Quality assurance of radiotherapy in the ongoing EORTC 1219-DAHANCA-29 trial for HPV/p16 negative squamous cell carcinoma of the head and neck: Results of the benchmark case procedure

Christiaens, Melissa; Collette, Sandra; Overgaard, Jens; Grégoire, Vincent; Kaźmierska, Joanna; Castadot, Pierre; Giralt, Jordi; Grant, Warren; Tomsej, M.; Bar-Deroma, R.; Monti, A.F.; Hurkmans, Coen; Weber, Damien Charles

doi:10.1016/j.radonc.2017.04.019

Cited by 16 publications

(7 citation statements)

References 35 publications

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“…Our study demonstrated significant interobserver and interdisciplinary differences in tumor bed delineation, emphasizing that peer review quality assurance remained of utmost importance to ensure accurate target delineation [22] . A recent single institution study by Cardenas et al [15] indicated that peer review quality assurance led to major plan changes in 14% of patients.…”

Section: Discussionmentioning

confidence: 80%

A prospective in silico analysis of interdisciplinary and interobserver spatial variability in post-operative target delineation of high-risk oral cavity cancers: Does physician specialty matter?

Dyer

Kalpathy–Cramer

et al. 2018

Clinical and Translational Radiation Oncology

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BackgroundThe aim of this study was to determine the interdisciplinary agreement in identifying the post-operative tumor bed.MethodsThree radiation oncologists (ROs), four surgeons, and three radiologists segmented post-operative tumor and nodal beds for three patients with oral cavity cancer. Specialty cohort composite contours were created by STAPLE algorithm implementation results for interspecialty comparison. Dice similarity coefficient and Hausdorff distance were utilized to compare spatial differentials between specialties.ResultsThere were significant differences between disciplines in target delineation. There was unacceptable variation in Dice similarity coefficient for each observer and discipline when compared to the STAPLE contours. Within surgery and radiology disciplines, there was good consistency in volumes. ROs and radiologists have similar Dice similarity coefficient scores compared to surgeons.ConclusionThere were significant interdisciplinary differences in perceptions of tissue-at-risk. Better communication and explicit description of at-risk areas between disciplines is required to ensure high-risk areas are adequately targeted.

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Section: Discussionmentioning

confidence: 80%

A prospective in silico analysis of interdisciplinary and interobserver spatial variability in post-operative target delineation of high-risk oral cavity cancers: Does physician specialty matter?

Dyer

Kalpathy–Cramer

et al. 2018

Clinical and Translational Radiation Oncology

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“…This comprised 15 structures from 3 PCa RCTs 12 , 13 , 14 (we combined the structures from the 3 RCTs to cover our full treatment spectrum) and 14 structures from an HNSCC RCT. 15 For both cohorts, we then expanded the set by 3 to 4 structures that were important to our local practice. We manually mapped the resulting 36 structures to their TG-263 name.…”

Section: Methodsmentioning

confidence: 99%

“…To focus our work on the structures that are relevant to clinical research, 2 radiation oncology doctors reviewed the protocols of large contemporary randomized controlled trials (RCTs) and identified the structure names that they contained. This comprised 15 structures from 3 PCa RCTs12, 13, 14 (we combined the structures from the 3 RCTs to cover our full treatment spectrum) and 14 structures from an HNSCC RCT 15 . For both cohorts, we then expanded the set by 3 to 4 structures that were important to our local practice.…”

Section: Methodsmentioning

confidence: 99%

Big Data Readiness in Radiation Oncology: An Efficient Approach for Relabeling Radiation Therapy Structures With Their TG-263 Standard Name in Real-World Data Sets

Schuler

Kipritidis

Eade

et al. 2019

Advances in Radiation Oncology

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PurposeTo prepare for big data analyses on radiation therapy data, we developed Stature, a tool-supported approach for standardization of structure names in existing radiation therapy plans. We applied the widely endorsed nomenclature standard TG-263 as the mapping target and quantified the structure name inconsistency in 2 real-world data sets.Methods and MaterialsThe clinically relevant structures in the radiation therapy plans were identified by reference to randomized controlled trials. The Stature approach was used by clinicians to identify the synonyms for each relevant structure, which was then mapped to the corresponding TG-263 name. We applied Stature to standardize the structure names for 654 patients with prostate cancer (PCa) and 224 patients with head and neck squamous cell carcinoma (HNSCC) who received curative radiation therapy at our institution between 2007 and 2017. The accuracy of the Stature process was manually validated in a random sample from each cohort. For the HNSCC cohort we measured the resource requirements for Stature, and for the PCa cohort we demonstrated its impact on an example clinical analytics scenario.ResultsAll but 1 synonym group (“Hydrogel”) was mapped to the corresponding TG-263 name, resulting in a TG-263 relabel rate of 99% (8837 of 8925 structures). For the PCa cohort, Stature matched a total of 5969 structures. Of these, 5682 structures were exact matches (ie, following local naming convention), 284 were matched via a synonym, and 3 required manual matching. This original radiation therapy structure names therefore had a naming inconsistency rate of 4.81%. For the HNSCC cohort, Stature mapped a total of 2956 structures (2638 exact, 304 synonym, 14 manual; 10.76% inconsistency rate) and required 7.5 clinician hours. The clinician hours required were one-fifth of those that would be required for manual relabeling. The accuracy of Stature was 99.97% (PCa) and 99.61% (HNSCC).ConclusionsThe Stature approach was highly accurate and had significant resource efficiencies compared with manual curation.

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“…Dummy-run studies have been reported from the Radiation Therapy Oncology Group (RTOG) and the European Organisation for Research and Treatment of Cancer (EORTC) [20–25]. For instance, variations in the target volume and OAR definitions in head and neck cancer, lung, and prostate cancer were observed [20–23]. Generally, they concluded that a strict quality assurance procedure should be followed for radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Dummy-run for standardizing plan quality of intensity-modulated radiotherapy for postoperative uterine cervical cancer: Japan Clinical Oncology Group study (JCOG1402)

et al. 2019

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Background The purpose of this study was to assess compliance with treatment planning in a dummy-run for a multicenter clinical trial involving patients with high-risk postoperative uterine cervical cancer using intensity-modulated radiation therapy (IMRT) (JCOG1402 trial). Methods For the dummy-run, we prepared a computed tomography dataset comprising two anonymized cases of post-hysterectomy cervical cancer. These were sent to the 47 participating institutions to assess institutional plan quality such as delineations and dose distributions. Results Central review showed 3 and 4 deviations per treatment plan on average. The deviations related to the nodal and vaginal cuff clinical target volume (CTV) delineation, which accounted for approximately 50% of the total deviations. The CTV vaginal cuff showed considerable differences in delineation compared with the nodal CTV. For the Dice similarity coefficient, case 1 showed a mean ± 1σ of 0.81 ± 0.03 and 0.60 ± 0.09 for the nodal and the CTV vaginal cuff, respectively, while these were 0.81 ± 0.04 and 0.54 ± 0.14, respectively, for case two. Of the 47 institutions, 10 were required to resubmit their treatment plan because the delineations, planning target volume margin, and required dose distributions were not in accordance with the JCOG1402 protocol. Conclusions The dummy-run test in postoperative uterine cervical cancer demonstrated substantial deviations in the delineations, particularly for the CTV vaginal cuff. The analysis data could provide helpful information on delineation and planning, allowing standardization of IMRT planning for postoperative uterine cervical cancer. Trial registration Japanese Clinical Trial Registry #: UMIN000027017 at https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000030672;language=J Electronic supplementary material The online version of this article (10.1186/s13014-019-1340-y) contains supplementary material, which is available to authorized users.

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Quality assurance of radiotherapy in the ongoing EORTC 1219-DAHANCA-29 trial for HPV/p16 negative squamous cell carcinoma of the head and neck: Results of the benchmark case procedure

Cited by 16 publications

References 35 publications

A prospective in silico analysis of interdisciplinary and interobserver spatial variability in post-operative target delineation of high-risk oral cavity cancers: Does physician specialty matter?

A prospective in silico analysis of interdisciplinary and interobserver spatial variability in post-operative target delineation of high-risk oral cavity cancers: Does physician specialty matter?

Big Data Readiness in Radiation Oncology: An Efficient Approach for Relabeling Radiation Therapy Structures With Their TG-263 Standard Name in Real-World Data Sets

Dummy-run for standardizing plan quality of intensity-modulated radiotherapy for postoperative uterine cervical cancer: Japan Clinical Oncology Group study (JCOG1402)

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