The TRENDY multi-center randomized trial on hepatocellular carcinoma – Trial QA including automated treatment planning and benchmark-case results

The TRENDY trial is an international multi-center phase-II study, randomizing hepatocellular carcinoma (HCC) patients between transarterial chemoembolization (TACE) and stereotactic body radiation therapy (SBRT) with a target dose of 48–54 Gy in six fractions. The radiotherapy quality assurance (QA)...

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Bibliographic Details
Published in:Radiotherapy and oncology 2017-12, Vol.125 (3), p.507-513
Main Authors: Habraken, Steven J.M., Sharfo, Abdul Wahab M., Buijsen, Jeroen, Verbakel, Wilko F.A.R., Haasbeek, Cornelis J.A., Öllers, Michel C., Westerveld, Henrike, van Wieringen, Niek, Reerink, Onne, Seravalli, Enrica, Braam, Pètra M., Wendling, Markus, Lacornerie, Thomas, Mirabel, Xavier, Weytjens, Reinhilde, Depuydt, Lieselotte, Tanadini-Lang, Stephanie, Riesterer, Oliver, Haustermans, Karin, Depuydt, Tom, Dwarkasing, Roy S., Willemssen, François E.J.A., Heijmen, Ben J.M., Méndez Romero, Alejandra
Format: Article
Language:English
Subjects:
Automated treatment planning for plan QA
Benchmark-case delineation
Benchmark-case treatment planning
Benchmarking
Carcinoma, Hepatocellular - radiotherapy
Chemoembolization, Therapeutic
Humans
Liver Neoplasms - radiotherapy
Prospective Studies
QA in clinical trials
Quality Assurance, Health Care
Radiosurgery
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted - methods
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Summary:The TRENDY trial is an international multi-center phase-II study, randomizing hepatocellular carcinoma (HCC) patients between transarterial chemoembolization (TACE) and stereotactic body radiation therapy (SBRT) with a target dose of 48–54 Gy in six fractions. The radiotherapy quality assurance (QA) program, including prospective plan feedback based on automated treatment planning, is described and results are reported. Scans of a single patient were used as a benchmark case. Contours submitted by nine participating centers were compared with reference contours. The subsequent planning round was based on a single set of contours. A total of 20 plans from participating centers, including 12 from the benchmark case, 5 from a clinical pilot and 3 from the first study patients, were compared to automatically generated VMAT plans. For the submitted liver contours, Dice Similarity Coefficients (DSC) with the reference delineation ranged from 0.925 to 0.954. For the GTV, the DSC varied between 0.721 and 0.876. For the 12 plans on the benchmark case, healthy liver normal-tissue complication probabilities (NTCPs) ranged from 0.2% to 22.2% with little correlation between NCTP and PTV-D95% (R2 
ISSN:0167-8140
1879-0887
DOI:10.1016/j.radonc.2017.09.007