Prospective review of radiotherapy trials through implementation of standardized multicentre workflow and IT infrastructure

Evaluating Target Volume Delineation in the Era of Precision Radiotherapy: FRCR, Revalidation and Beyond

“…Much of the recent work on outlining variation in the UK has been conducted within the Radiotherapy Trials Quality Assurance (RTTQA) group. Outlining for clinical trials is assessed both in the clinician pre-trial approval for participation in a specific trial or group of trials [4] and in individual case reviews of on-trial patients [10]. The pre-accrual outlining exercise is commonly compared with a predefined reference (gold standard) volume, which may be defined by an individual clinician, but more commonly by a group of senior clinical oncologists, as this reflects the uncertainties and variations that occur even among expert outliners [11].…”

Surgical treatment of multiple ipsilateral breast cancers

“…TM techniques comprise either extended breast tissue excisions for cancer(s) with simple reconing of breast tissue, or a reduction therapeutic mammoplasty. In principle, treating MC cancers using two or more separate wide local excisions as part of a TM approach merits future investigation, particularly in respect of radiotherapy boost(s) to one or more tumour beds. The MIAMI trial proposes multidisciplinary working for accurate image‐guided preoperative localization of impalpable cancers and adherence to guidelines for intraoperative placement of tumour bed clips.…”

“…In principle, treating MC cancers using two or more separate wide local excisions as part of a TM approach merits future investigation, particularly in respect of radiotherapy boost(s) to one or more tumour beds. The MIAMI trial proposes multidisciplinary working for accurate image‐guided preoperative localization of impalpable cancers and adherence to guidelines for intraoperative placement of tumour bed clips. Intraoperative tumour bed clips outline the tumour bed cavity and overcome the challenges of positioning clips within locally displaced TM tissues.…”

“…The MIAMI trial proposes multidisciplinary working for accurate image‐guided preoperative localization of impalpable cancers and adherence to guidelines for intraoperative placement of tumour bed clips. Intraoperative tumour bed clips outline the tumour bed cavity and overcome the challenges of positioning clips within locally displaced TM tissues. Recommendation for potentially two separate tumour‐bed radiotherapy boosts in a single breast is novel, but anticipated in a minority of patients with multicentric cancers.…”

“…Intraoperative tumour bed clips outline the tumour bed cavity and overcome the challenges of positioning clips within locally displaced TM tissues. Recommendation for potentially two separate tumour‐bed radiotherapy boosts in a single breast is novel, but anticipated in a minority of patients with multicentric cancers. Quality assurance for dual radiotherapy boosts in the MIAMI trial will be via the National Radiotherapy Trials Quality Assurance group at Mount Vernon Hospital, Northwood, UK 7 .…”