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
1 From the Departments of Radiation Oncology, Ankara Oncology Hospital, Ankara, Turkey
2 From the Departments of Radiation Oncology, Washington University in St. Louis, St. Louis, USA
3 From the Departments of Radiation Oncology, Catharina Hospital, Eindhoven, The Netherlands
4 QA Strategic Committee, EORTC, Brussels, Belgium
5 From the Departments of Head Quarter, EORTC, Brussels, Belgium
6 From the Departments of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands
7 From the Departments of Institut Català d’Oncologia, HU Germans Trias, Badalona, Catalonia, Spain
8 From the Department of Radiation Oncology, Geneva University Hospital, Radiation Oncology, Geneva, CH-1211, Switzerland
Radiation Oncology 2013, 8:23 doi:10.1186/1748-717X-8-23Published: 30 January 2013
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.
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/ webcite) and were assessed prospectively.
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.
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.