Pretreatment central quality control for craniospinal irradiation in non-metastatic medulloblastoma: First experiences of the German radiotherapy quality control panel in the SIOP PNET5 MB trial
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Pretreatment central quality control for craniospinal irradiation in non-metastatic medulloblastoma: First experiences of the German radiotherapy quality control panel in the SIOP PNET5 MB trial. / Dietzsch, Stefan; Braesigk, Annett; Seidel, Clemens; Remmele, Julia; Kitzing, Ralf; Schlender, Tina; Mynarek, Martin; Geismar, Dirk; Jablonska, Karolina; Schwarz, Rudolf; Pazos, Montserrat; Walser, Marc; Frick, Silke; Gurtner, Kristin; Matuschek, Christiane; Harrabi, Semi Ben; Glück, Albrecht; Lewitzki, Victor; Dieckmann, Karin; Benesch, Martin; Gerber, Nicolas U; Rutkowski, Stefan; Timmermann, Beate; Kortmann, Rolf-Dieter.
In: STRAHLENTHER ONKOL, Vol. 197, No. 8, 08.2021, p. 674-682.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Pretreatment central quality control for craniospinal irradiation in non-metastatic medulloblastoma: First experiences of the German radiotherapy quality control panel in the SIOP PNET5 MB trial
AU - Dietzsch, Stefan
AU - Braesigk, Annett
AU - Seidel, Clemens
AU - Remmele, Julia
AU - Kitzing, Ralf
AU - Schlender, Tina
AU - Mynarek, Martin
AU - Geismar, Dirk
AU - Jablonska, Karolina
AU - Schwarz, Rudolf
AU - Pazos, Montserrat
AU - Walser, Marc
AU - Frick, Silke
AU - Gurtner, Kristin
AU - Matuschek, Christiane
AU - Harrabi, Semi Ben
AU - Glück, Albrecht
AU - Lewitzki, Victor
AU - Dieckmann, Karin
AU - Benesch, Martin
AU - Gerber, Nicolas U
AU - Rutkowski, Stefan
AU - Timmermann, Beate
AU - Kortmann, Rolf-Dieter
N1 - © 2020. The Author(s).
PY - 2021/8
Y1 - 2021/8
N2 - PURPOSE: Several studies have demonstrated the negative impact of radiotherapy protocol deviations on tumor control in medulloblastoma. In the SIOP PNET5 MB trial, a pretreatment radiotherapy quality control (RT-QC) program was introduced. A first analysis for patients enrolled in Germany, Switzerland and Austria with focus on types of deviations in the initial plan proposals and review criteria for modern radiation technologies was performed.METHODS AND PATIENTS: Sixty-nine craniospinal irradiation (CSI) plans were available for detailed analyses. RT-QC was performed according to protocol definitions on dose uniformity. Because of the lack of definitions for high-precision 3D conformal radiotherapy within the protocol, additional criteria for RT-QC on delineation and coverage of clinical target volume (CTV) and planning target volume (PTV) were defined and evaluated.RESULTS: Target volume (CTV/PTV) deviations occurred in 49.3% of initial CSI plan proposals (33.3% minor, 15.9% major). Dose uniformity deviations were less frequent (43.5%). Modification of the RT plan was recommended in 43.5% of CSI plans. Unacceptable RT plans were predominantly related to incorrect target delineation rather than dose uniformity. Unacceptable plans were negatively correlated to the number of enrolled patients per institution with a cutoff of 5 patients (p = 0.001).CONCLUSION: This prospective pretreatment individual case review study revealed a high rate of deviations and emphasizes the strong need of pretreatment RT-QC in clinical trials for medulloblastoma. Furthermore, the experiences point out the necessity of new RT-QC criteria for high-precision CSI techniques.
AB - PURPOSE: Several studies have demonstrated the negative impact of radiotherapy protocol deviations on tumor control in medulloblastoma. In the SIOP PNET5 MB trial, a pretreatment radiotherapy quality control (RT-QC) program was introduced. A first analysis for patients enrolled in Germany, Switzerland and Austria with focus on types of deviations in the initial plan proposals and review criteria for modern radiation technologies was performed.METHODS AND PATIENTS: Sixty-nine craniospinal irradiation (CSI) plans were available for detailed analyses. RT-QC was performed according to protocol definitions on dose uniformity. Because of the lack of definitions for high-precision 3D conformal radiotherapy within the protocol, additional criteria for RT-QC on delineation and coverage of clinical target volume (CTV) and planning target volume (PTV) were defined and evaluated.RESULTS: Target volume (CTV/PTV) deviations occurred in 49.3% of initial CSI plan proposals (33.3% minor, 15.9% major). Dose uniformity deviations were less frequent (43.5%). Modification of the RT plan was recommended in 43.5% of CSI plans. Unacceptable RT plans were predominantly related to incorrect target delineation rather than dose uniformity. Unacceptable plans were negatively correlated to the number of enrolled patients per institution with a cutoff of 5 patients (p = 0.001).CONCLUSION: This prospective pretreatment individual case review study revealed a high rate of deviations and emphasizes the strong need of pretreatment RT-QC in clinical trials for medulloblastoma. Furthermore, the experiences point out the necessity of new RT-QC criteria for high-precision CSI techniques.
U2 - 10.1007/s00066-020-01707-8
DO - 10.1007/s00066-020-01707-8
M3 - SCORING: Journal article
C2 - 33226469
VL - 197
SP - 674
EP - 682
JO - STRAHLENTHER ONKOL
JF - STRAHLENTHER ONKOL
SN - 0179-7158
IS - 8
ER -
