PMID- 10571215
OWN - NLM
STAT- MEDLINE
DCOM- 19991130
LR  - 20190708
IS  - 0360-3016 (Print)
IS  - 0360-3016 (Linking)
VI  - 45
IP  - 4
DP  - 1999 Nov 1
TI  - Comparison of prostate cancer treatment in two institutions: a quality control 
      study.
PG  - 1055-62
AB  - PURPOSE: To minimize differences in the treatment planning procedure between two 
      institutions within the context of a radiotherapy prostate cancer trial. PATIENTS 
      AND METHODS: Twenty-two patients with N0 M0 prostate cancer underwent a computed 
      tomography (CT) scan for radiotherapy treatment planning. For all patients, the 
      tumor and organs at risk were delineated, and a treatment plan was generated for 
      a three-field technique giving a dose of 78 Gy to the target volume. Ten of the 
      22 cases were delineated and planned in the other institution as well. The 
      delineated volumes and dose distributions were compared. RESULTS: All treatments 
      fulfilled the trial criteria. The mean volume ratio of the gross tumor volumes 
      (GTVs) in both institutions was 1.01, while the mean volume ratio of the planning 
      target volumes (PTVs) was 0.88. The three-dimensional (3D) PTV difference was 3 
      mm at the prostate apex and 6-8 mm at the seminal vesicles. This PTV difference 
      was mainly caused by a difference in the method of 3D expansion, and disappeared 
      when applying an improved algorithm in one institution. The treated volume (dose 
      > or =95% of isocenter dose) reflects the size of the PTV and the conformity of 
      the treatment technique. This volume was on average 66 cm3 smaller in institution 
      A than in institution B; the effect of the PTV difference was 31 cm3 and the 
      difference in technique accounted for 36 cm3. The mean delineated rectal volume 
      including filling was 112 cm3 and 125 cm3 for institution A and B, respectively. 
      This difference had a significant impact on the relative dose volume histogram 
      (DVH) of the rectum. CONCLUSION: Differences in GTV delineation were small and 
      comparable to earlier quantified differences between observers in one 
      institution. Different expansion methods for generation of the PTV significantly 
      influenced the amount of irradiated tissue. Strict definitions of target and 
      normal structures are mandatory for reliable trial results.
FAU - Rasch, C
AU  - Rasch C
AD  - Department of Radiotherapy, The Netherlands Cancer Institute/Antoni van 
      Leeuwenhoek Huis, Amsterdam. CRASCH@NKI.NL
FAU - Remeijer, P
AU  - Remeijer P
FAU - Koper, P C
AU  - Koper PC
FAU - Meijer, G J
AU  - Meijer GJ
FAU - Stroom, J C
AU  - Stroom JC
FAU - van Herk, M
AU  - van Herk M
FAU - Lebesque, J V
AU  - Lebesque JV
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - Humans
MH  - Male
MH  - Observer Variation
MH  - Prostatic Neoplasms/pathology/*radiotherapy
MH  - Quality Control
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/*standards
MH  - Rectum/anatomy & histology
MH  - Urinary Bladder/anatomy & histology
EDAT- 1999/11/26 00:00
MHDA- 1999/11/26 00:01
CRDT- 1999/11/26 00:00
PHST- 1999/11/26 00:00 [pubmed]
PHST- 1999/11/26 00:01 [medline]
PHST- 1999/11/26 00:00 [entrez]
AID - S0360-3016(99)00280-1 [pii]
AID - 10.1016/s0360-3016(99)00280-1 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 1999 Nov 1;45(4):1055-62. doi: 
      10.1016/s0360-3016(99)00280-1.