Quality assurance in the EORTC 22033-26033/CE5 phase III randomized trial for low grade glioma: The digital individual case review

Alysa Fairchild*, Damien C. Weber, Raquel Bar-Deroma, Akos Gulyban, Paul A. Fenton, Roger Stupp, Brigitta G. Baumert

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Introduction: The phase III EORTC 22033-26033/NCIC CE5 intergroup trial compares 50.4 Gy radiotherapy with up-front temozolomide in previously untreated low-grade glioma. We describe the digital EORTC individual case review (ICR) performed to evaluate protocol radiotherapy (RT) compliance. Methods: Fifty-eight institutions were asked to submit 1-2 randomly selected cases. Digital ICR datasets were uploaded to the EORTC server and accessed by three central reviewers. Twenty-seven parameters were analysed including volume delineation, treatment planning, organ at risk (OAR) dosimetry and verification. Consensus reviews were collated and summary statistics calculated. Results: Fifty-seven of seventy-two requested datasets from forty-eight institutions were technically usable. 31/57 received a major deviation for at least one section. Relocation accuracy was according to protocol in 45. Just over 30% had acceptable target volumes. OAR contours were missing in an average of 25% of cases. Up to one-third of those present were incorrectly drawn while dosimetry was largely protocol compliant. Beam energy was acceptable in 97% and 48 patients had per protocol beam arrangements. Conclusions: Digital RT plan submission and review within the EORTC 22033-26033 ICR provide a solid foundation for future quality assurance procedures. Strict evaluation resulted in overall grades of minor and major deviation for 37% and 32%, respectively.
Original languageEnglish
Pages (from-to)287-292
JournalRadiotherapy and Oncology
Issue number3
Publication statusPublished - Jun 2012


  • Low grade glioma
  • Quality assurance
  • Individual case review
  • Phase III

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