Radiotherapy Quality Assurance in the PORTEC-3 (TROG 08.04) Trial

Khaw, Pearly; Do, Viet; Lim, Karen; Cunninghame, J; Dixon, J. Brandon; Vassie, J; Bailey, Michael; Johnson, Carol; Kahl, Kai G.; Gordon, C.; Cook, O.; Foo, Kerwyn; Fyles, Anthony; Powell, M.J.; Haie-Méder, Christine; D’Amico, Romerai; Bessette, Paul; Mileshkin, Linda; Creutzberg, Carien L.; Moore, Alisha

doi:10.1016/j.clon.2021.11.015

Cited by 3 publications

(6 citation statements)

References 22 publications

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“…Reviewers were able to evaluate the volumes and plans via three-dimensional (3D) QA review systems which allowed 3D visualization of the radiotherapy plan as opposed to more traditional two-dimensional paper forms. Overall, the rate of major variations to recommended protocol criteria were low, which supported the safe introduction of the PORTEC-3 trial outcomes into clinical practice 10…”

Section: Quality Assurance In Gynecologic Radiation Oncology Clinical...mentioning

confidence: 76%

“…As summarized, modern gynecologic radiation oncology trials have incorporated varying degrees and styles of QA with most including at least a benchmarking exercise. The most common protocol deviations are associated with variations in target volume contouring and this appears to be applicable to both EBRT and brachytherapy 10–12 14 15. EMBRACE-II suggests that QA participation should be compulsory as voluntary QA is associated with a low response rate 14.…”

Section: Quality Assurance In Gynecologic Radiation Oncology Clinical...mentioning

confidence: 99%

“…EMBRACE-II suggests that QA participation should be compulsory as voluntary QA is associated with a low response rate 14. Both PORTEC-3 and PORTEC-4a highlighted the need for an ongoing QA program beyond the initial benchmarking exercise to maintain protocol compliance 10 11. Rapid technological advances and increased complexity will continue to heighten the need for sophisticated QA processes in gynecologic radiation oncology trials and experiences gained from recent trials should be reflected in future protocols and guidelines.…”

Section: Quality Assurance In Gynecologic Radiation Oncology Clinical...mentioning

confidence: 99%

“…Modern gynecologic radiation oncology clinical trial protocols now include extensive benchmarking criteria that must be met prior to recruiting patients 10–12 14 15. These benchmarking exercises can be challenging for departments as they adopt new imaging and computing modalities.…”

Section: Quality Assurance In Gynecologic Brachytherapymentioning

confidence: 99%

“…Overall, the rate of Review major variations to recommended protocol criteria were low, which supported the safe introduction the PORTEC-3 trial outcomes clinical practice. 10 PORTEC-4a is an ongoing clinical trial that investigates molecular integrated risk profile guided adjuvant treatment for endometrial cancer. Participating institutes were sent benchmark DICOMimages of pelvic computed tomography (CT) and magnetic resonance imaging (MRI) scans with cylinder in situ and requested to delineate the clinical target volume (CTV) and OAR as per the trial protocol and create a brachytherapy plan.…”

Section: Quality Assurance In Gynecologic Radiation Oncology Clinical...mentioning

confidence: 99%

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Why quality assurance is necessary in gynecologic radiation oncology

Chang

Moore

Dyk

et al. 2022

Int J Gynecol Cancer

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Quality assurance (QA) in radiation oncology involves all checks and processes that ensure that radiotherapy is delivered in an optimal and intended manner. QA is essential for the accurate delivery of brachytherapy and external beam radiotherapy in patients diagnosed with gynecologic malignancies. Inadequate QA can adversely impact clinical outcomes and reduce the reliability of clinical trials. This review highlights the importance of QA in gynecologic radiation oncology and explores the pertinent issues related to its implementation.

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Section: Quality Assurance In Gynecologic Radiation Oncology Clinical...mentioning

confidence: 76%

Section: Quality Assurance In Gynecologic Radiation Oncology Clinical...mentioning

confidence: 99%

Section: Quality Assurance In Gynecologic Radiation Oncology Clinical...mentioning

confidence: 99%

Section: Quality Assurance In Gynecologic Brachytherapymentioning

confidence: 99%

Section: Quality Assurance In Gynecologic Radiation Oncology Clinical...mentioning

confidence: 99%

See 3 more Smart Citations

Why quality assurance is necessary in gynecologic radiation oncology

Chang

Moore

Dyk

et al. 2022

Int J Gynecol Cancer

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Radiotherapy trial quality assurance processes: a systematic review

Brooks,

Miles,

Hoskin

2024

The Lancet Oncology

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Dummy run quality assurance study in the Korean Radiation Oncology Group 19 − 09 multi-institutional prospective cohort study of breast cancer

et al. 2022

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Background The Korean Radiation Oncology Group (KROG) 19 − 09 prospective cohort study aims to determine the effect of regional nodal irradiation on regional recurrence rates in ypN0 breast cancer patients. Dosimetric variations between radiotherapy (RT) plans of participating institutions may affect the clinical outcome of the study. We performed this study to assess inter-institutional dosimetric variations by dummy run. Methods Twelve participating institutions created RT plans for four clinical scenarios using computed tomography images of two dummy cases. Based on a reference structure set, we analyzed dose-volume histograms after collecting the RT plans. Results We found variations in dose distribution between institutions, especially in the regional nodal areas. Whole breast and regional nodal irradiation (WBI + RNI) plans had lower inter-institutional agreement and similarity for 95% isodose lines than WBI plans. Fleiss’s kappa values, which were used to measure inter-institutional agreement for the 95% isodose lines, were 0.830 and 0.767 for the large and medium breast WBI plans, respectively, and 0.731 and 0.679 for the large and medium breast WBI + RNI plans, respectively. There were outliers in minimum dose delivered to 95% of the structure (D95%) of axillary level 1 among WBI plans and in D95% of the interpectoral region and axillary level 4 among WBI + RNI plans. Conclusion We found inter-institutional and inter-case variations in radiation dose delivered to target volumes and organs at risk. As KROG 19 − 09 is a prospective cohort study, we accepted the dosimetric variation among the different institutions. Actual patient RT plan data should be collected to achieve reliable KROG 19 − 09 study results.

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Radiotherapy Quality Assurance in the PORTEC-3 (TROG 08.04) Trial

Cited by 3 publications

References 22 publications

Why quality assurance is necessary in gynecologic radiation oncology

Why quality assurance is necessary in gynecologic radiation oncology

Radiotherapy trial quality assurance processes: a systematic review

Dummy run quality assurance study in the Korean Radiation Oncology Group 19 − 09 multi-institutional prospective cohort study of breast cancer

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