Globalization of the Radiation Therapy Oncology Group: Implementation of a model for service expansion and public health improvement

The Radiation Therapy Oncology Group (RTOG) is part of the cooperative group network that is overseen by the National Cancer Institute (NCI). Although the NCI is a US-based group, it has empowered the cooperative groups to recruit foreign institutions to participate in collaborative clinical trials. The RTOG undertook the challenge of globalizing its efforts in 2004. This article describes the rationale for this decision and the tactics adopted by the first hospital outside of North America to enroll patients onto RTOG trials. The challenges confronted by foreign institutions seeking admission to the RTOG and the mechanism by which Tel Aviv Medical Center (TAMC) met these challenges are described. Shortly after its acceptance, TAMC emerged as one of the leading accruers of patients to RTOG studies. The public health implications of this accomplishment are discussed.