Faculty Collaboration Database

Consensus Quality Measures and Dose Constraints for Lung Cancer From the Veterans Affairs Radiation Oncology Quality Surveillance Program and ASTRO Expert Panel. Pract Radiat Oncol 2023;13(5):413-428

Date

04/20/2023

Pubmed ID

37075838

DOI

10.1016/j.prro.2023.04.003

Scopus ID

2-s2.0-85163287912 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

PURPOSE: For patients with lung cancer, it is critical to provide evidence-based radiation therapy to ensure high-quality care. The US Department of Veterans Affairs (VA) National Radiation Oncology Program partnered with the American Society for Radiation Oncology (ASTRO) as part of the VA Radiation Oncology Quality Surveillance to develop lung cancer quality metrics and assess quality of care as a pilot program in 2016. This article presents recently updated consensus quality measures and dose-volume histogram (DVH) constraints.

METHODS AND MATERIALS: A series of measures and performance standards were reviewed and developed by a Blue-Ribbon Panel of lung cancer experts in conjunction with ASTRO in 2022. As part of this initiative, quality, surveillance, and aspirational metrics were developed for (1) initial consultation and workup; (2) simulation, treatment planning, and treatment delivery; and (3) follow-up. The DVH metrics for target and organ-at-risk treatment planning dose constraints were also reviewed and defined.

RESULTS: Altogether, a total of 19 lung cancer quality metrics were developed. There were 121 DVH constraints developed for various fractionation regimens, including ultrahypofractionated (1, 3, 4, or 5 fractions), hypofractionated (10 and 15 fractionations), and conventional fractionation (30-35 fractions).

CONCLUSIONS: The devised measures will be implemented for quality surveillance for veterans both inside and outside of the VA system and will provide a resource for lung cancer-specific quality metrics. The recommended DVH constraints serve as a unique, comprehensive resource for evidence- and expert consensus-based constraints across multiple fractionation schemas.

Author List

Puckett LL, Titi M, Kujundzic K, Dawes SL, Gore EM, Katsoulakis E, Park JH, Solanki AA, Kapoor R, Kelly M, Palta J, Chetty IJ, Jabbour SK, Liao Z, Movsas B, Thomas CR Jr, Timmerman RD, Werner-Wasik M, Kudner R, Wilson E, Simone CB 2nd

Authors

Elizabeth M. Gore MD Professor in the Radiation Oncology department at Medical College of Wisconsin
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
Lung Neoplasms
Quality Indicators, Health Care
Radiation Oncology
United States
Veterans