目标:最近,已制定并发布了相关部位放射治疗(ISRT)指南,以取代以往淋巴瘤患者相关部位放射治疗的概念.然而,这些ISRT指南可以用不同的方式解释,给前瞻性临床试验带来困难。本研究报告了有关ISRT指南解释的调查结果。
方法:44位淋巴瘤放射肿瘤学家被要求参加一项调查,该调查包括7个不同的病例和9个问题。问题与ISRT轮廓有关,并要求受访者在2个不同的答案(无“正确”答案)和第三个允许写入选项之间进行选择。
结果:52%的受访者回答了问卷。在那些回答的人中,72%的人已经练习了10年以上,46%的人每年治疗>20例霍奇金淋巴瘤病例,100%熟悉ISRT概念。在与7个案例相关的9个问题中,3在专家放射肿瘤学家之间的一致性超过70%。其中六个问题的一致性不到70%(范围,56%-67%)。
结论:即使在专业放射肿瘤学家中,ISRT指南的解释是可变的。需要进一步指导ISRT现场设计,以减少执业医师之间的差异。
OBJECTIVE: Recently, involved-site radiation therapy (ISRT)
guidelines have been developed and published to replace the previous concept of involved-field radiation therapy for patients with lymphoma. However, these ISRT
guidelines may be interpreted in different ways, posing difficulties for prospective clinical trials. This study reports survey results regarding interpretation of the ISRT
guidelines.
METHODS: Forty-four expert lymphoma radiation oncologists were asked to participate in a survey that included 7 different cases associated with 9 questions. The questions pertained to ISRT contouring and asked respondents to choose between 2 different answers (no \"correct\" answer) and a third write-in option allowed.
RESULTS: Fifty-two percent of those surveyed responded to the questionnaire. Among those who responded, 72% have practiced for >10 years, 46% have treated >20 Hodgkin lymphoma cases annually, and 100% were familiar with the ISRT concept. Among the 9 questions associated with the 7 cases, 3 had concordance among the expert radiation oncologists of greater than 70%. Six of the questions had less than 70% concordance (range, 56%-67%).
CONCLUSIONS: Even among expert radiation oncologists, interpretation of ISRT
guidelines is variable. Further guidance for ISRT field design will be needed to reduce variability among practicing physicians.