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EORTC 22043-30041 试验在前列腺癌术后放疗中的质量保证:模拟运行程序的结果。

Quality assurance of the EORTC 22043-30041 trial in post-operative radiotherapy in prostate cancer: results of the Dummy Run procedure.

机构信息

EORTC Headquarters, Brussels, Belgium.

出版信息

Radiother Oncol. 2013 Jun;107(3):346-51. doi: 10.1016/j.radonc.2013.04.020. Epub 2013 May 23.

Abstract

BACKGROUND AND PURPOSE

The EORTC 22043-30041 trial investigates the role of the addition of androgen suppression to post-operative radiotherapy in patients who have undergone radical prostatectomy. As part of the quality assurance of radiotherapy (QART) a Dummy Run (DR) procedure was performed.

MATERIALS AND METHOD

The protocol included detailed and published delineation guidelines. Participating institutions digitally submitted radiotherapy treatment volumes and a treatment plan for a standard clinical case. Submissions were centrally reviewed using the VODCA software platform.

RESULTS

Thirty-eight submissions from thirty-one institutions were reviewed. Six were accepted without comments. Twenty-three were accepted with comments on one or more items: target volume delineation (22), OAR delineation (23), planning and dosimetry (3) or treatment verification (1). Nine submissions were rejected requiring resubmission, seven for target volume delineation reasons alone. Intervention to highlight the importance of delineation guidelines was made prior to the entry of the first patient in the trial. After this, a lower percentage of resubmissions was required.

CONCLUSIONS

The EORTC 22043-30041 Dummy Run highlights the need for timely and effective QART in clinical trials. The variation in target volume and OAR definition demonstrates that clinical guidelines and radiotherapy protocols are not a substitute for QART procedures. Early intervention in response to the Dummy Run improved protocol understanding.

摘要

背景与目的

EORTC 22043-30041 试验研究了在接受根治性前列腺切除术的患者中,将雄激素抑制添加到术后放疗中的作用。作为放疗质量保证(QART)的一部分,进行了模拟运行(DR)程序。

材料与方法

该方案包括详细和已发表的勾画指南。参与机构以数字方式提交了放疗治疗体积和标准临床病例的治疗计划。使用 VODCA 软件平台对提交内容进行了集中审查。

结果

从 31 个机构中审查了 38 份提交材料。其中 6 份被接受,无意见。23 份被接受,但对一个或多个项目有意见:靶区勾画(22)、OAR 勾画(23)、计划和剂量学(3)或治疗验证(1)。9 份提交材料被拒绝,需要重新提交,其中 7 份仅因靶区勾画原因被拒绝。在试验入组第一位患者之前,就已经进行了干预以强调勾画指南的重要性。此后,需要重新提交的比例降低了。

结论

EORTC 22043-30041 模拟运行突出了临床试验中及时有效的 QART 的必要性。靶区和 OAR 定义的差异表明,临床指南和放疗方案不能替代 QART 程序。对模拟运行的早期干预提高了对方案的理解。

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