Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Belgium; Department of Oncology, KU Leuven, Belgium.
Department of Research, Belgian Cancer Registry, Brussels, Belgium.
Radiother Oncol. 2014 Jun;111(3):400-5. doi: 10.1016/j.radonc.2014.03.003. Epub 2014 Apr 17.
Quality assurance (QA) for radiation treatment has become a priority since poorly delivered radiotherapy can negatively influence patient outcome. Within a national project we evaluated the feasibility of a central review platform and its role in improving uniformity of clinical target volume (CTV) delineation in daily practice.
All Belgian radiotherapy departments were invited to participate and were asked to upload CTVs for rectal cancer treatment onto a secured server. These were centrally reviewed and feedback was given per e-mail. For each five consecutive patients per centre, the overlap parameter dice coefficient (DC) and the volumetric parameters volumetric ratio (RV) and commonly contoured volume (VCC) were calculated.
Twenty departments submitted 1224 eligible cases of which 909 were modified (74.3%). There was a significant increase in RV and VCC between the first ten patients per centre and the others. This was not seen for DC. Statistical analysis did not show a further significant improvement in delineation over the entire review period.
Central review was feasible and increased the uniformity in CTV delineation in the first ten rectal cancer patients per centre. The observations in this study can be used to optimize future QA initiatives.
由于放疗质量不佳会对患者的治疗效果产生负面影响，因此，放疗的质量保证（QA）已成为当务之急。在一个国家项目中，我们评估了中央审查平台的可行性及其在提高日常实践中临床靶区（CTV）勾画一致性方面的作用。
邀请所有比利时放疗科参与，并要求他们将直肠癌治疗的 CTV 上传到安全服务器上。这些 CTV 将进行集中审查，并通过电子邮件提供反馈。对于每个中心的五个连续患者，将计算重叠参数骰子系数（DC）以及体积参数体积比（RV）和常见勾画体积（VCC）。
20 个科室提交了 1224 个符合条件的病例，其中 909 个（74.3%）进行了修改。在每个中心的前 10 名患者中，RV 和 VCC 显著增加，而 DC 则没有。统计分析显示，在整个审查期间，勾画没有进一步显著改善。
中央审查是可行的，并增加了每个中心前 10 名直肠癌患者 CTV 勾画的一致性。本研究中的观察结果可用于优化未来的 QA 计划。
