Abstract
BackgroundThe purpose of this study was to analyze the radiotherapy (RT) quality assurance (QA) assessment in Japan Clinical Oncology Group (JCOG) 0202, which was the first trial that required on-going RT QA review in the JCOG.MethodsJCOG 0202 was a multi-center phase III trial comparing two types of consolidation chemotherapy after concurrent chemoradiotherapy for limited-disease small cell lung cancer. RT requirements included a total dose of 45 Gy/30 fx (bis in die, BID/twice a day) without heterogeneity correction; elective nodal irradiation (ENI) of 30 Gy; at least 1 cm margin around the clinical target volume (CTV); and interfraction interval of 6 hours or longer. Dose constraints were defined in regards to the spinal cord and the lung. The QA assessment was classed as per protocol (PP), deviation acceptable (DA), violation unacceptable (VU), and incomplete/not evaluable (I/NE).ResultsA total of 283 cases were accrued, of which 204 were fully evaluable, excluding 79 I/NE cases. There were 18 VU in gross tumor volume (GTV) coverage (8% of 238 evaluated); 4 VU and 23 DA in elective nodal irradiation (ENI) (2% and 9% of 243 evaluated, respectively). Some VU were observed in organs at risk (1 VU in the lung and 5 VU in the spinal cord). Overall RT compliance (PP + DA) was 92% (187 of 204 fully evaluable). Comparison between the former and latter halves of the accrued cases revealed that the number of VU and DA had decreased.ConclusionThe results of the RT QA assessment in JCOG 0202 seemed to be acceptable, providing reliable results.
Highlights
Quality assurance (QA) and quality control are an integral part of multi-center clinical trials involving radiotherapy (RT)
In 1999, Japan Clinical Oncology Group (JCOG) trial 9812 was started to evaluate whether RT with carboplatin would result in longer survival than RT alone in elderly patients with unresectable stage III non-small cell lung cancer; due to excessive serious adverse events, the trial was terminated early when 46 patients were registered
With regard to elective nodal irradiation (ENI), 4 violation unacceptable (VU) and 23 deviation acceptable (DA) (2% and 9% of 243 evaluated, respectively) were observed. Of these 4 VU, a total dose of 45 Gy instead of 30 Gy was given in 3, and the contralateral hilum was irradiated in one case
Summary
Quality assurance (QA) and quality control are an integral part of multi-center clinical trials involving radiotherapy (RT). Several reports have shown that failure to adhere to the treatment protocol deteriorated the outcome in clinical trials [1,2,3,4,5]. To provide reliable results in clinical trials, it is important to keep each treatment as uniform as possible. In 1999, Japan Clinical Oncology Group (JCOG) trial 9812 was started to evaluate whether RT with carboplatin would result in longer survival than RT alone in elderly patients with unresectable stage III non-small cell lung cancer; due to excessive serious adverse events, the trial was terminated early when 46 patients were registered. The purpose of this study was to analyze the radiotherapy (RT) quality assurance (QA) assessment in Japan Clinical Oncology Group (JCOG) 0202, which was the first trial that required on-going RT QA review in the JCOG
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
