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Song YC, Hu ZH, Yan XN, Fang H, Tang Y, Jing H, Men K, Zhang N, Zhang J, Jin J, Zhong QZ, Ma J, Yang WF, Zhong YH, Dong LH, Wang XH, Wu HF, Du XH, Hou XR, Tie J, Lu YF, Zhao LN, Li YX, Wang SL. Quality assurance in a phase III, multicenter, randomized trial of POstmastectomy radioThErapy in Node posiTive breast cancer with or without Internal mAmmary nodaL irradiation (POTENTIAL): a planning benchmark case. Radiat Oncol 2023; 18:194. [PMID: 38031125 PMCID: PMC10685528 DOI: 10.1186/s13014-023-02379-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/13/2023] [Indexed: 12/01/2023] Open
Abstract
PURPOSE To report the planning benchmark case results of the POTENTIAL trial-a multicenter, randomized, phase 3 trial-to evaluate the value of internal mammary nodal (IMN) irradiation for patients with high-risk breast cancer. METHODS All participating institutions were provided the outlines of one benchmark case, and they generated radiation therapy plans per protocol. The plans were evaluated by a quality assurance team, after which the institutions resubmitted their revised plans. The information on beams arrangement, skin flash, inhomogeneity corrections, and protocol compliance was assessed in the first and final submission. RESULTS The plans from 26 institutions were analyzed. Some major deviations were found in the first submission. The protocol compliance rates of dose coverage for the planning target volume of chest wall, supraclavicular fossa plus axilla, and IMN region (PTVim) were all significantly improved in the final submission, which were 96.2% vs. 69.2%, 100% vs. 76.9%, and 88.4% vs. 53.8%, respectively. For OARs, the compliance rates of heart Dmean, left anterior descending coronary artery V40Gy, ipsilateral lung V5Gy, and stomach V5Gy were significantly improved. In the first and final submission, the mean values of PTVim V100% were 79.9% vs. 92.7%; the mean values of heart Dmean were 11.5 Gy vs. 9.7 Gy for hypofractionated radiation therapy and 11.5 Gy vs. 11.0 Gy for conventional fractionated radiation therapy, respectively. CONCLUSION The major deviations were corrected and protocol compliance was significantly improved after revision, which highlighted the importance of planning benchmark case to guarantee the planning quality for multicenter trials.
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Affiliation(s)
- Yu-Chun Song
- Department of Radiation Oncology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Pan jia yuan nan li, Chaoyang District, Beijing, 100021, China
| | - Zhi-Hui Hu
- Department of Radiation Oncology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Pan jia yuan nan li, Chaoyang District, Beijing, 100021, China
| | - Xue-Na Yan
- Department of Radiation Oncology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Pan jia yuan nan li, Chaoyang District, Beijing, 100021, China
| | - Hui Fang
- Department of Radiation Oncology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Pan jia yuan nan li, Chaoyang District, Beijing, 100021, China
| | - Yu Tang
- Department of Radiation Oncology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Pan jia yuan nan li, Chaoyang District, Beijing, 100021, China
| | - Hao Jing
- Department of Radiation Oncology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Pan jia yuan nan li, Chaoyang District, Beijing, 100021, China
| | - Kuo Men
- Department of Radiation Oncology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Pan jia yuan nan li, Chaoyang District, Beijing, 100021, China
| | - Na Zhang
- Department of Radiation Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Jun Zhang
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jing Jin
- Department of Radiation Oncology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital &Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Qiu-Zi Zhong
- Department of Radiation Oncology, Beijing Hospital, Ministry of Health, Beijing, China
| | - Jun Ma
- Department of Radiation Oncology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Wei-Fang Yang
- Department of Radiation Oncology, Affiliated Taizhou Hospital of Wenzhou Medical University, Taizhou, China
| | - Ya-Hua Zhong
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Wuhan, China
| | - Li-Hua Dong
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, China
| | - Xiao-Hong Wang
- Department of Radiochemotherapy, Tangshan People's Hospital, Tangshan, China
| | - Hong-Fen Wu
- Department of Radiation Oncology, Cancer Hospital of Jilin Province, Changchun, China
| | - Xiang-Hui Du
- Department of Radiation Therapy, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, China
| | - Xiao-Rong Hou
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100005, China.
| | - Jian Tie
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, 100048, China.
| | - Yu-Fei Lu
- Department of Radiation Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450003, China.
| | - Li-Na Zhao
- Department of Radiation Oncology, Xijing Hospital, The First Affiliated Hospital of Fourth Military Medical University, Xi'an, 710032, China.
| | - Ye-Xiong Li
- Department of Radiation Oncology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Pan jia yuan nan li, Chaoyang District, Beijing, 100021, China.
| | - Shu-Lian Wang
- Department of Radiation Oncology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Pan jia yuan nan li, Chaoyang District, Beijing, 100021, China.
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Khalladi N, Dejean C, Bosset M, Pointreau Y, Kinj R, Racadot S, Castelli J, Huguet F, Renard S, Guihard S, Tao Y, Rouvier JM, Johnson A, Bourhis J, Xu Shan S, Thariat J. A priori quality assurance using a benchmark case of the randomized phase 2 GORTEC 2014-14 in oligometastatic head and neck cancer patients. Cancer Radiother 2021; 25:755-762. [PMID: 34565664 DOI: 10.1016/j.canrad.2021.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/19/2021] [Accepted: 04/28/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE 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. MATERIAL AND 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. CONCLUSION 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.
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Affiliation(s)
- N Khalladi
- Centre François Baclesse, 3, avenue General Harris, 14076 Caen, France
| | - C Dejean
- Centre Antoine Lacassagne, Nice, France
| | - M Bosset
- Centre Marie Curie, Valence, France
| | | | - R Kinj
- Centre Antoine Lacassagne, Nice, France
| | | | | | - F Huguet
- Centre hospitalier et universitaire Tenon, Paris, France
| | - S Renard
- Institut de Cancérologie de Lorraine, Nancy, France
| | - S Guihard
- Institut de Cancérologie Strasbourg Europe, Strasbourg, France
| | - Y Tao
- Institut Gustave Roussy, Villejuif, France
| | - J M Rouvier
- Centre hospitalier régional et universitaire, Besançon-Montbéliard, France
| | - A Johnson
- Centre François Baclesse, 3, avenue General Harris, 14076 Caen, France
| | - J Bourhis
- Centre hospitalier universitaire vaudois, Lausanne, Switzerland
| | - S Xu Shan
- Centre hospitalier universitaire vaudois, Lausanne, Switzerland
| | - J Thariat
- Centre François Baclesse, 3, avenue General Harris, 14076 Caen, France; Corpuscular Physics Laboratory-Normandy University, Caen, France.
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Stelmes JJ, Vu E, Grégoire V, Simon C, Clementel E, Kazmierska J, Grant W, Ozsahin M, Tomsej M, Vieillevigne L, Fortpied C, Hurkmans EC, Branquinho A, Andratschke N, Zimmermann F, Weber DC. Quality assurance of radiotherapy in the ongoing EORTC 1420 "Best of" trial for early stage oropharyngeal, supraglottic and hypopharyngeal carcinoma: results of the benchmark case procedure. Radiat Oncol 2021; 16:81. [PMID: 33933118 PMCID: PMC8088557 DOI: 10.1186/s13014-021-01809-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/19/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The current phase III EORTC 1420 Best-of trial (NCT02984410) compares the swallowing function after transoral surgery versus intensity modulated radiotherapy (RT) in patients with early-stage carcinoma of the oropharynx, supraglottis and hypopharynx. We report the analysis of the Benchmark Case (BC) procedures before patient recruitment with special attention to dysphagia/aspiration related structures (DARS). MATERIALS AND METHODS Submitted RT volumes and plans from participating centers were analyzed and compared against the gold-standard expert delineations and dose distributions. Descriptive analysis of protocol deviations was conducted. Mean Sorensen-Dice similarity index (mDSI) and Hausdorff distance (mHD) were applied to evaluate the inter-observer variability (IOV). RESULTS 65% (23/35) of the institutions needed more than one submission to achieve Quality assurance (RTQA) clearance. OAR volume delineations were the cause for rejection in 53% (40/76) of cases. IOV could be improved in 5 out of 12 OARs by more than 10 mm after resubmission (mHD). Despite this, final IOV for critical OARs in delineation remained significant among DARS by choosing an aleatory threshold of 0.7 (mDSI) and 15 mm (mHD). CONCLUSIONS This is to our knowledge the largest BC analysis among Head and neck RTQA programs performed in the framework of a prospective trial. Benchmarking identified non-common OARs and target delineations errors as the main source of deviations and IOV could be reduced in a significant number of cases after this process. Due to the substantial resources involved with benchmarking, future benchmark analyses should assess fully the impact on patients' clinical outcome.
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Affiliation(s)
- J-J Stelmes
- Radiation Oncology Department, Oncology Institute of Southern Switzerland, Via Athos Gallino 12, 6500, Bellinzona, Switzerland.
| | - E Vu
- Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | | | - C Simon
- Lausanne University Hospital, Lausanne, Switzerland
| | | | | | - W Grant
- Gloucestershire Hospitals, NHS Foundation Trust, Gloucester, UK
| | - M Ozsahin
- Lausanne University Hospital, Lausanne, Switzerland
| | - M Tomsej
- Hospital of Charleroi, Charleroi, Belgium
| | | | | | | | - A Branquinho
- Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | | | - F Zimmermann
- University Hospital of Basel, Basel, Switzerland
| | - D-C Weber
- University Hospital of Bern, Bern, Switzerland
- Paul-Scherrer-Institute, Villigen, Switzerland
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Janke T, Koullapis P, Kassinos SC, Bauer K. PIV measurements of the SimInhale benchmark case. Eur J Pharm Sci 2019; 133:183-189. [PMID: 30940542 DOI: 10.1016/j.ejps.2019.03.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/26/2019] [Accepted: 03/27/2019] [Indexed: 11/15/2022]
Abstract
Particle Image Velocimetry (PIV) measurements with the aim of providing experimental data for the SimInhale benchmark case are presented within this work. We, therefore, present a refractive index matched, transparent model of the benchmark geometry, in which the velocity and turbulent kinetic energy fields are examined at flow rates comparable to 15, 30 and 60 L/min (Re ≈ 1000-4500) in air. Furthermore, these results are compared with Large Eddy Simulations (LES). The results reveal a Reynolds number independence of the qualitative velocity field in the range covered within this work. Good agreement is found between the PIV and LES data, with a slight over-prediction of turbulent kinetic energies by the simulations. The obtained experimental data will be part of a common, publicly accessible ERCOFTAC database along with additional results published recently.
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Affiliation(s)
- T Janke
- Institute of Mechanics and Fluid Dynamics, TU Bergakademie Freiberg, Freiberg, Germany.
| | - P Koullapis
- Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | - S C Kassinos
- Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | - K Bauer
- Institute of Mechanics and Fluid Dynamics, TU Bergakademie Freiberg, Freiberg, Germany
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Koullapis P, Kassinos SC, Muela J, Perez-Segarra C, Rigola J, Lehmkuhl O, Cui Y, Sommerfeld M, Elcner J, Jicha M, Saveljic I, Filipovic N, Lizal F, Nicolaou L. Regional aerosol deposition in the human airways: The SimInhale benchmark case and a critical assessment of in silico methods. Eur J Pharm Sci 2017; 113:77-94. [PMID: 28890203 DOI: 10.1016/j.ejps.2017.09.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/01/2017] [Accepted: 09/04/2017] [Indexed: 10/18/2022]
Abstract
Regional deposition effects are important in the pulmonary delivery of drugs intended for the topical treatment of respiratory ailments. They also play a critical role in the systemic delivery of drugs with limited lung bioavailability. In recent years, significant improvements in the quality of pulmonary imaging have taken place, however the resolution of current imaging modalities remains inadequate for quantifying regional deposition. Computational Fluid-Particle Dynamics (CFPD) can fill this gap by providing detailed information about regional deposition in the extrathoracic and conducting airways. It is therefore not surprising that the last 15years have seen an exponential growth in the application of CFPD methods in this area. Survey of the recent literature however, reveals a wide variability in the range of modelling approaches used and in the assumptions made about important physical processes taking place during aerosol inhalation. The purpose of this work is to provide a concise critical review of the computational approaches used to date, and to present a benchmark case for validation of future studies in the upper airways. In the spirit of providing the wider community with a reference for quality assurance of CFPD studies, in vitro deposition measurements have been conducted in a human-based model of the upper airways, and several groups within MP1404 SimInhale have computed the same case using a variety of simulation and discretization approaches. Here, we report the results of this collaborative effort and provide a critical discussion of the performance of the various simulation methods. The benchmark case, in vitro deposition data and in silico results will be published online and made available to the wider community. Particle image velocimetry measurements of the flow, as well as additional numerical results from the community, will be appended to the online database as they become available in the future.
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Affiliation(s)
- P Koullapis
- Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | - S C Kassinos
- Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | - J Muela
- Heat and Mass Transfer Technological Centre, Universitat Politècnica de Catalunya, Terrassa, Spain
| | - C Perez-Segarra
- Heat and Mass Transfer Technological Centre, Universitat Politècnica de Catalunya, Terrassa, Spain
| | - J Rigola
- Heat and Mass Transfer Technological Centre, Universitat Politècnica de Catalunya, Terrassa, Spain
| | - O Lehmkuhl
- Barcelona Supercomputing Center, Barcelona, Spain
| | - Y Cui
- Chair of Applied Mechanics, Friedrich-Alexander University Erlangen-Nuremberg, Germany
| | - M Sommerfeld
- Institute of Process Engineering, Otto von Guericke-University Magdeburg, Halle, Germany
| | - J Elcner
- Faculty of Mechanical Engineering, Brno University of Technology, Brno, Czech Republic
| | - M Jicha
- Faculty of Mechanical Engineering, Brno University of Technology, Brno, Czech Republic
| | - I Saveljic
- Faculty of Engineering, University of Kragujevac, Kragujevac, Serbia
| | - N Filipovic
- Faculty of Engineering, University of Kragujevac, Kragujevac, Serbia
| | - F Lizal
- Faculty of Mechanical Engineering, Brno University of Technology, Brno, Czech Republic
| | - L Nicolaou
- Department of Mechanical Engineering, Imperial College London, London, UK.
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