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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.
Afiliação
  • Dietzsch S; Department for Radiation Oncology, University of Leipzig Medical Center, Stephanstr. 9a, 04103, Leipzig, Germany. stefan.dietzsch@medizin.uni-leipzig.de.
  • Braesigk A; Department for Radiation Oncology, University of Leipzig Medical Center, Stephanstr. 9a, 04103, Leipzig, Germany.
  • Seidel C; Department for Radiation Oncology, University of Leipzig Medical Center, Stephanstr. 9a, 04103, Leipzig, Germany.
  • Remmele J; Department for Radiation Oncology, University of Leipzig Medical Center, Stephanstr. 9a, 04103, Leipzig, Germany.
  • Kitzing R; Department for Radiation Oncology, University of Leipzig Medical Center, Stephanstr. 9a, 04103, Leipzig, Germany.
  • Schlender T; Department for Radiation Oncology, University of Leipzig Medical Center, Stephanstr. 9a, 04103, Leipzig, Germany.
  • Mynarek M; Departement of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Geismar D; Clinic for Particle Therapy, West German Proton Therapy Centre, University of Essen, Essen, Germany.
  • Jablonska K; Faculty of Medicine, Department of Radiation Oncology, University of Cologne, Cologne, Germany.
  • Schwarz R; Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Pazos M; Department of Radiotherapy and Radiation Oncology, Ludwig Maximilian University Munich, Munich, Germany.
  • Walser M; Center for Protontherapy, Paul Scherrer Institute, Villigen, Switzerland.
  • Frick S; Department of Radiotherapy and Radiation Oncology, Hospital Bremen Mitte, Bremen, Germany.
  • Gurtner K; Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
  • Matuschek C; Department of Radiation Oncology, Medical Faculty Heinrich Heine University Duesseldorf, Duesseldorf, Germany.
  • Harrabi SB; Department of Radiation Oncology and Radiotherapy, Heidelberg University Hospital, Heidelberg, Germany.
  • Glück A; Radiation Oncology, Munich-Schwabing Municipal Hospital, Munich, Germany.
  • Lewitzki V; Department of Radiotherapy, University of Wuerzburg, Wuerzburg, Germany.
  • Dieckmann K; Department of Radiotherapy, Medical University of Vienna, Vienna, Austria.
  • Benesch M; Division of Pediatric Hematology/Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
  • Gerber NU; University Children's Hospital of Zurich, Zurich, Switzerland.
  • Rutkowski S; Departement of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Timmermann B; Clinic for Particle Therapy, West German Proton Therapy Centre, University of Essen, Essen, Germany.
  • Kortmann RD; Department for Radiation Oncology, University of Leipzig Medical Center, Stephanstr. 9a, 04103, Leipzig, Germany.
Strahlenther Onkol ; 197(8): 674-682, 2021 Aug.
Article em En | MEDLINE | ID: mdl-33226469
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.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Cerebelares / Radiação Cranioespinal / Meduloblastoma Tipo de estudo: Clinical_trials / Etiology_studies / Guideline / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male País como assunto: Europa Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Cerebelares / Radiação Cranioespinal / Meduloblastoma Tipo de estudo: Clinical_trials / Etiology_studies / Guideline / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male País como assunto: Europa Idioma: En Ano de publicação: 2021 Tipo de documento: Article