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Radiotherapy quality assurance report from children's oncology group AHOD0031. Int J Radiat Oncol Biol Phys 2015 Apr 01;91(5):1065-71

Date

02/12/2015

Pubmed ID

25670539

Pubmed Central ID

PMC5240783

DOI

10.1016/j.ijrobp.2014.11.034

Scopus ID

2-s2.0-84925351290   7 Citations

Abstract

PURPOSE: A phase 3 trial assessing response-based therapy in intermediate-risk Hodgkin lymphoma mandated real-time central review of involved field radiation therapy (IFRT) and imaging records by a centralized review center to maximize protocol compliance. We report the impact of centralized radiation therapy review on protocol compliance.

METHODS AND MATERIALS: Review of simulation films, port films, and dosimetry records was required before and after treatment. Records were reviewed by study-affiliated or review center-affiliated radiation oncologists. A deviation of 6% to 10% from protocol-specified dose was scored as "minor"; a deviation of >10% was "major." A volume deviation was scored as "minor" if margins were less than specified or "major" if fields transected disease-bearing areas. Interventional review and final compliance review scores were assigned to each radiation therapy case and compared.

RESULTS: Of 1712 patients enrolled, 1173 underwent IFRT at 256 institutions in 7 countries. An interventional review was performed in 88% of patients and a final review in 98%. Overall, minor and major deviations were found in 12% and 6% of patients, respectively. Among the cases for which ≥1 pre-IFRT modification was requested by the Quality Assurance Review Center and subsequently made by the treating institution, 100% were made compliant on final review. By contrast, among the cases for which ≥1 modification was requested but not made by the treating institution, 10% were deemed compliant on final review.

CONCLUSIONS: In a large trial with complex treatment pathways and heterogeneous radiation therapy fields, central review was performed in a large percentage of cases before IFRT and identified frequent potential deviations in a timely manner. When suggested modifications were performed by the institutions, deviations were almost eliminated.

Author List

Dharmarajan KV, Friedman DL, FitzGerald TJ, McCarten KM, Constine LS, Chen L, Kessel SK, Iandoli M, Laurie F, Schwartz CL, Wolden SL

Author

Cindy L. Schwartz MD, MPH Chief, Professor in the Pediatrics department at Medical College of Wisconsin




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

Adolescent
Antineoplastic Combined Chemotherapy Protocols
Bleomycin
Child
Child, Preschool
Cyclophosphamide
Doxorubicin
Etoposide
Guideline Adherence
Hodgkin Disease
Humans
Infant
Infant, Newborn
Prednisone
Quality Assurance, Health Care
Radiography
Vincristine
Young Adult
jenkins-FCD Prod-461 7d7c6113fc1a2757d2947d29fae5861c878125ab