Targeted Intervention to Improve the Quality of Head and Neck Radiation Therapy Treatment Planning in the Netherlands: Short and Long-Term Impact

Autor: Patricia Doornaert, Max Dahele, Chris H J Terhaard, C.P.J. Raaijmakers, Luc J Bos, Jeroen B. van de Kamer, Marion Essers, Johannes H.A.M. Kaanders, Wilko F.A.R. Verbakel
Přispěvatelé: Radiation Oncology, CCA - Cancer Treatment and quality of life
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Organs at Risk
medicine.medical_specialty
Cancer Research
Time Factors
medicine.medical_treatment
Submandibular Gland
Tonsillar Neoplasms
Locally advanced
Radiation Dosage
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
All institutes and research themes of the Radboud University Medical Center
Tongue
Swallowing
Intervention (counseling)
Journal Article
Humans
Parotid Gland
Medicine
Dosimetry
Radiology
Nuclear Medicine and imaging
Radiation treatment planning
Head and neck
Netherlands
Radiation
business.industry
Radiotherapy Planning
Computer-Assisted
Head and neck cancer
medicine.disease
Quality Improvement
Radiation therapy
Benchmarking
Oncology
Head and Neck Neoplasms
Radiology Nuclear Medicine and imaging
Health Care Surveys
030220 oncology & carcinogenesis
Pharyngeal Muscles
Radiotherapy
Intensity-Modulated
Radiology
business
Organ Sparing Treatments
Rare cancers Radboud Institute for Health Sciences [Radboudumc 9]
Zdroj: International Journal of Radiation Oncology, Biology, Physics, 105, 3, pp. 514-524
International Journal of Radiation Oncology Biology Physics, 105(3), 514. Elsevier Inc.
International Journal of Radiation Oncology Biology Physics, 105(3), 514-524. Elsevier Inc.
International Journal of Radiation Oncology, Biology, Physics, 105, 514-524
Verbakel, W F A R, Doornaert, P A H, Raaijmakers, C P J, Bos, L J, Essers, M, van de Kamer, J B, Dahele, M, Terhaard, C H J & Kaanders, J H A M 2019, ' Targeted Intervention to Improve the Quality of Head and Neck Radiation Therapy Treatment Planning in the Netherlands: Short and Long-Term Impact ', International Journal of Radiation Oncology Biology Physics, vol. 105, no. 3, pp. 514-524 . https://doi.org/10.1016/j.ijrobp.2019.07.005
ISSN: 0360-3016
DOI: 10.1016/j.ijrobp.2019.07.005
Popis: Purpose To benchmark and improve, through means of a targeted intervention, the quality of intensity modulated radiation therapy treatment planning for locally advanced head and neck cancer (HNC) in the Netherlands. The short and long-term impact of this intervention was assessed. Methods and materials A delineated computed tomography-scan of an oropharynx HNC case was sent to all 15 Dutch radiation therapy centers treating HNC. Aims for planning target volume and organ-at-risk (OAR) dosimetry were established by consensus. Each center generated a treatment plan. In a targeted intervention, OAR sparing of all plans was discussed, and centers with the best OAR sparing shared their planning strategies. Impact of the intervention was assessed by (1) short-term (half a year after intervention) replanning of the original case and (2) long-term (1 and 3 years after intervention) planning of new cases. Results Benchmarking revealed substantial difference in OAR doses. Initial mean doses were 22 Gy (range, 15-31 Gy), 35 Gy (18-49 Gy), and 37 Gy (20-46 Gy) for the contralateral parotid gland, contralateral submandibular gland, and combined swallowing structures, respectively. Replanning after targeted intervention significantly reduced mean doses and variation, but clinically relevant differences still remained: 18 Gy (14-22 Gy), 28 Gy (17-45 Gy), and 29 Gy (18-39 Gy), respectively. One and 3 years later the variation remained stable. Conclusions Despite many years of HNC intensity modulated radiation therapy experience, initial treatment plans showed surprisingly large variations. The simple targeted intervention used in this analysis improved OAR sparing, and its impact was durable; however, fairly large dose differences still continue to exist. Additional work is needed to understand these variations and to minimize them. A national radiation oncology platform can be instrumental for developing and maintaining high-quality planning protocols.
Databáze: OpenAIRE
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