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Quality assurance of the PREOPANC trial (2012-003181-40) for preoperative radiochemotherapy in pancreatic cancer : The dummy run. | LitMetric

AI Article Synopsis

  • The PREOPANC trial is a Dutch study comparing preoperative radiochemotherapy to direct surgery for (borderline) resectable pancreatic cancer patients, focusing on evaluating protocol compliance and radiation plan quality.
  • Eleven radiation oncology departments created treatment plans for a 'dummy' patient by delineating various tumor volumes and adhering to the trial's radiotherapy protocol.
  • The results showed variability in internal gross tumor volume among institutions, but all achieved the required treatment coverage without risking surrounding organs, allowing them to continue participating in the trial.

Article Abstract

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 with a mean iGTV of 41.5 cm (standard deviation 14.8 cm). 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.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5519646PMC
http://dx.doi.org/10.1007/s00066-017-1153-6DOI Listing

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