Radiotherapy quality assurance for the RTOG 0834/EORTC 26053-22054/NCIC CTG CEC.1/CATNON intergroup trial “concurrent and adjuvant temozolomide chemotherapy in newly diagnosed non-1p/19q deleted anaplastic glioma”: Individual case review analysis

• Published in: Radiotherapy and oncology 2018-05, Vol.127 (2), p.292-298
• Main Authors: Abrunhosa-Branquinho, André N., Bar-Deroma, Raquel, Collette, Sandra, Clementel, Enrico, Liu, Yan, Hurkmans, Coen W., Feuvret, Loïc, Van Beek, Karen, van den Bent, Martin, Baumert, Brigitta G., Weber, Damien C.
• Format: Article
• Language: English
• Subjects: Anaplastic glioma; Antineoplastic Agents, Alkylating - therapeutic use; Brain Neoplasms - drug therapy; Brain Neoplasms - genetics; Brain Neoplasms - pathology; Brain Neoplasms - radiotherapy; Chemotherapy, Adjuvant; Chromosome Deletion; Chromosomes, Human, Pair 1; Chromosomes, Human, Pair 19; Dacarbazine - analogs & derivatives; Dacarbazine - therapeutic use; EORTC; Glioma - drug therapy; Glioma - genetics; Glioma - pathology; Glioma - radiotherapy; Humans; Individual case review; Phase III trial; Prospective Studies; Quality Assurance, Health Care; Radiotherapy; Radiotherapy Planning, Computer-Assisted - methods; Retrospective Studies; RTQA; Temozolomide; Tomography, X-Ray Computed - methods
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/j.radonc.2018.03.013

The EORTC phase III 26053-22054/ RTOG 0834/NCIC CTG CEC.1/CATNON intergroup trial was designed to evaluate the impact on concurrent and adjuvant temozolomide chemotherapy in newly diagnosed non-1p/19q deleted anaplastic gliomas. The primary endpoint was overall survival. We report the results of retrospective individual case reviews (ICRs) for the first patient randomized per institution to detect the compliance with the study protocol. Sixty-nine institutions were required to submit the radiotherapy plan of their first randomized patient. Full digital datasets uploaded to the EORTC server were assessed by three independent and blinded reviewers through the EORTC radiotherapy quality assurance platform. Sixty-two (90%) of sixty-nine ICRs were received and assessable. Of the 62 cases, 22 were evaluated as per protocol (35.5%), 11 as acceptable variation (17.7%) and 29 were classified as unacceptable variations (46.8%). Most common unacceptable variations were related to the PTV dose (n = 19, 31%) and delineation (n = 17, 27%) processes. The ICR analysis showed a significant number of unacceptable variations with potential impact on tumor control and/or toxicity profile. Prospective ICRs are encouraged for future studies to prevent and correct protocol violations before start of treatment.