Table 1

General requirements

QI 1: Treatment decisions discussed at a multidisciplinary team meeting
TypeProcess indicator
DescriptionThe decision for any therapeutic intervention (excluding diagnostic procedure, ie, biopsies or conization performed with a diagnostic intent) has been taken by a multidisciplinary team, including at least a gynecologic oncologist or specialized gynecologic surgeon dedicated to the management of gynecological cancer, a radiologist, a medical or clinical oncologist, a pathologist, and a radiation oncologist specialized in the treatment of gynecological cancers and with expertise in brachytherapy
Specifications Numerator: number of cervical cancer patients for whom the decision for any therapeutic intervention has been reached within a multidisciplinary team
Denominator: all patients with cervical cancer referred to that center
Target≥95%
QI 2: Required pretreatment workup
TypeOutcome indicator
DescriptionThe minimal pre-radiotherapy workup for a histologically confirmed cervical cancer includes a clinical examination, pelvic MRI, and 18-FDG PET-CT
Specifications Numerator: number of patients with histologically confirmed cervical cancer who receive a workup as defined above, before primary radiotherapy treatment (excluding palliative cases)
Denominator: all patients with histologically confirmed cervical cancer treated with primary radiotherapy treatment (excluding palliative cases)
Target≥90%.
QI 3: Time to primary radiotherapy
TypeOutcome indicator
DescriptionTime between referral to the center and initiation of primary radiotherapy treatment
Specifications Numerator: number of cervical cancer patients who start their primary radiotherapy treatment within 6 weeks from the date the patient is referred for the first time to the center
Denominator: all patients with cervical cancer treated with primary radiotherapy treatment
TargetsOptimal target: ≥90%
Minimum required target: ≥75%
QI 4: Center participating in clinical trials in gynecological cancers
TypeStructural indicator
DescriptionThe center participates in clinical trials in gynecological cancers involving radiotherapy
Specifications Numerator: not applicable
Denominator: not applicable
TargetAt least one ongoing clinical trial or one clinical trial conducted in the past 5 years in gynecological cancers involving radiotherapy
QI 5: Patients are treated with upfront radiotherapy and/or concurrent chemotherapy
TypeOutcome indicator
DescriptionPatients with node negative IB3–IIA2 not treated with surgery and patients with stage IIB–IVa cervical cancer are treated with upfront radiotherapy and/or concurrent chemotherapy
Specifications Numerator: number of patients with the above criteria treated with upfront radiotherapy and/or concurrent chemotherapy (outside of a clinical trial)
Denominator: total number of patients with the above criteria referred to a center (and treated outside of a clinical trial)
Target≥95%
QI 6: Patients are treated with brachytherapy boost
TypeOutcome indicator
DescriptionPatients treated with EBRT (with curative intent) for cervical cancer are treated with a brachytherapy boost
Specifications Numerator: number of patients treated with EBRT (with curative intent) for cervical cancer treated with a brachytherapy boost
Denominator: total number of patients treated with EBRT (with curative intent) for cervical cancer
Target≥95%
  • EBRT, external beam radiotherapy; 18-FDG PET-CT, positron emission tomography–computed tomography with 2-deoxy-2-fluorine-18-fluoro-D-glucose; MRI, magnetic resonance imaging; QI, quality indicator.