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



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.

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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.

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Correspondence to J. López Torrecilla.

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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.

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

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Appendix 1

Appendix 1

JOSÉ ANTONIO MEDINA CARMONA (H. Virgen de la Victoria, Málaga); LAURA DÍAZ GÓMEZ (H. Universitario Puerta del Mar, Puerto de Santa María); MIGUEL MARTÍNEZ CARRILLO (Complejo Hospitalario Jaén, Jaén); AMALIA PALACIOS EITO (H. Reina Sofía, Córdoba); JOSÉ EXPÓSITO HERNÁNDEZ (H. Virgen de las Nieves, Granada); ELOÍSA BAYO LOZANO (H. Virgen Macarena, Sevilla); DAVID VICENTE CARMONA (H. Juan Ramón Jiménez, Huelva); ISMAEL HERRUZO CABRERA (H. Regional Univ. Carlos Haya, Málaga); JOSÉ ANTONIO GONZÁLEZ FERREIRA (Genesis Care Sevilla, Sevilla); MARTIN TEJEDOR (H. Univ. Miguel Servet, Zaragoza); GERMAN JUAN (H. Univ. Central de Asturias, Oviedo); JOSE PARDO (H. Universitari Son Espases, Mallorca); CARLOS FERRER (H. Provincial de Castellón, Castellón); LUIS LARREA (Clínica Virgen del Consuelo (VITAS), Valencia); LEONCIO ARRIBAS (Fund. Inst. Valenciano de Oncología (IVO) Valencia); ENRIQUE GARCIA MIRAGALL (H. General Elche); EDUARDO FERRER (H. Clínico Universitario de Valencia); Alejandro Tormo (H. Universitario La Fe, Valencia); PABLO SOLER (IMED, Elche); MARTA LLORET (H. Negrín, Las Palmas); MARIA VICTORIA VILLAS (Complejo Hospitalario Univ. de Albacete); EVA LOZANO (H. de Ciudad Real); MERCEDES TEIJEIRA (H. Provincial Divino Vallés, Burgos); LUIS PEREZ ROMASANTA (H. Universitario de Salamanca); MANUEL ALGARA (H. de l’Esperança, Barcelona); MERITXELL ARENAS (H. Univ. De Sant Joan de Reus); JORDI GIRALT (H. Gral. de la Vall d’Hebrón, Barcelona); LUIS ANGLADA (H. Univ. de Girona Dr. Josep Trueta ICO); BENJAMIN GUIX (Inst.Médico de Oncología Radioterápica (IMOR), Barcelona); GEMMA SANCHO (H. Santa Creu i Sant Pau, Barcelona); JULIA LUISA MUÑOZ (H. Infanta Cristina, Badajoz); ANTONIO GOMEZ Caamaño (H. Clínico Universitario de Santiago); VICTOR MUÑOZ (H. Do Meixoeiro, Vigo); MAITE MURILLO (H. Univ. de la Princesa, Madrid); PILAR SAMPER (H. Rey Juan Carlos, Móstoles); MARIA JESUS RUIZ (H. Univ. La Paz, Madrid); JUAN SALINAS (H. General Universitario Santa Lucia, Cartagena); FERNANDO ARIAS (H. de Navarra, Pamplona); JUAN PABLO CIRIA (H. Universitario Donostia, San Sebastián).

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López Torrecilla, J., Marín i Borràs, S., Ruiz-Alonso, A. et al. 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. Clin Transl Oncol 21, 519–533 (2019). https://doi.org/10.1007/s12094-018-1943-z

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  • Radiation oncology
  • Quality indicators
  • Delphi
  • Consensus
  • Healthcare services