Proton quality assurance through the Global Harmonisation Group 

The Global Harmonisation Group for Quality Assurance in Clinical Trials (GHG) has established a subcommittee for proton quality assurance. The goal of the subcommittee is to combine particle therapy and QA expertise from around the world for the purpose of harmonising clinical trial credentialing (including dosimetry audits) of particle therapy centers. 
The subcommittee consists of members from the European Organisation for Research and Treatment of Cancer (EORTC), the US Imagining and Radiation Oncology Core (IROC), the Japan Clinical Oncology Group (JCOG), the UK Radiotherapy Trials Quality Assurance Group (RTTQA), the Trans-Tasman Radiation Oncology Group (TROG), the International Atomic Energy Agency (IAEA), and the Australian Clinical Dosimetry Service (ACDS). 
The subcommittee members have shared details of their existing proton QA programs to review where there are gaps in services and room for growth and collaboration. Three working groups have been established to focus on specific components of proton therapy review: (1) Dosimetry/Equipment QA, (2) Treatment Plan Assessment, and (3) Patient Positioning, Immobilization, IGRT and Treatment Review. Dosimetry and Equipment QA have been developed by individual QA groups and the GHG are comparing the various methods to ensure equivalence. We are collaborating on the development of anthropomorphic phantoms, funded through JCOG. The working group on Treatment Plan assessment is developing consensus guidelines for case review of proton plans. 
The standardization of such practices will enable global collaboration for proton clinical trial research, helping to boost the statistical power of clinical trials.