Dummy Run of Quality Assurance Program before Prospective Study of Hippocampus-Sparing Whole-Brain Radiotherapy and Simultaneous Integrated Boost for Multiple Brain Metastases from Non-small Cell Lung Cancer: Korean Radiation Oncology Group (KROG) 17-06 Study

• Published in: Cancer research and treatment Vol. 51; no. 3; pp. 1001 - 1010
• Main Authors: Chung, Eunah, Noh, Jae Myoung, Lee, Kyu Chan, Kim, Jin Hee, Chung, Weon Kuu, Suh, Yang-Gun, Lee, Jung Ae, Seol, Ki Ho, Wu, Hong Gyun, Kim, Yeon Sil, Noh, O Kyu, Park, Jae Won, Lee, Dong Soo, Lee, Jihae, Kim, Young Suk, Park, Woo-Yoon, Kang, Min Kyu, Jo, Sunmi, Ahn, Yong Chan
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Cancer Association 01.07.2019; 대한암학회
• Subjects: Brain Neoplasms - radiotherapy; Brain Neoplasms - secondary; Carcinoma, Non-Small-Cell Lung - radiotherapy; Computer Simulation; Cranial Irradiation - methods; Hippocampus; Humans; Lung Neoplasms - radiotherapy; Organ Sparing Treatments - methods; Original; Prospective Studies; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted; Radiotherapy, Intensity-Modulated; 의약학; Dummy run; QA program; Hippocampus-sparing whole brain radiotherapy; Multi-institutional study; Non-small cell lung cancer
• ISSN: 1598-2998; 2005-9256; 2005-9256
• DOI: 10.4143/crt.2018.415

Lung Cancer Subcommittee of Korean Radiation Oncology Group (KROG) has recently launched a prospective clinical trial (KROG 17-06) of hippocampus-sparing whole brain radiotherapy (HS-WBRT) with simultaneous integrated boost (SIB) in treating multiple brain metastases from non-small cell lung cancer. In order to improve trial quality, dummy run studies among the participating institutions were designed. This work reported the results of two-step dummy run procedures of the KROG 17-06 study. Two steps tested hippocampus contouring variability and radiation therapy planning compliance. In the first step, the variation of the hippocampus delineation was investigated for two representative cases using the Dice similarity coefficients. In the second step, the participating institutions were requested to generate a HS-WBRT with SIB treatment plan for another representative case. The compliance of the treatment plans to the planning protocol was evaluated. In the first step, the median Dice similarity coefficients of the hippocampus contours for two other dummy run cases changed from 0.669 (range, 0.073 to 0.712) to 0.690 (range, 0.522 to 0.750) and from 0.291 (range, 0.219 to 0.522) to 0.412 (range, 0.264 to 0.598) after providing the hippocampus contouring feedback. In the second step, with providing additional plan priority and extended dose constraints to the target volumes and normal structures, we observed the improved compliance of the treatment plans to the planning protocol. The dummy run studies demonstrated the notable inter-institutional variability in delineating the hippocampus and treatment plan generation, which could be decreased through feedback from the trial center.