Department of Radiation Oncology, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria, Australia.
GenesisCare Radiation Oncology, Division Radiation Oncology, St. Vincent's Hospital, Melbourne, Australia.
Oral Oncol. 2019 Jan;88:180-185. doi: 10.1016/j.oraloncology.2018.11.014. Epub 2018 Dec 10.
Head and Neck Cancer (HNC) radiation oncologists (ROs) enjoy the immense pleasure of curing patients, working within a large multidisciplinary team to effectively deliver curative intent treatment whilst also aiming to minimise late treatment toxicity. Secondary analyses of large-scale HNC clinical trials have shown the critical impact of the quality of radiotherapy plans, where protocol non-compliant plans have yielded inferior survival rates approximating 20%. The peer review process in routine day-to-day HNC practice shows that even in major academic centers a significant proportion of RT plans may require changes to the radiotherapy planning volume. Optimising the therapeutic ratio in HNC has been dramatically facilitated by intensity modulated radiotherapy (IMRT), but that technology has also increased the complexity of HNC radiotherapy treatment and high-volume centers with experienced clinicians may be best placed to deliver this most accurately. International consensus guidelines to standardise or benchmark best practice with respect to the RT-QA process in HNC are needed. The aim of this paper is to highlight the importance of the RT-QA process in the HNC treatment process and to make some recommendations for its inclusion in both clinical trials and routine clinical practice.
头颈部癌症（HNC）放射肿瘤学家（RO）在治愈患者方面感到非常高兴，他们在一个大型多学科团队中工作，旨在有效地提供有治愈意图的治疗，同时尽量减少晚期治疗毒性。对大型 HNC 临床试验的二次分析表明，放射治疗计划的质量具有至关重要的影响，不符合方案的计划导致生存率降低约 20%。HNC 常规日常实践中的同行评审过程表明，即使在主要学术中心，相当一部分 RT 计划也可能需要更改放射治疗计划体积。调强放疗（IMRT）极大地优化了 HNC 中的治疗比率，但该技术也增加了 HNC 放射治疗的复杂性，经验丰富的临床医生的大容量中心可能最适合最准确地提供这种治疗。需要制定国际共识指南，以规范或基准 HNC 中 RT-QA 过程的最佳实践。本文的目的是强调 RT-QA 过程在 HNC 治疗过程中的重要性，并就其纳入临床试验和常规临床实践提出一些建议。
