OnCo
ideasIdea

Core-funded radiotherapy trials infrastructure with central quality assurance

Radiotherapy trials need physicists to check every plan and central review of every target drawn, which nobody pays for. Fund that infrastructure permanently so trials are faster and results are trustworthy.

A national or international radiotherapy trials infrastructure providing centralised contouring review, plan quality assurance, dosimetry audit, imaging and outcome data platforms and statistical support to academic radiotherapy trials, with core funding rather than per-trial grants. The UK's RTTQA group and CTRad, NRG's IROC and EORTC's RTQA show the model; their capacity limits how many trials can run. Quality assurance is the difference between radiotherapy trials that change practice (CHHiP, PACE, FAST-Forward) and those that fail from protocol deviation, which has measurably worsened outcomes in several past trials.

Hypothesis
Core-funded QA infrastructure doubles the number of randomised radiotherapy trials opening per year in participating countries and reduces major protocol deviations to under 5% of plans, with trials reaching target accrual on time in most cases.
Rationale
The TROG 02.02 head and neck trial showed that poor plan quality erased the treatment effect; conversely, hypofractionation trials with strong QA changed global practice within a few years of publication. Radiotherapy has produced some of the highest-value trials in oncology per dollar; the constraint is infrastructure capacity.
What would test it
Fund infrastructure for one country for four years with throughput targets; compare trials opened, deviation rates and time to accrual with the preceding four years.
Maturity
being tested at scale
Who has to act
policy
Cost to try
Large (over $50M)
Years to first evidence
4
Bottlenecks it attacks

Connected

18top

Pages like this

not linked directly; found by shared links