Journal Article

Quality assurance of the PREOPANC trial (2012-003181-40) for preoperative radiochemotherapy in pancreatic cancer

Lens, Eelco, van Eijck, Casper H. J., Versteijne, Eva, Punt, Cornelis J. A., van Tienhoven, Geertjan, Suker, Mustafa, van der Horst, Astrid, Visser, Jorrit, Bel, Arjan

2017

Overview

Background The Dutch Pancreatic Cancer Group initiated the national, multicentre, controlled PREOPANC trial, randomising between preoperative radiochemotherapy and direct explorative laparotomy for patients with (borderline) resectable pancreatic cancer. The aim of this dummy run is to evaluate compliance with the radiotherapy protocol of this trial, and the quality of delineation and radiation plans. Methods Eleven radiation oncology departments open for accrual of patients in the PREOPANC trial were provided with all necessary information of a selected ‘dummy’ patient. Each institute was asked to delineate the target volumes, including gross tumour volume, internal gross tumour volume (iGTV), internal clinical target volume, and planning target volume. The institutions were also asked to provide a radiation treatment plan in accordance with the PREOPANC trial protocol. Results The range of the iGTV was 19.3–77.2 cm 3 with a mean iGTV of 41.5 cm 3 (standard deviation 14.8 cm 3 ). Nine institutions made a treatment plan using an arc technique for treatment delivery, one an intensity modulated technique and one a 3-field conformal technique. All institutions reached the prescribed target coverage, without exceeding the organs at risk constraints. The institution with the 3‑field conformal technique was advised to use a more sophisticated technique (e. g. volumetric modulated arc therapy) to reduce the dose to the spinal cord. Conclusion All institutions showed acceptable deviations from the PREOPANC trial protocol and achieved an acceptable quality of delineation and radiation technique. All institutions were allowed to continue participation in the PREOPANC trial.

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V
• Subject: Adult / Cancer / Cancer therapies / Chemoradiotherapy, Adjuvant - standards / Chemoradiotherapy, Adjuvant - statistics & numerical data / Delineation / Female / Guideline Adherence - statistics & numerical data / Guideline Adherence - utilization / Humans / Male / Medicine / Medicine & Public Health / Netherlands / Oncology / Organs / Original / Original Article / Pancreatectomy - standards / Pancreatic cancer / Pancreatic Neoplasms - radiotherapy / Pancreatic Neoplasms - surgery / Patients / Preoperative Care - standards / Preoperative Care - statistics & numerical data / Quality / Quality assurance / Quality Assurance, Health Care - methods / Quality control / Radiation therapy / Radiotherapy / Radiotherapy Dosage / Radiotherapy Planning, Computer-Assisted - standards / Radiotherapy Planning, Computer-Assisted - statistics & numerical data / Radiotherapy, Intensity-Modulated - standards / Radiotherapy, Intensity-Modulated - statistics & numerical data / Reproducibility of Results / Rope / Sensitivity and Specificity / Spinal cord / Treatment Outcome / Tumor Burden