Radiotherapy quality assurance in the TROG 12.01 randomised trial and its impact on loco-regional failure
IntroductionThere is no consensus as to what specifically constitutes head and neck cancer radiotherapy quality assurance (HNC RT QA). The aims of this study are to (1) describe the RT QA processes used in the TROG 12.01 study, (2) review the RT QA processes undertaken for all patients with loco-reg...
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Frontiers Media S.A.
2024-02-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1333098/full |
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| author | June Corry June Corry June Corry Alisha Moore Liz Kenny Liz Kenny Chris Wratten Tsien Fua Charles Lin Sandro Porceddu Chen Liu Michael Ruemelin Amy Sharkey Lachlan McDowell Dean Wilkinson Albert Tiong Danny Rischin Danny Rischin |
| author_facet | June Corry June Corry June Corry Alisha Moore Liz Kenny Liz Kenny Chris Wratten Tsien Fua Charles Lin Sandro Porceddu Chen Liu Michael Ruemelin Amy Sharkey Lachlan McDowell Dean Wilkinson Albert Tiong Danny Rischin Danny Rischin |
| author_sort | June Corry |
| collection | DOAJ |
| description | IntroductionThere is no consensus as to what specifically constitutes head and neck cancer radiotherapy quality assurance (HNC RT QA). The aims of this study are to (1) describe the RT QA processes used in the TROG 12.01 study, (2) review the RT QA processes undertaken for all patients with loco-regional failure (LRF), and (3) provide prospective data to propose a consensus statement regarding the minimal components and optimal timing of HNC RT QA.Materials and methodsAll patients undergoing RT QA in the original TROG 12.01 study were included in this substudy. All participating sites completed IMRT credentialling and a clinical benchmark case. Real-time (pre-treatment) RT QA was performed for the first patient of each treating radiation oncologist, and for one in five of subsequent patients. Protocol violations were deemed major if they related to contour and/or dose of gross tumour volume (GTV), high dose planning target volume (PTVhd), or critical organs of risk (spinal cord, mandible, and brachial plexus).ResultsThirty HNROs from 15 institutions accrued 182 patients. There were 28 clinical benchmark cases, 27 pre-treatment RT QA cases, and 38 post-treatment cases. Comprehensive RT QA was performed in 65/182 (36%) treated patients. Major protocol violations were found in 5/28 benchmark cases, 5/27 pre-treatment cases, and 6/38 post-treatment cases. An independent review of all nine LRF cases showed major protocol violations in four of nine cases.ConclusionOnly pre-treatment RT QA can improve patient outcomes. The minimal components of RT QA in HNC are GTVs, PTVhd, and critical organs at risk. What constitutes major dosimetric violations needs to be harmonised. |
| first_indexed | 2024-03-08T05:54:07Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-08T05:54:07Z |
| publishDate | 2024-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-eed51e51a36d492180e08acfdd75954a2024-02-05T05:03:53ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-02-011310.3389/fonc.2023.13330981333098Radiotherapy quality assurance in the TROG 12.01 randomised trial and its impact on loco-regional failureJune Corry0June Corry1June Corry2Alisha Moore3Liz Kenny4Liz Kenny5Chris Wratten6Tsien Fua7Charles Lin8Sandro Porceddu9Chen Liu10Michael Ruemelin11Amy Sharkey12Lachlan McDowell13Dean Wilkinson14Albert Tiong15Danny Rischin16Danny Rischin17Genesiscare Radiation Oncology Department, St Vincents Hospital, Melbourne, VIC, AustraliaDepartment Medicine, University of Melbourne, Melbourne, VIC, AustraliaDepartment Radiation Oncology, Peter MacCallum Cancer Center, Melbourne, VIC, AustraliaDepartment Radiation Quality Assurance, Trans-Tasman Radiation Oncology Group (TROG), Newcastle, NSW, AustraliaDepartment Radiation Oncology, Royal Brisbane and Women’s Hospital, Brisbane, QLD, AustraliaFaculty Medicine, University of Queensland, Brisbane, QLD, AustraliaDepartment Radiation Oncology, Calvary Mater Hospital and University Newcastle, Newcastle, NSW, AustraliaDepartment Radiation Oncology, Peter MacCallum Cancer Center, Melbourne, VIC, AustraliaDepartment Radiation Oncology, Royal Brisbane and Women’s Hospital, Brisbane, QLD, AustraliaDepartment Radiation Oncology, Princess Alexander Hospital, Brisbane, QLD, AustraliaDepartment Radiation Oncology, Peter MacCallum Cancer Center, Melbourne, VIC, AustraliaDepartment Radiation Therapy, Peter MacCallum Cancer Center, Melbourne, VIC, AustraliaDepartment Radiation Therapy, Peter MacCallum Cancer Center, Melbourne, VIC, AustraliaDepartment Radiation Oncology, Peter MacCallum Cancer Center, Melbourne, VIC, Australia0Department Radiation Therapy, Illawarra Cancer Care Centre, Wollongong, NSW, AustraliaDepartment Radiation Oncology, Peter MacCallum Cancer Center, Melbourne, VIC, Australia1Department Medical Oncology, Peter MacCallum Cancer Center, Melbourne, VIC, Australia2Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, AustraliaIntroductionThere is no consensus as to what specifically constitutes head and neck cancer radiotherapy quality assurance (HNC RT QA). The aims of this study are to (1) describe the RT QA processes used in the TROG 12.01 study, (2) review the RT QA processes undertaken for all patients with loco-regional failure (LRF), and (3) provide prospective data to propose a consensus statement regarding the minimal components and optimal timing of HNC RT QA.Materials and methodsAll patients undergoing RT QA in the original TROG 12.01 study were included in this substudy. All participating sites completed IMRT credentialling and a clinical benchmark case. Real-time (pre-treatment) RT QA was performed for the first patient of each treating radiation oncologist, and for one in five of subsequent patients. Protocol violations were deemed major if they related to contour and/or dose of gross tumour volume (GTV), high dose planning target volume (PTVhd), or critical organs of risk (spinal cord, mandible, and brachial plexus).ResultsThirty HNROs from 15 institutions accrued 182 patients. There were 28 clinical benchmark cases, 27 pre-treatment RT QA cases, and 38 post-treatment cases. Comprehensive RT QA was performed in 65/182 (36%) treated patients. Major protocol violations were found in 5/28 benchmark cases, 5/27 pre-treatment cases, and 6/38 post-treatment cases. An independent review of all nine LRF cases showed major protocol violations in four of nine cases.ConclusionOnly pre-treatment RT QA can improve patient outcomes. The minimal components of RT QA in HNC are GTVs, PTVhd, and critical organs at risk. What constitutes major dosimetric violations needs to be harmonised.https://www.frontiersin.org/articles/10.3389/fonc.2023.1333098/fullquality assuranceintensity modulated radiotherapy (IMRT)radiotherapyhead and neck (H&N) cancerhuman papilloma virus - HPV |
| spellingShingle | June Corry June Corry June Corry Alisha Moore Liz Kenny Liz Kenny Chris Wratten Tsien Fua Charles Lin Sandro Porceddu Chen Liu Michael Ruemelin Amy Sharkey Lachlan McDowell Dean Wilkinson Albert Tiong Danny Rischin Danny Rischin Radiotherapy quality assurance in the TROG 12.01 randomised trial and its impact on loco-regional failure Frontiers in Oncology quality assurance intensity modulated radiotherapy (IMRT) radiotherapy head and neck (H&N) cancer human papilloma virus - HPV |
| title | Radiotherapy quality assurance in the TROG 12.01 randomised trial and its impact on loco-regional failure |
| title_full | Radiotherapy quality assurance in the TROG 12.01 randomised trial and its impact on loco-regional failure |
| title_fullStr | Radiotherapy quality assurance in the TROG 12.01 randomised trial and its impact on loco-regional failure |
| title_full_unstemmed | Radiotherapy quality assurance in the TROG 12.01 randomised trial and its impact on loco-regional failure |
| title_short | Radiotherapy quality assurance in the TROG 12.01 randomised trial and its impact on loco-regional failure |
| title_sort | radiotherapy quality assurance in the trog 12 01 randomised trial and its impact on loco regional failure |
| topic | quality assurance intensity modulated radiotherapy (IMRT) radiotherapy head and neck (H&N) cancer human papilloma virus - HPV |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1333098/full |
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