Can Radiation Therapy Quality Assurance Improve Nasopharyngeal Cancer Outcomes in Low- and Middle-Income Countries: Reporting the First Phase of a Prospective International Atomic Energy Agency Study

Corry, June; Ng, Wai Tong; Moore, Alisha; Choi, Hyun‐Seok; Le, Quynh Thu; Holmes, Sofee; Munandar, Arie; Wang, Shengzi; Camacho, Ángela; Setakornnukul, Jiraporn; Jiarpinitnun, Chuleeporn; Laskar, Sarbani Ghosh; Benjaafar, Noureddine; Faheem, Mohammad; Jin, Feng; Ammar, C. Nasr Ben; Ali, Rubina; Boualga, Kada; Abdelwahab, Sherif; Sommat, Kiattisa; Tao, Yungan; O’Sullivan, Brian; Lee, Nancy; Zubizaretta, Eduardo; Prajogi, Gregorius Ben; Hopkins, Kirsten; Rosenblatt, Eduardo; Lee, Anne W.M.

doi:10.1016/j.ijrobp.2021.08.013

Cited by 10 publications

(7 citation statements)

References 12 publications

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“…Incidental radiation exposure to the heart during breast radiation therapy increases the risk of heart disease with regard to the dose–response relationship between heart radiation dose and an acute coronary event [ 13 , 14 ]. Moreover, radiation-related hypothyroidism [ 15 ], radiation pneumonitis [ 16 ], and secondary contralateral breast cancer [ 17 ] have been reported in patients with breast cancer. In addition, in clinical trials including radiotherapy, standardization of treatment is problematic because of the variability in delineating the target and OARs [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of deep learning-based autosegmentation in breast cancer radiotherapy

et al. 2021

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Purpose To study the performance of a proposed deep learning-based autocontouring system in delineating organs at risk (OARs) in breast radiotherapy with a group of experts. Methods Eleven experts from two institutions delineated nine OARs in 10 cases of adjuvant radiotherapy after breast-conserving surgery. Autocontours were then provided to the experts for correction. Overall, 110 manual contours, 110 corrected autocontours, and 10 autocontours of each type of OAR were analyzed. The Dice similarity coefficient (DSC) and Hausdorff distance (HD) were used to compare the degree of agreement between the best manual contour (chosen by an independent expert committee) and each autocontour, corrected autocontour, and manual contour. Higher DSCs and lower HDs indicated a better geometric overlap. The amount of time reduction using the autocontouring system was examined. User satisfaction was evaluated using a survey. Results Manual contours, corrected autocontours, and autocontours had a similar accuracy in the average DSC value (0.88 vs. 0.90 vs. 0.90). The accuracy of autocontours ranked the second place, based on DSCs, and the first place, based on HDs among the manual contours. Interphysician variations among the experts were reduced in corrected autocontours, compared to variations in manual contours (DSC: 0.89–0.90 vs. 0.87–0.90; HD: 4.3–5.8 mm vs. 5.3–7.6 mm). Among the manual delineations, the breast contours had the largest variations, which improved most significantly with the autocontouring system. The total mean times for nine OARs were 37 min for manual contours and 6 min for corrected autocontours. The results of the survey revealed good user satisfaction. Conclusions The autocontouring system had a similar performance in OARs as that of the experts’ manual contouring. This system can be valuable in improving the quality of breast radiotherapy and reducing interphysician variability in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Evaluation of deep learning-based autosegmentation in breast cancer radiotherapy

et al. 2021

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“…The challenge for radiation oncologists now resides in determining the optimal extents of high- and low-risk clinical target volumes (CTV), which could vary significantly depending on the presenting stage of disease as well as institutional practices and consensus guidelines [ 4 , 5 ]. Regular quality assurance programs and peer reviews also play an essential role in ensuring correct target delineation and satisfactory dosimetry [ 6 ].…”

Section: Target Delineationmentioning

confidence: 99%

Current Radiotherapy Considerations for Nasopharyngeal Carcinoma

Chow

Beitler³

et al. 2022

Cancers

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Radiotherapy is the primary treatment modality for nasopharyngeal carcinoma (NPC). Successful curative treatment requires optimal radiotherapy planning and precise beam delivery that maximizes locoregional control while minimizing treatment-related side effects. In this article, we highlight considerations in target delineation, radiation dose, and the adoption of technological advances with the aim of optimizing the benefits of radiotherapy in NPC patients.

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“…Phase I of the IAEA study has been completed and reported. 11 The survey of staff and equipment in the country of each of the 14 participating centers showed that all but one had intensity-modulated radiotherapy facilities, although the number of machines per center (range, 1-13) and radiation oncologists (range, 5-21) varied widely. Approximately 40% of the patients did not have a staging MRI performed, which is a known independent prognostic factor in NPC, 8,12 and only 20% had a staging whole-body PET scan.…”

Section: Nasopharyngeal Cancer In Low-and Middle-income Countriesmentioning

confidence: 99%

Disadvantaged Subgroups Within the Global Head and Neck Cancer Population: How Can We Optimize Care?

Corry

Jun

et al. 2022

American Society of Clinical Oncology Educational Book

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Within the global head and neck cancer population, there are subgroups of patients with poorer cancer outcomes independent from tumor characteristics. In this article, we review three such groups. The first group comprises patients with nasopharyngeal cancer in low- and middle-income countries where access to high-volume, well-resourced radiotherapy centers is limited. We discuss a recent study that is aiming to improve outcomes through the instigation of a comprehensive radiotherapy quality assurance program. The second group comprises patients with low socioeconomic status in a high-income country who experience substantial financial toxicity, defined as financial hardship for patients due to health care costs. We review causes and consequences of financial toxicity and discuss how it can be mitigated. The third group comprises older patients who may poorly tolerate and not benefit from intensive standard-of-care treatment. We discuss the role of geriatric assessment, particularly in relation to the use of chemotherapy. Through better recognition and understanding of disadvantaged groups within the global head and neck cancer population, we will be better placed to instigate the necessary changes to improve outcomes and quality of life for patients with head and neck cancer.

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Can Radiation Therapy Quality Assurance Improve Nasopharyngeal Cancer Outcomes in Low- and Middle-Income Countries: Reporting the First Phase of a Prospective International Atomic Energy Agency Study

Cited by 10 publications

References 12 publications

Evaluation of deep learning-based autosegmentation in breast cancer radiotherapy

Evaluation of deep learning-based autosegmentation in breast cancer radiotherapy

Current Radiotherapy Considerations for Nasopharyngeal Carcinoma

Disadvantaged Subgroups Within the Global Head and Neck Cancer Population: How Can We Optimize Care?

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