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Title: Radiotherapy Quality Assurance Report From Children's Oncology Group AHOD0031

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 onmore » 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.« less
Authors:
 [1] ;  [2] ;  [3] ;  [4] ;  [5] ;  [6] ; ; ;  [3] ;  [7] ;  [8]
  1. Mount Sinai Medical Center, New York, New York (United States)
  2. Vanderbilt University, Nashville, Tennessee (United States)
  3. Quality Assurance Review Center, Lincoln, Rhode Island (United States)
  4. Rhode Island Hospital/Warren Alpert Medical School of Brown University, Providence, Rhode Island (United States)
  5. University of Rochester Medical Center, Rochester, New York (United States)
  6. Children's Oncology Group, Arcadia, California (United States)
  7. MD Anderson Cancer Center, Houston, Texas (United States)
  8. Memorial Sloan-Kettering Cancer Center, New York, New York (United States)
Publication Date:
OSTI Identifier:
22458682
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 91; Journal Issue: 5; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOMEDICAL RADIOGRAPHY; CHILDREN; COMPARATIVE EVALUATIONS; COMPLIANCE; DOSIMETRY; LYMPHOMAS; MEDICAL PERSONNEL; MODIFICATIONS; PATIENTS; QUALITY ASSURANCE; RADIATION DOSES; RADIOTHERAPY; REVIEWS; SIMULATION