The quality assurance process for the ARTSCAN head and neck study – A practical interactive approach for QA in 3DCRT and IMRT

Johansson, Karl-Axel; Nilsson, Per; Zackrisson, Björn; Ohlson, Birgitta; Kjellén, Elisabeth; Mercke, Claes; Alvarez-Fonseca, Mauricio; Billström, Anette; Björk‐Eriksson, Thomas; Björ, Ove; Ekberg, Lars; Friesland, Signe; Karlsson, Magnus; Lagerlund, Magnus; Lundkvist, Lena; Löfroth, Per‐Olov; Löfvander-Thapper, Kerstin; Nilsson, Alla; Nyman, Jan; Persson, Essie; Reizenstein, Johan; Wiklund, Fredrik; Wittgren, Lena

doi:10.1016/j.radonc.2007.12.005

Cited by 22 publications

(13 citation statements)

References 19 publications

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“…After 5 years, survival was followed through the Swedish population registry. Details about the patient material, methods, and structure for data collection in the ARTSCAN trial are described elsewhere [30,43]. …”

Section: Methodsmentioning

confidence: 99%

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Weight and body mass index in relation to irradiated volume and to overall survival in patients with oropharyngeal cancer: a retrospective cohort study

et al. 2014

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BackgroundWeight loss is a common problem in patients with Squamous Cell Carcinoma of the Head and Neck (SCCHN) treated with radiotherapy (RT). The aims of the present study were to determine if treated volume (TV), as a measure of the radiation dose burden, can predict weight loss in patients with oropharyngeal cancer and to analyze weight loss and body mass index (BMI) in the same patient group in relation to 5-year overall survival.MethodsThe ARTSCAN trial is a prospective, randomized, multicenter trial in patients with SCCHN. Nutritional data from the ARTSCAN trial were analyzed retrospectively using univariate and multivariate statistical methods based on information on percentage weight loss from the start of RT up to five months after the termination of RT (study cohort 1, n = 232) and information on patients’ BMI at the start of RT (study cohort 2, n = 203). TV was defined as the volume of the patient receiving at least 95% of the prescribed dose. TV64.6 Gy encompasses macroscopic tumor and TV43.7 Gy elective lymph nodes of the neck.ResultsTV64.6 Gy and TV43.7 Gy were both significantly correlated with higher weight loss up to five months after the termination of RT in study cohort 1 (p < 0.001 for both). BMI at the start of RT was shown to be a prognostic factor for 5-year overall survival in study cohort 2 but weight loss was not. The hazard ratios and 95% confidence intervals were 3.78 (1.46–9.75) and 2.57 (1.43–4.62) in patients with underweight and normal weight, respectively.ConclusionsTV can predict weight loss during RT in patients with oropharyngeal cancer regardless of clinical stage. A high BMI (>25 kg/m2) at the start of RT is positively associated with survival in patients with oropharyngeal cancer.

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Section: Methodsmentioning

confidence: 99%

“…A more detailed presentation of the RT and the quality assurance process of the trial have been reported earlier [30,43]. In short, 68 Gy was prescribed to the known tumor in the oropharynx and metastatic cervical lymph node/nodes.…”

Section: Methodsmentioning

confidence: 99%

Weight and body mass index in relation to irradiated volume and to overall survival in patients with oropharyngeal cancer: a retrospective cohort study

et al. 2014

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“…Altogether 12 treatment centers participated in the study, making it nationwide. The quality assurance program for the ARTSCAN study is described elsewhere [11]. For more information about the RT techniques and dose fractionation schedules used see Zackrisson et al [10].…”

Section: Methodsmentioning

confidence: 99%

Weight loss in patients with head and neck cancer during and after conventional and accelerated radiotherapy

et al. 2012

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Background Weight loss is common among patients with squamous cell carcinoma of the head and neck (SCCHN) and is mainly due to tumor and treatment related factors. The aim of the present study was to evaluate weight loss in patients with SCCHN undergoing two different radiotherapy (RT) schedules.Material and methodsNutritional data were analyzed from the ARTSCAN study, a controlled randomized prospective Swedish multicenter study conducted with the aim of comparing conventional fractionation (2.0 Gy per day, total 68 Gy during 7 weeks) and accelerated fractionation (1.1 + 2.0 Gy per day, total 68 Gy during 4.5 weeks). Seven hundred and fifty patients were randomized and 712 patients were followed from the start of RT in the present nutritional study.ResultsThe patients had a weight loss of 11.3% (± 8.6%) during the acute phase (start of RT up to five months after the termination of RT). No difference in weight loss was seen between the two RT fractionation schedules (p = 0.839). Three factors were significantly predictive for weight loss during the acute phase, i.e. tumor site, overweight/obesity or lack of tube feeding at the start of RT. Moreover, the nadir point of weight loss occurred at five months after the termination of RT.ConclusionThe results of the present study showed no difference in weight loss between the two RT fractionation schedules and also highlight that weight loss in SCCHN is a multifactorial problem. Moreover, the nadir of weight loss occurred at five months after the termination of treatment which calls for more intense nutritional interventions during the period after treatment.

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“…The patient characteristics and the methods of the study have been described in detail previously [1,17]. In brief, the study originally included 750 patients with squamous cell carcinoma of the oral cavity, oropharynx, larynx (except T1-2, N0 glottic cancers) and hypopharynx.…”

Section: Patients Trial Design and Radiotherapymentioning

confidence: 99%

“…They were included during the last years of the recruitment period. A comprehensive QA-programme was performed to monitor the treatment [17].…”

Section: Patients Trial Design and Radiotherapymentioning

confidence: 99%

Mature results from a Swedish comparison study of conventional versus accelerated radiotherapy in head and neck squamous cell carcinoma – The ARTSCAN trial

Zackrisson

Kjellén

Söderstrom

et al. 2015

Radiotherapy and Oncology

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The quality assurance process for the ARTSCAN head and neck study – A practical interactive approach for QA in 3DCRT and IMRT

Cited by 22 publications

References 19 publications

Weight and body mass index in relation to irradiated volume and to overall survival in patients with oropharyngeal cancer: a retrospective cohort study

Weight and body mass index in relation to irradiated volume and to overall survival in patients with oropharyngeal cancer: a retrospective cohort study

Weight loss in patients with head and neck cancer during and after conventional and accelerated radiotherapy

Mature results from a Swedish comparison study of conventional versus accelerated radiotherapy in head and neck squamous cell carcinoma – The ARTSCAN trial

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