目的:作为GORTEC2014-14OMET随机2期研究质量保证过程的一部分,进行了一个基准案例(BC),在寡转移的头颈部鳞状细胞癌(HNSCC)中,测试了仅多部位立体定向放射治疗(SBRT)作为全身治疗和SBRT替代方法的可能性。
方法:调查中心对处方的依从性,划界,对研究方案中提供的计划和评估建议进行了评估.此外,经典剂量学分析辅以使用构象指数的定量几何分析。
结果:20个中心参与了BC分析。其中,在两个中心报告了四个主要偏差(MaD).MaD中的两个(10%)中心省略了卫星肿瘤结节,并在修订后进行了第二次验证。他们各自的DICE指数为0.37和0,颅外SBRT装置的使用次优。参与中心之间存在显著的残余异质性,包括那些有类似SBRT设备的,使用标准指标和几何指标影响计划质量。
结论:使用BC对临床研究中心的参与进行的先验QA显示出与良好的SBRT实践的偏差,并导致20个参与中心中的一个被排除在外。大多数中心已证明严格遵守研究方案。质量指标的使用增加了一种改进计划质量评估的补充方法。
OBJECTIVE: A Benchmark
Case (BC) was performed as part of the quality assurance process of the randomized phase 2 GORTEC 2014-14 OMET study, testing the possibility of multisite stereotactic radiation therapy (SBRT) alone in oligometastatic head and neck squamous cell carcinoma (HNSCC) as an alternative to systemic treatment and SBRT.
METHODS: Compliance of the investigating centers with the prescription, delineation, planning and evaluation recommendations available in the research protocol was assessed. In addition, classical dosimetric analysis was supplemented by quantitative geometric analysis using conformation indices.
RESULTS: Twenty centers participated in the BC analysis. Among them, four major deviations (MaD) were reported in two centers. Two (10%) centers in MaD had omitted the satellite tumor nodule and secondarily validated after revision. Their respective DICE indexes were 0.37 and 0 and use of extracranial SBRT devices suboptimal There were significant residual heterogeneities between participating centers, including those with a similar SBRT equipment, with impact of plan quality using standard indicators and geometric indices.
CONCLUSIONS: A priori QA using a BC conditioning the participation of the clinical investigation centers showed deviations from good SBRT practice and led to the exclusion of one out of the twenty participating centers. The majority of centers have demonstrated rigorous compliance with the research protocol. The use of quality indexes adds a complementary approach to improve assessment of plan quality.