Quality improvements in prostate radiotherapy: Outcomes and impact of comprehensive quality assurance during the <scp>TROG</scp> 03.04 ‘<scp>RADAR</scp>’ trial

Kearvell, Rachel; Haworth, Annette; Ebert, Martin A.; Murray, Janice; Hooton, B.W.; Richardson, Sharon; Joseph, David; Lamb, David; Spry, Nigel; Duchesne, Gillian; Denham, James W.

doi:10.1111/1754-9485.12025

Cited by 38 publications

(51 citation statements)

References 30 publications

(32 reference statements)

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“…Consistency in EBRT dose delivery was assessed via dosimetric audit of centres [3][4][5][6][7] and adherence to trial planning protocol via expert review of each treatment plan [8].…”

Section: Patients and Treatmentmentioning

confidence: 99%

Radiation dose escalation or longer androgen suppression for locally advanced prostate cancer? Data from the TROG 03.04 RADAR trial

Denham

Steigler

Joseph

et al. 2015

Radiotherapy and Oncology

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“…Consistency in EBRT dose delivery was assessed via dosimetric audit of centres [3][4][5][6][7] and adherence to trial planning protocol via expert review of each treatment plan [8].…”

Section: Patients and Treatmentmentioning

confidence: 99%

Radiation dose escalation or longer androgen suppression for locally advanced prostate cancer? Data from the TROG 03.04 RADAR trial

Denham

Steigler

Joseph

et al. 2015

Radiotherapy and Oncology

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“…Data collection, protocol requirements and QA have been summarised previously [15][16][17][18]. Accrual was from 23 centres in Australia and New Zealand between 2003 and 2008.…”

Section: Patients and Treatmentsmentioning

confidence: 99%

“…-Form-based information on patient clinical factors comprising physical characteristics, comorbidities, medication intake and lifestyle factors captured at randomisation. More complete descriptions of the study protocol and treatment technique specifications can be found elsewhere [18].…”

Section: Patients and Treatmentsmentioning

confidence: 99%

Dosimetry, clinical factors and medication intake influencing urinary symptoms after prostate radiotherapy: An analysis of data from the RADAR prostate radiotherapy trial

Yahya

Ebert

Bulsara

et al. 2015

Radiotherapy and Oncology

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Urinary symptoms (frequency, incontinence, dysuria and haematuria) were prospectively assessed using LENT-SOMA to a median of 72 months. The endpoints assessed were prevalence (grade≥1) at the end of radiotherapy (representing acute symptoms), at 18-, 36-and 54-month follow-ups (representing late symptoms) and peak late incidence including only grade≥2. Impact of factors were assessed using multivariate logistic regression models with correction for over-optimism. Results: Baseline symptoms, non-insulin dependent diabetes mellitus, age and PC1 (correlated to the mean dose) impact symptoms at >1 timepoints. Associations at a single timepoint were found for cerebrovascular condition, ECOG status and non-steroidal anti-inflammatory drug intake. Peak incidence analysis shows the impact of baseline, bowel and cerebrovascular condition and smoking status. Conclusions:The prevalence and incidence analysis provide a complementary view for urinary symptom prediction. Sustained impacts across time points were found for several factors while some associations were not repeated at different time points suggesting poorer or transient impact.4

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“…It is noteworthy that trial participation is a catalyst for assessing practices and implementing quality improvement studies. Haworth et al estimated that 65% of centres participating in the RADAR SUAS made changes to daily practices to improve set-up accuracy 4,5…”

Section: Introductionmentioning

confidence: 99%

Quality improvement process to assess tattoo alignment, set‐up accuracy and isocentre reproducibility in pelvic radiotherapy patients

Elsner

Francis

Hruby

et al. 2014

J of Medical Radiation Sci

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IntroductionThis quality improvement study tested three methods of tattoo alignment and isocentre definition to investigate if aligning lateral tattoos to minimise pitch, roll and yaw decreased set-up error, and if defining the isocentre using the lateral tattoos for cranio-caudal (CC) position improved isocentre reproducibility. The study population was patients receiving curative external beam radiotherapy (EBRT) for prostate cancer. The results are applicable to all supine pelvic EBRT patients.MethodsThe three sequential cohorts recruited 11, 11 and 10 patients respectively. A data set of 20 orthogonal pairs of electronic portal images (EPI) was acquired for each patient. EPIs were matched offline to digitally reconstructed radiographs. In cohort 1, lateral tattoos were adjusted to minimise roll. The anterior tattoo was used to define the isocentre. In cohort 2, lateral tattoos were aligned to minimise roll and yaw. Isocentre was defined as per cohort 1. In cohort 3, lateral tattoos were aligned as per cohort 2 and the anterior tattoo was adjusted to minimise pitch. Isocentre was defined by the lateral tattoos for CC position and the anterior tattoo for the left–right position.ResultsCohort 3 results were superior as CC systematic and random set-up errors reduced from −1.3 mm to −0.5 mm, and 3.1 mm to 1.4 mm respectively, from cohort 1 to cohort 3. Isocentre reproducibility also improved from 86.7% to 92.1% of treatment isocentres within 5 mm of the planned isocentre.ConclusionThe methods of tattoo alignment and isocentre definition in cohort 3 reduced set-up errors and improved isocentre reproducibility.

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Quality improvements in prostate radiotherapy: Outcomes and impact of comprehensive quality assurance during the TROG 03.04 ‘RADAR’ trial

Abstract: The application of a suite of complementary QA activities allows the quality of trial data to be optimised and quantified, and can provide a catalyst for reforming treatment practices.

Cited by 38 publications

References 30 publications

Radiation dose escalation or longer androgen suppression for locally advanced prostate cancer? Data from the TROG 03.04 RADAR trial

Radiation dose escalation or longer androgen suppression for locally advanced prostate cancer? Data from the TROG 03.04 RADAR trial

Dosimetry, clinical factors and medication intake influencing urinary symptoms after prostate radiotherapy: An analysis of data from the RADAR prostate radiotherapy trial

Quality improvement process to assess tattoo alignment, set‐up accuracy and isocentre reproducibility in pelvic radiotherapy patients

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