National Radiotherapy Trials Quality Assurance (RTTQA) Group, Joint Department of Physics, Royal Marsden NHSFT, Sutton, UK; The Institute of Cancer Research, London, UK.
Weston Park Hospital, Sheffield, UK.
Clin Oncol (R Coll Radiol). 2021 Feb;33(2):131-136. doi: 10.1016/j.clon.2020.12.002. Epub 2020 Dec 18.
Multicentre clinical trials involving a dosimetry component are becoming more prevalent in molecular radiotherapy and are essential to generate the evidence to support individualised approaches to treatment planning and to ensure that sufficient patients are recruited to achieve the statistical significance required. Quality assurance programmes should be considered to support the standardisation required to achieve meaningful results. Trials should be designed to ensure that dosimetry results from image acquisition systems across centres are comparable by incorporating steps to standardise the methodologies used for the quantification of images and dosimetry. Furthermore, it is essential to assess the expertise and resources available at each participating site prior to trial commencement. A quality assurance plan should be drawn up and training provided if necessary. Standardisation of quantification and dosimetry methodologies used in a trial are essential to ensure that results from different centres may be collated. In addition, appropriate uncertainty analysis should be carried out to correct for differences in methodologies between centres. Recommendations are provided to support dosimetry studies based on the experience of several previous and ongoing multicentre trials.
多中心临床试验涉及剂量学部分在分子放疗中越来越普遍,对于生成支持个体化治疗计划的证据以及确保招募足够的患者以达到所需的统计学意义至关重要。应考虑质量保证计划来支持实现有意义结果所需的标准化。试验应设计为确保通过纳入标准化用于图像和剂量学定量的方法的步骤,使来自中心之间的图像采集系统的剂量学结果具有可比性。此外,在试验开始之前,必须评估每个参与站点的专业知识和资源。应制定质量保证计划并在必要时提供培训。试验中使用的定量和剂量学方法的标准化对于确保来自不同中心的结果可以合并至关重要。此外,应进行适当的不确定性分析,以纠正中心之间方法学的差异。根据几个以前和正在进行的多中心试验的经验,提供了支持剂量学研究的建议。