Abstract：
OBJECTIVE: For patients with lung cancer, it is critical to provide evidence-based radiation therapy to ensure high-quality care. The US Department of Veterans Affairs (VA) National Radiation Oncology Program partnered with the American Society for Radiation Oncology (ASTRO) as part of the VA Radiation Oncology Quality Surveillance to develop lung cancer quality metrics and assess quality of care as a pilot program in 2016. This article presents recently updated consensus quality measures and dose-volume histogram (DVH) constraints.
METHODS: A series of measures and performance standards were reviewed and developed by a Blue-Ribbon Panel of lung cancer experts in conjunction with ASTRO in 2022. As part of this initiative, quality, surveillance, and aspirational metrics were developed for (1) initial consultation and workup; (2) simulation, treatment planning, and treatment delivery; and (3) follow-up. The DVH metrics for target and organ-at-risk treatment planning dose constraints were also reviewed and defined.
RESULTS: Altogether, a total of 19 lung cancer quality metrics were developed. There were 121 DVH constraints developed for various fractionation regimens, including ultrahypofractionated (1, 3, 4, or 5 fractions), hypofractionated (10 and 15 fractionations), and conventional fractionation (30-35 fractions).
CONCLUSIONS: The devised measures will be implemented for quality surveillance for veterans both inside and outside of the VA system and will provide a resource for lung cancer-specific quality metrics. The recommended DVH constraints serve as a unique, comprehensive resource for evidence- and expert consensus-based constraints across multiple fractionation schemas.
METHODS: A series of measures and performance standards were reviewed and developed by a Blue-Ribbon Panel of lung cancer experts in conjunction with ASTRO in 2022. As part of this initiative, quality, surveillance, and aspirational metrics were developed for (1) initial consultation and workup; (2) simulation, treatment planning, and treatment delivery; and (3) follow-up. The DVH metrics for target and organ-at-risk treatment planning dose constraints were also reviewed and defined.
RESULTS: Altogether, a total of 19 lung cancer quality metrics were developed. There were 121 DVH constraints developed for various fractionation regimens, including ultrahypofractionated (1, 3, 4, or 5 fractions), hypofractionated (10 and 15 fractionations), and conventional fractionation (30-35 fractions).
CONCLUSIONS: The devised measures will be implemented for quality surveillance for veterans both inside and outside of the VA system and will provide a resource for lung cancer-specific quality metrics. The recommended DVH constraints serve as a unique, comprehensive resource for evidence- and expert consensus-based constraints across multiple fractionation schemas.
摘要：
背景：对于肺癌患者，提供循证放射治疗以确保高质量的治疗至关重要.VA国家放射肿瘤学计划（VANROP）与美国放射肿瘤学学会（ASTRO）合作，作为VA放射肿瘤学质量监测（VAROQS）的一部分，以开发肺癌质量指标并评估护理质量作为2016年的试点计划。在这里，我们提出了最近更新的共识质量测量和剂量-体积直方图(DVH)约束.
方法：2022年，蓝带肺癌专家小组与ASTRO一起审查并制定了一系列措施和性能标准。作为这一举措的一部分,质量,监视,并为a)初步咨询和工作制定了理想的指标，b)模拟,治疗计划,和治疗交付，andc)FollowUp.还审查并定义了靶和器官风险治疗计划剂量限制的DVH指标。
结果：总之，共制定了19项肺癌质量指标.有121DVH约束开发各种分馏方案，包括超分割（1,3,4,5馏分[s]），高分馏(10和15分馏)，和常规分馏（30-35馏分）。
结论：所设计的措施将用于退伍军人系统内外的质量监测，以及为肺癌特定的质量指标提供资源。推荐的DVH约束作为一个独特的，跨多个分割模式的综合证据资源和基于专家共识的约束。
方法：2022年，蓝带肺癌专家小组与ASTRO一起审查并制定了一系列措施和性能标准。作为这一举措的一部分,质量,监视,并为a)初步咨询和工作制定了理想的指标，b)模拟,治疗计划,和治疗交付，andc)FollowUp.还审查并定义了靶和器官风险治疗计划剂量限制的DVH指标。
结果：总之，共制定了19项肺癌质量指标.有121DVH约束开发各种分馏方案，包括超分割（1,3,4,5馏分[s]），高分馏(10和15分馏)，和常规分馏（30-35馏分）。
结论：所设计的措施将用于退伍军人系统内外的质量监测，以及为肺癌特定的质量指标提供资源。推荐的DVH约束作为一个独特的，跨多个分割模式的综合证据资源和基于专家共识的约束。
