage
Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
Michael
M
Milosevic
D003697:Delphi Technique; D005260:Female; D006801:Humans; D011787:Quality of Health Care; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*