Faculty Collaboration Database

Consensus Quality Measures and Dose Constraints for Prostate Cancer From the Veterans Affairs Radiation Oncology Quality Surveillance Program and American Society for Radiation Oncology Expert Panel. Pract Radiat Oncol 2023;13(2):e149-e165

Date

12/16/2022

Pubmed ID

36522277

DOI

10.1016/j.prro.2022.08.018

Scopus ID

2-s2.0-85148380070 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

PURPOSE: There are no agreed upon measures to comprehensively determine the quality of radiation oncology (RO) care delivered for prostate cancer. Consequently, it is difficult to assess the implementation of scientific advances and adherence to best practices in routine clinical practice. To address this need, the US Department of Veterans Affairs (VA) National Radiation Oncology Program established the VA Radiation Oncology Quality Surveillance (VA ROQS) Program to develop clinical quality measures to assess the quality of RO care delivered to Veterans with cancer. This article reports the prostate cancer consensus measures.

METHODS AND MATERIALS: The VA ROQS Program contracted with the American Society for Radiation Oncology to commission a Blue Ribbon Panel of prostate cancer experts to develop a set of evidence-based measures and performance expectations. From February to June 2021, the panel developed quality, aspirational, and surveillance measures for (1) initial consultation and workup, (2) simulation, treatment planning, and delivery, and (3) follow-up. Dose-volume histogram (DVH) constraints to be used as quality measures for definitive and post-prostatectomy radiation therapy were selected. The panel also identified the optimal Common Terminology Criteria for Adverse Events, version 5.0 (CTCAE V5.0), toxicity terms to assess in follow-up.

RESULTS: Eighteen prostate-specific measures were developed (13 quality, 2 aspirational, and 3 surveillance). DVH metrics tailored to conventional, moderately hypofractionated, and ultrahypofractionated regimens were identified. Decision trees to determine performance for each measure were developed. Eighteen CTCAE V5.0 terms were selected in the sexual, urinary, and gastrointestinal domains as highest priority for assessment during follow-up.

CONCLUSIONS: This set of measures and DVH constraints serves as a tool for assessing the comprehensive quality of RO care for prostate cancer. These measures will be used for ongoing quality surveillance and improvement among veterans receiving care across VA and community sites. These measures can also be applied to clinical settings outside of those serving veterans.

Author List

Solanki AA, Puckett LL, Kujundzic K, Katsoulakis E, Park J, Kapoor R, Hagan M, Kelly M, Palta J, Ballas LK, DeMarco J, Hoffman KE, Lawton CAF, Michalski J, Potters L, Zelefsky M, Kudner R, Dawes S, Wilson E, Sandler H

Author

Lindsay L. Puckett MD Assistant Professor in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Consensus
Humans
Male
Prostatic Neoplasms
Quality Indicators, Health Care
Radiation Oncology
United States
Veterans