Clinical and Translational Oncology

, Volume 21, Issue 4, pp 519–533 | Cite as

Quality indicators in radiation oncology: proposal of the Spanish Society of Radiation Oncology (SEOR) for a continuous improvement of the quality of care in oncology

  • J. López TorrecillaEmail author
  • S. Marín i Borràs
  • A. Ruiz-Alonso
  • J. Jaen Olasolo
  • M. L. Vázquez de la Torre
  • E. Bóveda Carro
  • A. Rodríguez
  • E. Ignacio García
  • F. Caballero Martínez
  • F. J. Campos Lucas
  • P. C. Lara Jiménez
  • J. Contreras Martínez
  • C. Ferrer Albiach
Brief Research Article



Current cancer treatment options include surgical intervention, radiotherapy, and chemotherapy. The quality of the provision of each of them and their effective coordination determines the results in terms of benefit/risk. Regarding the radiation oncology treatments, there are not stabilised quality indicators to be used to perform control and continuous improvement processes for healthcare services. Therefore, the Spanish Society of Radiation Oncology has undertaken a comprehensive project to establish quality indicators for use with the information systems available in most Spanish healthcare services.


A two-round Delphi study examines consensus of several possible quality indicators (n = 28) in daily practice. These indicators were defined after a bibliographic search and the assessment by radiation oncology specialists (n = 8). They included aspects regarding treatment equipment, patient preparation, treatment, and follow-up processes and were divided in structure, process, and outcome indicators.


After the evaluation of the defined quality indicators (n = 28) by an expert panel (38 radiation oncologist), 26 indicators achieved consensus in terms of agreement with the statement. Two quality indicators did not achieve consensus.


There is a high degree of consensus in Spanish Radiation Oncology specialists on which indicators in routine clinical practice can best measure quality. These indicators can be used to classify services based on several parameters (patients, equipments, complexity of the techniques used, and scientific research). Furthermore, these indicators allow assess our current situation and set improvements’ objectives.


Radiation oncology Quality indicators Delphi Consensus Healthcare services 



We thank all the participants in the Delphi study for helping to contribute to improve the situation of RO in Spain; the participant’s names and affiliations are listed in Appendix 1.

Compliance with Ethical Standards

Conflict of interest

The Quality Indicators in Radiation Oncology is a scientific initiative by the Spanish Society of Radiation Oncology (SEOR). The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals.

Informed consent

For this type of study formal consent is not required.


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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2018

Authors and Affiliations

  • J. López Torrecilla
    • 1
    Email author
  • S. Marín i Borràs
    • 2
  • A. Ruiz-Alonso
    • 3
  • J. Jaen Olasolo
    • 4
  • M. L. Vázquez de la Torre
    • 5
  • E. Bóveda Carro
    • 6
  • A. Rodríguez
    • 7
  • E. Ignacio García
    • 8
  • F. Caballero Martínez
    • 9
  • F. J. Campos Lucas
    • 9
  • P. C. Lara Jiménez
    • 10
    • 11
  • J. Contreras Martínez
    • 12
  • C. Ferrer Albiach
    • 13
  1. 1.Department of Radiation Oncology-ERESAHospital General Universitario de ValenciaValenciaSpain
  2. 2.Department of Radiation OncologyHospital Duran i Reynals, Institut Català d´OncologiaL’Hospitalet de LlobregatSpain
  3. 3.Department of Radiation OncologyHospital Universitario Doce de OctubreMadridSpain
  4. 4.Department of Radiation OncologyHospital Universitario Puerta del Mar. Instituto de Investigación Biomédica de Cádiz (INiBICA)CádizSpain
  5. 5.Department of Radiation OncologyHospital Do MeixoeiroVigoSpain
  6. 6.Department of Radiation OncologyHospital Universitario CrucesBaracaldoSpain
  7. 7.Department of Radiation OncologyHospital Ruber InternacionalMadridSpain
  8. 8.Departamento de Enfermería y FisioterapiaUniversidad de CádizCádizSpain
  9. 9.School of Health SciencesFrancisco de Vitoria UniversityPozuelo de Alarcón, MadridSpain
  10. 10.Department of Radiation OncologyHospital Universitario Dr NegrínLas PalmasSpain
  11. 11.Clinical OncologyUniversidad de Las PalmasLas PalmasSpain
  12. 12.Department of Radiation OncologyHospital Regional, Universitario Carlos HayaMálagaSpain
  13. 13.Department of Radiation OncologyConsorcio Hospitalario Provincial de CastellónCastellónSpain

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