ProCaLung is a national registry collecting radiation treatment parameters of patients having lung cancer that extends to mediastinal lymph nodes. The project includes a peer review activity.

The purpose of this public health program is similar to an audit whose objective is to promote quality of radiation oncology in Belgium. It is run by Institut Jules Bordet on behalf of the College of Physicians for Radiotherapy Centers of the Belgian Health Federal Public Service, in close collaboration with the Belgian Cancer Registry.

All Belgian radiotherapy centers are invited to participate in ProCaLung but their participation is not mandatory. The centers who accept to participate show a commitment to quality assurance as the radiotherapy-treatment-related parameters they generate will be analyzed to establish national statistics. It includes a peer-review process based on international guidelines for mediastinal nodes delineations given for informational purposes. The public interest program also collects technical parameters as they were planned and delivered during the course of chest radiation treatment. This includes the delineations of tumors, nodes and chest organs on simulation-CT images, PET/CT images, chest-CT images and the clinical information related to the lung cancer. Results/statistics will be published at the end of the project.

Inclusion Criteria:

• Histologically confirmed NSCLC only
• Locally advanced disease (Stage III) with positive mediastinal nodes
• PET/CT staged
• Curative intent radiotherapy
• Chemotherapy (ChT): Without, Sequential ChT - Radiotherapy (RT) (max 2 cycles), Concurrent (± induction ChT)
• Prescription dose ≥ 60 Gy (EQD2)

Exclusion Criteria:

• Prior history of thoracic RT
• Malignant pleural effusion
• History of malignancy in the last 3 years, except basal-cell skin cancer and intra-epithelial neoplasia
• Progression after induction chemotherapy
• Use of concurrent targeted, immunomodulating or anti-angiogenic agents except if the patient is included in a clinical trial

All patients treated with thoracic radiotherapy in Belgium for NSCLC with at least one positive mediastinal node.