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, Ben Harrabi, Semi, Gluek, Albrecht, Lewitzki, Victor, Dieckmann, Karin, Benesch, Martin, Gerber, Nicolas U., Rutkowski, Stefan, Timmermann, Beate and Kortmann, Rolf-Dieter . 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. Strahlenther. Onkol.. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1439-099X

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Abstract

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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Dietzsch, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Braesigk, AnnettUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Seidel, ClemensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Remmele, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kitzing, RalfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schlender, TinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mynarek, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Geismar, DirkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jablonska, KarolinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schwarz, RudolfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pazos, MontserratUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Walser, MarcUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Frick, SilkeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gurtner, KristinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Matuschek, ChristianeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ben Harrabi, SemiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gluek, AlbrechtUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lewitzki, VictorUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dieckmann, KarinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Benesch, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gerber, Nicolas U.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rutkowski, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Timmermann, BeateUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kortmann, Rolf-DieterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-310909
DOI: 10.1007/s00066-020-01707-8
Journal or Publication Title: Strahlenther. Onkol.
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1439-099X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
STANDARD-RISK MEDULLOBLASTOMA; RADIATION-THERAPY QUALITY; PEDIATRIC MEDULLOBLASTOMA; BRAIN-TUMORS; ASSURANCE; CHEMOTHERAPY; DEVIATIONS; SOCIETY; SYSTEM; FUTUREMultiple languages
Oncology; Radiology, Nuclear Medicine & Medical ImagingMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/31090

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