Quality Assurance Team for Radiation Oncology (QUATRO) – IAEA methodology for comprehensive audits of radiotherapy practices: A tool for Quality Improvement – Second edition published in 2022

The IAEA has a long history of providing assistance for dosimetry audits to its Member States. Together with the World Health Organization, it has operated postal dose audit programmes to verify the calibration of radiotherapy beams since 1969. The programme currently covers 139 Member States. Quality audits can be of various types, either reviewing specific critical parts of the radiotherapy process (dosimetry audit) or assessing the whole process (comprehensive audit) including staff, equipment and procedures, patient protection and safety and the overall performance of the department. An independent external audit (peer review) is important to ensure adequate quality of practice and treatment delivery and is also a requirement of the IAEA International Basic Safety Standard. The IAEA, through its technical cooperation programme, has received numerous requests from low- and middle-income countries to perform comprehensive audits to assess the entire radiotherapy process. In response to these requests, the IAEA has developed a methodology for the comprehensive audit in radiotherapy called Quality Assurance Team for Radiation Oncology (QUATRO), with an objective to review and evaluate the quality of all components of the radiotherapy programme, including professional competence, with a view to quality improvement.