Radiation therapy (RT) is a cornerstone of cancer treatment and is increasingly integrated into pharmaceutical clinical trials. Its complexity demands rigorous quality assurance (RTQA) to reduce variability, ensure compliance, and protect trial integrity. Studies show protocol deviations in up to 32% of RT cases, nearly doubling recurrence and mortality risks. RTQA programs define standards, monitor compliance, and provide feedback to improve plans before treatment begins. Key elements include treatment guidelines, site qualification, and case reviews. Without robust RTQA, poor-quality RT can mask drug efficacy, jeopardizing trial outcomes and patient safety.

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