Quality assurance of radiotherapy in the ongoing EORTC 22042-26042 trial for atypical and malignant meningioma: results from the dummy runs and prospective individual case Reviews.

Abstract

BACKGROUND:

The ongoing EORTC 22042-26042 trial evaluates the efficacy of high-dose radiotherapy (RT) in atypical/malignant meningioma. The results of the Dummy Run (DR) and prospective Individual Case Review (ICR) were analyzed in this Quality Assurance (QA) study.

MATERIAL/METHODS:

Institutions were requested to submit a protocol compliant treatment plan for the DR and ICR, respectively. DR-plans (n=12) and ICR-plans (n=50) were uploaded to the Image-Guided Therapy QA Center of Advanced Technology Consortium server (http://atc.wustl.edu/) and were assessed prospectively.

RESULTS:

Major deviations were observed in 25% (n=3) of DR-plans while no minor deviations were observed. Major and minor deviations were observed in 22% (n=11) and 10% (n=5) of the ICR-plans, respectively. Eighteen% of ICRs could not be analyzed prospectively, as a result of corrupted or late data submission. CTV to PTV margins were respected in all cases. Deviations were negatively associated with the number of submitted cases per institution (p=0.0013), with a cutoff of 5 patients per institutions. No association (p=0.12) was observed between DR and ICR results, suggesting that DR's results did not predict for an improved QA process in accrued brain tumor patients.

CONCLUSIONS:

A substantial number of protocol deviations were observed in this prospective QA study. The number of cases accrued per institution was a significant determinant for protocol deviation. These data suggest that successful DR is not a guarantee for protocol compliance for accrued patients. Prospective ICRs should be performed to prevent protocol deviations.

• Authors: Mehtap Coskun, William Straube, Coen W Hurkmans, Christos Melidis, Patricia F de Haan, Salvador Villà, Sandra Collette, Damien C Weber
• Journal: Radiation oncology (London, England) (Radiat Oncol) Vol. 8 Pg. 23 (Jan 30 2013) ISSN: 1748-717X [Electronic] England
• PMID: 23363568 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Topics

• Clinical Protocols (standards)
• Humans
• Meningeal Neoplasms
• Meningioma (radiotherapy)
• Prospective Studies
• Quality Assurance, Health Care
• Radiation Oncology (standards)
• Radiotherapy Planning, Computer-Assisted (classification, standards)