National Radiotherapy Trials Quality Assurance (RTTQA) Group, University College Hospital (UCLH), 235 Euston Road, London NW1 2BU, United Kingdom.
The Royal Marsden NHS Foundation Trust, Downs Road, Sutton SM2 5PT, United Kingdom.
Radiother Oncol. 2024 Oct;199:110460. doi: 10.1016/j.radonc.2024.110460. Epub 2024 Jul 26.
Radiotherapy trial quality assurance (RT QA) is crucial for ensuring the safe and reliable delivery of radiotherapy trials, and minimizing inter-institutional variations. While previous studies focused on outlining and planning quality assurance (QA), this work explores the process of Image-Guided Radiotherapy (IGRT), and adaptive radiotherapy. This study presents findings from during-accrual QA in the RAIDER trial, evaluating concordance between online and offline plan selections for bladder cancer participants undergoing adaptive radiotherapy. RAIDER had two seamless stages; stage 1 assessed adherence to dose constraints of dose escalated radiotherapy (DART) and stage 2 assessed safety. The RT QA programme was updated from stage 1 to stage 2.
Data from all participants in the adaptive arms (standard dose adaptive radiotherapy (SART) and DART) of the trial was requested (33 centres across the UK, Australia and New Zealand). Data collection spanned September 2015 to December 2022 and included the plans selected online, on Cone-Beam Computed Tomography (CBCT) data. Concordance with the plans selected offline by the independent RT QA central reviewer was evaluated.
Analysable data was received for 72 participants, giving a total of 884 CBCTs. The overall concordance rate was 83% (723/884). From stage 1 to stage 2 the concordance in the plans selected improved from 75% (369/495) to 91% (354/389).
During-accrual IGRT QA positively influenced plan selection concordance, highlighting the need for ongoing support when introducing a new technique. Overall, it contributes to advancing the understanding and implementation of QA measures in adaptive radiotherapy trials.
放射治疗试验质量保证（RT QA）对于确保放射治疗试验的安全可靠实施以及最大限度地减少机构间差异至关重要。虽然之前的研究侧重于概述和规划质量保证（QA），但这项工作探讨了图像引导放射治疗（IGRT）和自适应放射治疗的过程。本研究报告了 RAIDER 试验中进行中的 QA 结果，评估了接受自适应放射治疗的膀胱癌患者在线和离线计划选择之间的一致性。RAIDER 有两个无缝阶段；第 1 阶段评估了剂量递增放射治疗（DART）剂量限制的依从性，第 2 阶段评估了安全性。RT QA 计划从第 1 阶段更新到第 2 阶段。
请求了试验自适应臂（标准剂量自适应放射治疗（SART）和 DART）中所有参与者的数据（来自英国、澳大利亚和新西兰的 33 个中心）。数据收集从 2015 年 9 月到 2022 年 12 月，包括在线选择的计划和锥形束计算机断层扫描（CBCT）数据。评估了与独立 RT QA 中央审查员离线选择的计划的一致性。
收到了 72 名参与者的可分析数据，总共 884 个 CBCT。总体一致性率为 83%（723/884）。从第 1 阶段到第 2 阶段，所选计划的一致性从 75%（369/495）提高到 91%（354/389）。
进行中的 IGRT QA 对计划选择的一致性产生了积极影响，强调了在引入新技术时需要持续支持。总体而言，它有助于提高对自适应放射治疗试验中 QA 措施的理解和实施。
