An audit of the use of agreed treatment protocols at a major centre for cancer treatment.

The treatment that a patient with cancer receives may vary considerably, depending on where and by whom the treatment is given. Agreement on treatment protocols for patients undergoing cancer treatment is clearly a desirable aim. Within departments this will result in greater uniformity of treatment, lead to greater safety, facilitate the evaluation of treatment strategies, and improve cost effectiveness. We have examined prospectively the extent to which treatment protocols are being adhered to within a major cancer treatment centre. One hundred newly registered cancer patients were studied. The results are encouraging, with complete adherence to protocol for 84. Of the 16 occurrences of deviation from a protocol this was unavoidable for three and of minor importance for five, being relatively small changes in radiotherapy dose reflecting particular clinical situations. Thus, eight deviations represented serious departures from the protocols by the responsible clinicians. This study has shown that in a major cancer treatment centre the development of agreed treatment protocols is both feasible and practical.