DESCRIPTION: (Applicant's Description) In the last decade, the treatment planning and delivery process has dramatically changed with the development and use of sophisticated technology such as 3-D treatment planning, automated plan optimization, intensity modulated radiation therapy (IMRT), automated and computer controlled radiation therapy (CCRT) delivery, and electronic portal imaging. In the current program project, all of these technological advances are linked to form a high precision conformal therapy treatment planning and delivery process. In this program project, each of the projects contributes new technology and knowledge to the planning and delivery process in an attempt to optimize the treatment of each patient as well as the eventual clinical outcome of each patient. The development, implementation, and other aspects of work on the treatment planning/delivery process is handled by Core B. Core C is responsible for the quality assurance of the entire planning/ delivery process. This involves two major tasks, one of which is performing the prescribed quality assurance tasks. However, a critical task assigned to this core is the re-evaluation of all the quality assurance aspects of the planning/delivery process, followed by the development of new and more appropriate quality assurance for the entire computer- controlled conformal and IMRT planning and delivery process. The challenge for Core C is to develop a prototype quality assurance (QA) program for 1) the new planning and delivery tools developed elsewhere in the program project, and 2) the new clinical treatment planning and delivery process developed and used for the work of this program project. Core C will assemble a cross-functional team to study, develop, perform, analyze and ultimately redefine the procedures for: overall CCRT treatment delivery process QA; network-linked CCRT QA; periodic QA for systems and machines; individual patient treatment plan QA; QA for treatment planning and optimization systems; IMRT-specific QA issues; QA for dynamic refinement treatment strategies; and QA required for the clinical dose escalation and normal tissue complication study protocols of a Project.