The Radiation Therapy Oncology Group (RTOG) was initially organized in 1968 under the direction of Dr. Simon Kramer as a national clinical cooperative group for the purpose of conducting radiation therapy research and cooperative clinical investigations. Funding from the National Cancer Institute began in 1971. The group has grown considerably since the activation of its first study in 1968, an adjuvant methotrexate study for head and neck cancer. The methotrexate study employed combinations of radiation, methotrexate and surgery in the treatment of advanced head and neck cancer, and is considered a milestone in interdisciplinary clinical efforts. The over 700 patients accessed to this study formed the baseline for many of the clinical investigations in the area of head and neck cancer.

Since its inception the Group has activated 300 protocols and accrued a total of about 60,000 patients to cooperative group studies.

The RTOG is a multi-institutional cooperative organization, the principal objectives of which include: 1) increasing the survival of patients with malignant diseases in which control of the local-regional tumor is a major determinant of outcome; 2) demonstrating the contributions of new modalities to the therapy of cancer, adjunctive to the established modalities of surgical resection, radiation therapy and chemotherapy; 3) improving the quality of life of patients by preserving structure and function while maintaining or increasing survival, and providing palliation and preserving dignity for patients who are not cured; 4) preventing second and subsequent malignant tumors among patients cured of cancer, and 5) seeking greater understanding of the biology of several types of cancer.

The Group provides an infrastructure for clinical investigators from the United States and Canada to seek more effective treatments for cancer. Radiation, surgical and medical oncologists, pathologists, laboratory scientists and diagnostic imaging specialists seek to expand knowledge of basic biology and clinical manifestations of cancer, and thereby find means to increase survival, decrease morbidity, and relieve symptoms among those afflicted. As the Group has pursued studies a decade or more ago that have resulted in treatments that are considered standard today, so it is striving to identify new therapies which can be transferred to the community as standard for the 21st century. This transfer is facilitated by the interaction of clinicians and laboratory scientists from academic medical centers with postgraduate training programs and oncologists in the private practice of medicine. An important sidelight of this interaction is a common understanding of quality assurance requirements to achieve the most effective care throughout the general medical community for standard as well as new modalities. Results from therapeutic efforts have permitted new understandings that can be brought to bear on the prevention of second and subsequent tumors in cured patients at high risk; pilot studies in single institutions suggest great promise and provide the basis for group wide investigations of chemoprevention.

The RTOG has established mechanisms to assure compliance with protocols in all aspects of radiation therapy, dose prescription and delivery. The Group emphasizes day-to-day quality control in patient registration procedures, radiation therapy treatment review, data management, pathology review, medical oncology review and surgical review.

RTOG is an active coordinator of and participant in Intergroup studies. Over the years the Group has participated in over 45 Intergroup trials and has coordinated 17 of those Intergroup studies, thereby broadening the Group's research efforts and patient population to the greatest number of participants possible.

The Group Headquarters and Statistical Unit are located at the offices of the American College of Radiology in Philadelphia, PA. The Headquarters Office has been in Philadelphia since the Group's inception, while the current Statistical Unit was formed in 1982.

1. To increase survival in leading types of cancer afflicting citizens of the United States by effective integration of local-regional therapy with ionizing radiation and/or resection, and systemic therapy with cytotoxic drugs and hormones.
2. To evaluate new methods of delivery of radiation therapy and surgery (3-dimensional conformal radiation therapy and stereotactic radiosurgery) to improve local-regional control and survival.
3. To decrease morbidity from cancer and its treatments by conserving structures and preserving functions by using careful integration of surgery, chemotherapy, and radiation therapy.
4. To seek enhancement of radiation therapy efficacy through altered fractionation and/or chemical and biologic modification.
5. To correlate laboratory findings with treatment outcomes: (a) to better understand the fundamental nature of malignant processes, (b) to predict responsiveness of tumors to radiation therapy, hormone therapy, and cytotoxic chemotherapy, (c) to predict and prevent the development of second malignant tumors, and (d) to predict and prevent adverse effects of treatment.
6. To increase the availability of clinical investigations to special populations, especially economically disadvantaged minorities and women, and to evaluate outcomes of RTOG studies with respect to such groups.
7. To assess formal quality-of-life endpoints in RTOG trials in order to seek means to improve the quality as well as the duration of survival.
8. To encourage laboratory scientists not previously collaborating with cooperative groups to undertake cooperative investigations.
9. To refine standards for radiotherapeutic, surgical, and chemotherapeutic delivery and to disseminate them throughout the medical community for improved control of cancer.
10. To better understand the nature of late effects of cancer treatment and to pursue the means to prevent or mitigate them.
11. To collaborate with other clinical cooperative groups in investigations of uncommon malignant diseases to achieve the most rapid treatment advances.

1. To coordinate the scientific activities of Group members and committees and to foster the design and implementation of protocols within a unified research program. To communicate with NCI and the study chairs in the review of all protocols.
2. To provide administrative support for Group functions, including:
1. Distribution of protocols to members.
2. Entry of patients into studies.
3. Assistance to each study chair, as required, through communication with individual members and the statisticians.
4. Compilation and distribution of all Group reports.
5. Arrangement of all Group and committee meetings; the recording and distribution of minutes of these meetings.
6. Tabulation of submitted forms and requests for overdue ones.
3. To provide data management review and clarification of all submitted patient information.
4. To provide training to investigators and Research Associates at member institutions.
5. To establish the data base required by the statistical unit for analysis of RTOG studies.
6. To coordinate the Group's quality assurance program.
7. To provide administrative support for RTOG committees such as the Pathology, Medical Oncology, and Surgery Committees as well as Membership Evaluation, Publications, etc.
8. To monitor Group grant awards and expenditures including the reimbursement of Group members for case accrual, data management activities and scientific contributions.