General Credentialing Form

ARST-1321 Requirements

Institutions that were previously credentialed to participate in another protocol or have a question about your status for this protocol, please fill out the Credentialing Status Inquiry form.

This study requires credentialing. The credentialing requirements are different depending on whether you are using a 3DCRT or IMRT technique. You can be credentialed for either 3DCRT or IMRT or both depending on your physician’s preference.

3D credentialing:

• No credentialing is required for 3DCRT unless reduced margins are used.

• If your institution plans to utilize PTV margins of less than 1 cm, complete the IGRT credentialing requirements. Prior credentialing for RTOG 0630 will be accepted. See irocri.qarc.org under “Benchmarks” for instructions on IGRT credentialing.

IMRT credentialing:

• Must complete and submit to IROC Houston the IMRT Facility Questionnaire.

• Irradiate the IROC Houston's IMRT H&N phantom. Please fill in the phantom request form online.

• Complete and submit the IMRT Benchmark to IROC RI.

• If an institution is using IMRT with gating or tracking, the institution must irradiate IROC Houston’s lung phantom with motion platform. Please fill in the phantom request form online.

Proton credentialing:

• Proton Therapy: Each beam line used to treat patients on this study must be approved for clinical trial use by the IROC Houston.

• If an institution is using proton therapy with gating or tracking or other motion management, the institution must irradiate IROC Houston’s proton lung phantom with motion platform. Please fill in the phantom request form online. If no motion is used, no additional phantom is required.