Brachytherapy quality assurance in the PORTEC-4a trial for molecular-integrated risk profile guided adjuvant treatment of endometrial cancer

B.G. Wortman; E. Astreinidou; M.S. Laman; E.M. van der Steen-Banasik; L.C.H.W. Lutgens; H. Westerveld; F. Koppe; A. Slot; H.A. van den Berg; M.E. Nowee; S. Bijmolt; T.C. Stam; A.G. Zwanenburg; J.W.M. Mens; I.M. Jurgenliemk-Schulz; A. Snyers; C.M. Gillham; N. Weidner; S. Kommoss; K. Vandecasteele; V. Tomancova; C.L. Creutzberg; R.A. Nout; PORTEC Study Grp

doi:10.1016/j.radonc.2020.10.038

Brachytherapy quality assurance in the PORTEC-4a trial for molecular-integrated risk profile guided adjuvant treatment of endometrial cancer

B.G. Wortman^*, E. Astreinidou, M.S. Laman, E.M. van der Steen-Banasik, L.C.H.W. Lutgens, H. Westerveld, F. Koppe, A. Slot, H.A. van den Berg, M.E. Nowee, S. Bijmolt, T.C. Stam, A.G. Zwanenburg, J.W.M. Mens, I.M. Jurgenliemk-Schulz, A. Snyers, C.M. Gillham, N. Weidner, S. Kommoss, K. VandecasteeleV. Tomancova, C.L. Creutzberg, R.A. Nout, PORTEC Study Grp

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective: The PORTEC-4a trial investigates molecular-integrated risk profile guided adjuvant treatment for endometrial cancer. The quality assurance programme included a dummy run for vaginal brachytherapy prior to site activation, and annual quality assurance to verify protocol adherence. Aims of this study were to evaluate vaginal brachytherapy quality and protocol adherence.Methods: For the dummy run, institutes were invited to create a brachytherapy plan on a provided CT-scan with the applicator in situ. For annual quality assurance, institutes provided data of one randomly selected brachytherapy case. A brachytherapy panel reviewed and scored the brachytherapy plans according to a checklist.Results: At the dummy run, 15 out of 21 (71.4%) institutes needed adjustments of delineation or planning. After adjustments, the mean dose at the vaginal apex (protocol: 100%; 7 Gy) decreased from 100.7% to 99.9% and range and standard deviation (SD) narrowed from 83.6-135.1 to 96.4-101.4 and 8.8 to 1.1, respectively. At annual quality assurance, 22 out of 27 (81.5%) cases had no or minor and 5 out of 27 (18.5%) major deviations. Most deviations were related to delineation, mean dose at the vaginal apex (98.0%, 74.7-114.2, SD 7.6) or reference volume length.Conclusions: Most feedback during the brachytherapy quality assurance procedure of the PORTEC-4a trial was related to delineation, dose at the vaginal apex and the reference volume length. Annual quality assurance is essential to promote protocol compliance, ensuring high quality vaginal brachytherapy in all participating institutes. (C) 2020 The Authors. Published by Elsevier B.V.

Original language	English
Pages (from-to)	160-166
Number of pages	7
Journal	Radiotherapy and Oncology
Volume	155
DOIs	https://doi.org/10.1016/j.radonc.2020.10.038
Publication status	Published - 1 Feb 2021

Keywords

Brachytherapy
Dummy run
Endometrial cancer
Quality assurance
IMPACT
RADIOTHERAPY
OUTCOMES
DOSE-RATE BRACHYTHERAPY
CARCINOMA
RADIATION-THERAPY
DUMMY RUN

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Wortman, B. G., Astreinidou, E., Laman, M. S., van der Steen-Banasik, E. M., Lutgens, L. C. H. W., Westerveld, H., Koppe, F., Slot, A., van den Berg, H. A., Nowee, M. E., Bijmolt, S., Stam, T. C., Zwanenburg, A. G., Mens, J. W. M., Jurgenliemk-Schulz, I. M., Snyers, A., Gillham, C. M., Weidner, N., Kommoss, S., ... PORTEC Study Grp (2021). Brachytherapy quality assurance in the PORTEC-4a trial for molecular-integrated risk profile guided adjuvant treatment of endometrial cancer. Radiotherapy and Oncology, 155, 160-166. https://doi.org/10.1016/j.radonc.2020.10.038

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title = "Brachytherapy quality assurance in the PORTEC-4a trial for molecular-integrated risk profile guided adjuvant treatment of endometrial cancer",

abstract = "Objective: The PORTEC-4a trial investigates molecular-integrated risk profile guided adjuvant treatment for endometrial cancer. The quality assurance programme included a dummy run for vaginal brachytherapy prior to site activation, and annual quality assurance to verify protocol adherence. Aims of this study were to evaluate vaginal brachytherapy quality and protocol adherence.Methods: For the dummy run, institutes were invited to create a brachytherapy plan on a provided CT-scan with the applicator in situ. For annual quality assurance, institutes provided data of one randomly selected brachytherapy case. A brachytherapy panel reviewed and scored the brachytherapy plans according to a checklist.Results: At the dummy run, 15 out of 21 (71.4%) institutes needed adjustments of delineation or planning. After adjustments, the mean dose at the vaginal apex (protocol: 100%; 7 Gy) decreased from 100.7% to 99.9% and range and standard deviation (SD) narrowed from 83.6-135.1 to 96.4-101.4 and 8.8 to 1.1, respectively. At annual quality assurance, 22 out of 27 (81.5%) cases had no or minor and 5 out of 27 (18.5%) major deviations. Most deviations were related to delineation, mean dose at the vaginal apex (98.0%, 74.7-114.2, SD 7.6) or reference volume length.Conclusions: Most feedback during the brachytherapy quality assurance procedure of the PORTEC-4a trial was related to delineation, dose at the vaginal apex and the reference volume length. Annual quality assurance is essential to promote protocol compliance, ensuring high quality vaginal brachytherapy in all participating institutes. (C) 2020 The Authors. Published by Elsevier B.V.",

keywords = "Brachytherapy, Dummy run, Endometrial cancer, Quality assurance, IMPACT, RADIOTHERAPY, OUTCOMES, DOSE-RATE BRACHYTHERAPY, CARCINOMA, RADIATION-THERAPY, DUMMY RUN",

author = "B.G. Wortman and E. Astreinidou and M.S. Laman and {van der Steen-Banasik}, E.M. and L.C.H.W. Lutgens and H. Westerveld and F. Koppe and A. Slot and {van den Berg}, H.A. and M.E. Nowee and S. Bijmolt and T.C. Stam and A.G. Zwanenburg and J.W.M. Mens and I.M. Jurgenliemk-Schulz and A. Snyers and C.M. Gillham and N. Weidner and S. Kommoss and K. Vandecasteele and V. Tomancova and C.L. Creutzberg and R.A. Nout and {PORTEC Study Grp}",

year = "2021",

month = feb,

day = "1",

doi = "10.1016/j.radonc.2020.10.038",

language = "English",

volume = "155",

pages = "160--166",

journal = "Radiotherapy and Oncology",

issn = "0167-8140",

publisher = "Elsevier Ireland Ltd",

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Wortman, BG, Astreinidou, E, Laman, MS, van der Steen-Banasik, EM, Lutgens, LCHW, Westerveld, H, Koppe, F, Slot, A, van den Berg, HA, Nowee, ME, Bijmolt, S, Stam, TC, Zwanenburg, AG, Mens, JWM, Jurgenliemk-Schulz, IM, Snyers, A, Gillham, CM, Weidner, N, Kommoss, S, Vandecasteele, K, Tomancova, V, Creutzberg, CL, Nout, RA & PORTEC Study Grp 2021, 'Brachytherapy quality assurance in the PORTEC-4a trial for molecular-integrated risk profile guided adjuvant treatment of endometrial cancer', Radiotherapy and Oncology, vol. 155, pp. 160-166. https://doi.org/10.1016/j.radonc.2020.10.038

TY - JOUR

T1 - Brachytherapy quality assurance in the PORTEC-4a trial for molecular-integrated risk profile guided adjuvant treatment of endometrial cancer

AU - Wortman, B.G.

AU - Astreinidou, E.

AU - Laman, M.S.

AU - van der Steen-Banasik, E.M.

AU - Lutgens, L.C.H.W.

AU - Westerveld, H.

AU - Koppe, F.

AU - Slot, A.

AU - van den Berg, H.A.

AU - Nowee, M.E.

AU - Bijmolt, S.

AU - Stam, T.C.

AU - Zwanenburg, A.G.

AU - Mens, J.W.M.

AU - Jurgenliemk-Schulz, I.M.

AU - Snyers, A.

AU - Gillham, C.M.

AU - Weidner, N.

AU - Kommoss, S.

AU - Vandecasteele, K.

AU - Tomancova, V.

AU - Creutzberg, C.L.

AU - Nout, R.A.

AU - PORTEC Study Grp

PY - 2021/2/1

Y1 - 2021/2/1

N2 - Objective: The PORTEC-4a trial investigates molecular-integrated risk profile guided adjuvant treatment for endometrial cancer. The quality assurance programme included a dummy run for vaginal brachytherapy prior to site activation, and annual quality assurance to verify protocol adherence. Aims of this study were to evaluate vaginal brachytherapy quality and protocol adherence.Methods: For the dummy run, institutes were invited to create a brachytherapy plan on a provided CT-scan with the applicator in situ. For annual quality assurance, institutes provided data of one randomly selected brachytherapy case. A brachytherapy panel reviewed and scored the brachytherapy plans according to a checklist.Results: At the dummy run, 15 out of 21 (71.4%) institutes needed adjustments of delineation or planning. After adjustments, the mean dose at the vaginal apex (protocol: 100%; 7 Gy) decreased from 100.7% to 99.9% and range and standard deviation (SD) narrowed from 83.6-135.1 to 96.4-101.4 and 8.8 to 1.1, respectively. At annual quality assurance, 22 out of 27 (81.5%) cases had no or minor and 5 out of 27 (18.5%) major deviations. Most deviations were related to delineation, mean dose at the vaginal apex (98.0%, 74.7-114.2, SD 7.6) or reference volume length.Conclusions: Most feedback during the brachytherapy quality assurance procedure of the PORTEC-4a trial was related to delineation, dose at the vaginal apex and the reference volume length. Annual quality assurance is essential to promote protocol compliance, ensuring high quality vaginal brachytherapy in all participating institutes. (C) 2020 The Authors. Published by Elsevier B.V.

AB - Objective: The PORTEC-4a trial investigates molecular-integrated risk profile guided adjuvant treatment for endometrial cancer. The quality assurance programme included a dummy run for vaginal brachytherapy prior to site activation, and annual quality assurance to verify protocol adherence. Aims of this study were to evaluate vaginal brachytherapy quality and protocol adherence.Methods: For the dummy run, institutes were invited to create a brachytherapy plan on a provided CT-scan with the applicator in situ. For annual quality assurance, institutes provided data of one randomly selected brachytherapy case. A brachytherapy panel reviewed and scored the brachytherapy plans according to a checklist.Results: At the dummy run, 15 out of 21 (71.4%) institutes needed adjustments of delineation or planning. After adjustments, the mean dose at the vaginal apex (protocol: 100%; 7 Gy) decreased from 100.7% to 99.9% and range and standard deviation (SD) narrowed from 83.6-135.1 to 96.4-101.4 and 8.8 to 1.1, respectively. At annual quality assurance, 22 out of 27 (81.5%) cases had no or minor and 5 out of 27 (18.5%) major deviations. Most deviations were related to delineation, mean dose at the vaginal apex (98.0%, 74.7-114.2, SD 7.6) or reference volume length.Conclusions: Most feedback during the brachytherapy quality assurance procedure of the PORTEC-4a trial was related to delineation, dose at the vaginal apex and the reference volume length. Annual quality assurance is essential to promote protocol compliance, ensuring high quality vaginal brachytherapy in all participating institutes. (C) 2020 The Authors. Published by Elsevier B.V.

KW - Brachytherapy

KW - Dummy run

KW - Endometrial cancer

KW - Quality assurance

KW - IMPACT

KW - RADIOTHERAPY

KW - OUTCOMES

KW - DOSE-RATE BRACHYTHERAPY

KW - CARCINOMA

KW - RADIATION-THERAPY

KW - DUMMY RUN

U2 - 10.1016/j.radonc.2020.10.038

DO - 10.1016/j.radonc.2020.10.038

M3 - Article

C2 - 33159971

SN - 0167-8140

VL - 155

SP - 160

EP - 166

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

ER -