Radiotherapy quality assurance of SBRT for patients with centrally located lung tumours within the multicentre phase II EORTC Lungtech trial: Benchmark case results

Autor: Coen W. Hurkmans, Nicolaus Andratschke, Ursula Nestle, Marcel Verheij, Sonja Adebahr, Enrico Clementel, M. Guckenberger, Damien C. Weber, Jan-Jacob Sonke, M. Lambrecht
Přispěvatelé: University of Zurich, Lambrecht, Marie, CCA - Cancer Treatment and quality of life
Rok vydání: 2019
Předmět:
Organs at Risk
medicine.medical_specialty
Lung Neoplasms
medicine.medical_treatment
2720 Hematology
Context (language use)
610 Medicine & health
Radiosurgery
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Sørensen–Dice coefficient
medicine
Dosimetry
Humans
2741 Radiology
Nuclear Medicine and Imaging
Radiology
Nuclear Medicine and imaging
Prospective Studies
Neoplasm Staging
Retrospective Studies
business.industry
Radiotherapy Planning
Computer-Assisted
Radiotherapy Dosage
Gold standard (test)
Hematology
Middle Aged
10044 Clinic for Radiation Oncology
Radiation therapy
Clinical trial
Benchmarking
Oncology
Radiology Nuclear Medicine and imaging
030220 oncology & carcinogenesis
Female
2730 Oncology
Radiology
Lung tumours
business
Quality assurance
Rare cancers Radboud Institute for Health Sciences [Radboudumc 9]
Zdroj: Radiotherapy and Oncology, 132, pp. 63-69
Radiotherapy and Oncology, 132, 63-69
Radiotherapy and Oncology, 132, 63-69. Elsevier Ireland Ltd
ISSN: 0167-8140
Popis: Item does not contain fulltext PURPOSE: To report on the benchmark case (BC) study performed in the context of the European Organisation for Research and Treatment of Cancer prospective multicentre Lungtech trial of SBRT for patients with inoperable centrally located lung tumours. METHODS AND MATERIALS: Target volume and organs at risk (OARs) delineations first needed to be acceptable before the treatment plan was reviewed. Retrospectively, Dice similarity coefficients of the OARs and the target volumes were calculated and a set of gold standard contours adapted for each institution margins was applied on the accepted dose submissions to evaluate the influence of acceptable delineation variations on dosimetry. RESULTS: Twenty-five institutions participated. Five BCs were accepted at the first attempt. Twenty institutions had to revise their delineation at least once and seven had to revise their planning once. The V60 Gy dose coverage improved significantly (p=0.05) between the first and final submissions from median (range) 94.8% (22.5-97.8) to 95.3% (70.5-99.3). The median Dice coefficient varied significantly between OARs: The lowest values were found for the brachial plexus 0.25 (0.01-0.54) and the highest for the spinal cord 0.89 (0.71-0.95). The mean PTV Dice coefficient was 0.82 (0.48-0.92). Applying the gold standard contours, only one institution remained compliant with the dose coverage criteria with V60 Gy median (range) of 83.4% (54.2-93.9). CONCLUSIONS: Clinical guidelines and radiotherapy protocols are not a substitute for timely radiotherapy quality assurance procedures, which improve dose coverage significantly. Delineation remains the main source of BC rejection and plan review without first reviewing delineation may not be efficient. Our results show that delineation variations seem to have a larger influence on PTV coverage than variations in planning and irradiation techniques and thus suggest that dose tolerance criteria should preferably take into account the accuracy of delineation.
Databáze: OpenAIRE
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