Impact of radiotherapy protocol adherence in NSCLC patients treated with concurrent chemoradiation: RTQA results of the PET-Plan trial
| Autor: | Jochen Fleckenstein, Y. Bultel, Hans Christian Rischke, Matthias Miederer, Peter Hass, Ursula Nestle, Stefan Lenz, Sonja Adebahr, Gabriele Holl, Stephanie Kremp, Alexander Thieme, Karin Dieckmann, Tanja Schimek-Jasch, Andreas Küsters, Susanne Martina Eschmann, M. Stockinger, M. Tosch, Thomas Hehr, Jochem König, Harald Binder, Anca-Ligia Grosu, Eleni Gkika, Michael Mix, Andrea Schaefer-Schuler |
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| Rok vydání: | 2021 |
| Předmět: |
Oncology
Protocol (science) medicine.medical_specialty Lung Neoplasms business.industry Nodal irradiation medicine.medical_treatment Planning target volume Chemoradiotherapy Hematology Concurrent chemoradiation Case review Radiation therapy Carcinoma Non-Small-Cell Lung Positron-Emission Tomography Internal medicine medicine Overall survival Humans Radiology Nuclear Medicine and imaging Prospective Studies Non small cell business |
| Zdroj: | Radiotherapy and Oncology. 163:32-38 |
| ISSN: | 0167-8140 |
| Popis: | Introduction The success of intensification and personalisation of the curative treatment of non-small cell lung cancer (NSCLC) is strongly associated with the precision in radiotherapy. Here, we evaluate the impact of radiotherapy protocol adherence in a prospective multicentre trial. Methods In the open-label, randomised, controlled PET-Plan trial, patients with inoperable NSCLC were randomized at a 1:1 ratio regarding the target volume delineation informed by 1F-FDG PET and CT plus elective nodal irradiation (arm A) or target volumes informed by PET alone (arm B) and received iso-toxically dose-escalated concurrent chemoradiation. The prospectively organised quality assurance program (RTQA) included individual case review by predefined criteria. For evaluation, protocol adherence was scored as per protocol (pP), with minor (miD), intermediate (inD) and major (maD) deviations. In order to exclude biases through patients who discontinued treatment, patients who received ≥60 Gy were additionally analysed. Results Between 05/2009–11/2016, 205 patients were randomized, 204 patients started treatment according to protocol of which 31 (15%) patients had maD. Patients with maD had an inferior overall survival (OS) (HR 2.9, 95% CI 1.8–4.4, p Conclusions Non-adherence to the radiotherapy protocol was associated with an inferior OS and loco-regional control. These results underline the importance of RTQA. |
| Databáze: | OpenAIRE |
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