Radiation Oncology (Jul 2019)

Dummy-run for standardizing plan quality of intensity-modulated radiotherapy for postoperative uterine cervical cancer: Japan Clinical Oncology Group study (JCOG1402)

  • Hiroyuki Okamoto,
  • Naoya Murakami,
  • Fumiaki Isohashi,
  • Takahiro Kasamatsu,
  • Yoko Hasumi,
  • Kotaro Iijima,
  • Shie Nishioka,
  • Satoshi Nakamura,
  • Mitsuhiro Nakamura,
  • Teiji Nishio,
  • Hiroshi Igaki,
  • Yuko Nakayama,
  • Jun Itami,
  • Satoshi Ishikura,
  • Yasumasa Nishimura,
  • Takafumi Toita

DOI
https://doi.org/10.1186/s13014-019-1340-y
Journal volume & issue
Vol. 14, no. 1
pp. 1 – 9

Abstract

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Abstract Background The purpose of this study was to assess compliance with treatment planning in a dummy-run for a multicenter clinical trial involving patients with high-risk postoperative uterine cervical cancer using intensity-modulated radiation therapy (IMRT) (JCOG1402 trial). Methods For the dummy-run, we prepared a computed tomography dataset comprising two anonymized cases of post-hysterectomy cervical cancer. These were sent to the 47 participating institutions to assess institutional plan quality such as delineations and dose distributions. Results Central review showed 3 and 4 deviations per treatment plan on average. The deviations related to the nodal and vaginal cuff clinical target volume (CTV) delineation, which accounted for approximately 50% of the total deviations. The CTV vaginal cuff showed considerable differences in delineation compared with the nodal CTV. For the Dice similarity coefficient, case 1 showed a mean ± 1σ of 0.81 ± 0.03 and 0.60 ± 0.09 for the nodal and the CTV vaginal cuff, respectively, while these were 0.81 ± 0.04 and 0.54 ± 0.14, respectively, for case two. Of the 47 institutions, 10 were required to resubmit their treatment plan because the delineations, planning target volume margin, and required dose distributions were not in accordance with the JCOG1402 protocol. Conclusions The dummy-run test in postoperative uterine cervical cancer demonstrated substantial deviations in the delineations, particularly for the CTV vaginal cuff. The analysis data could provide helpful information on delineation and planning, allowing standardization of IMRT planning for postoperative uterine cervical cancer. Trial registration Japanese Clinical Trial Registry #: UMIN000027017 at https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000030672;language=J

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