Radiotherapy quality assurance for mesorectum treatment planning within the multi-center phase II STAR-TReC trial: Dutch results

Autor: Ernst C. Harderwijk, Baukelien van Triest, D. Eekhout, Georgiana Stoian, L. Bouwmans, Martijn Intven, Corrie A.M. Marijnen, Maaike Berbee, Rob H N Tijssen, Roy P.J. van den Ende, Kim Compagner, Tom Rozema, Ellen M. Kerkhof, Mariska de Smet, Uulke A. van der Heide, H.J.T. Rutten, Femke P. Peters, Jacqueline Theuws, Paul M. A. van Haaren, Richard A. M. Canters
Přispěvatelé: RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Radiotherapie, MUMC+: MA Radiotherapie OC (9)
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Organs at Risk
lcsh:Medical physics. Medical radiology. Nuclear medicine
medicine.medical_specialty
Quality Assurance
Health Care
SURGERY
medicine.medical_treatment
lcsh:R895-920
Phases of clinical research
Rectal neoplasms
Mesorectum
lcsh:RC254-282
030218 nuclear medicine & medical imaging
rectal-cancer
Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14]
03 medical and health sciences
All institutes and research themes of the Radboud University Medical Center
0302 clinical medicine
Treatment plan
Journal Article
Humans
Medicine
Radiology
Nuclear Medicine and imaging
Radiation treatment planning
Netherlands
dysfunction
TRANSANAL EXCISION
Radiotherapy
business.industry
Radiotherapy Planning
Computer-Assisted
Research
Rectum
Radiotherapy Dosage
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Total mesorectal excision
Quality assurance
3. Good health
Radiation therapy
Oncology
Radiology Nuclear Medicine and imaging
030220 oncology & carcinogenesis
Radiotherapy
Intensity-Modulated
Radiology
business
Organ Sparing Treatments
Treatment planning
Chemoradiotherapy
Zdroj: Radiation Oncology, Vol 15, Iss 1, Pp 1-10 (2020)
Radiation Oncology, 15(1). BioMed Central
Radiation Oncology, 15(1):41. BioMed Central Ltd
Radiation Oncology, 15
Radiation Oncology, 15, 1
Radiation Oncology (London, England)
Radiation Oncology, 15(1). BMC
ISSN: 1748-717X
Popis: Background The STAR-TReC trial is an international multi-center, randomized, phase II study assessing the feasibility of short-course radiotherapy or long-course chemoradiotherapy as an alternative to total mesorectal excision surgery. A new target volume is used for both (chemo)radiotherapy arms which includes only the mesorectum. The treatment planning QA revealed substantial variation in dose to organs at risk (OAR) between centers. Therefore, the aim of this study was to determine the treatment plan variability in terms of dose to OAR and assess the effect of a national study group meeting on the quality and variability of treatment plans for mesorectum-only planning for rectal cancer. Methods Eight centers produced 25 × 2 Gy treatment plans for five cases. The OAR were the bowel cavity, bladder and femoral heads. A study group meeting for the participating centers was organized to discuss the planning results. At the meeting, the values of the treatment plan DVH parameters were distributed among centers so that results could be compared. Subsequently, the centers were invited to perform replanning if they considered this to be necessary. Results All treatment plans, both initial planning and replanning, fulfilled the target constraints. Dose to OAR varied considerably for the initial planning, especially for dose levels below 20 Gy, indicating that there was room for trade-offs between the defined OAR. Five centers performed replanning for all cases. One center did not perform replanning at all and two centers performed replanning on two and three cases, respectively. On average, replanning reduced the bowel cavity V20Gy by 12.6%, bowel cavity V10Gy by 22.0%, bladder V35Gy by 14.7% and bladder V10Gy by 10.8%. In 26/30 replanned cases the V10Gy of both the bowel cavity and bladder was lower, indicating an overall lower dose to these OAR instead of a different trade-off. In addition, the bowel cavity V10Gy and V20Gy showed more similarity between centers. Conclusions Dose to OAR varied considerably between centers, especially for dose levels below 20 Gy. The study group meeting and the distribution of the initial planning results among centers resulted in lower dose to the defined OAR and reduced variability between centers after replanning. Trial registration The STAR-TReC trial, ClinicalTrials.gov Identifier: NCT02945566. Registered 26 October 2016, https://clinicaltrials.gov/ct2/show/NCT02945566).
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje