PMID- 36275452 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20221025 IS - 2405-6308 (Electronic) IS - 2405-6308 (Linking) VI - 37 DP - 2022 Nov TI - Lung SBRT credentialing in the Canadian OCOG-LUSTRE randomized trial. PG - 145-152 LID - 10.1016/j.ctro.2022.10.002 [doi] AB - PURPOSE: To report on the Stereotactic Body Radiation Therapy (SBRT) credentialing experience during the Phase III Ontario Clinical Oncology Group (OCOG) LUSTRE trial for stage I non-small cell lung cancer. METHODS: Three credentialing requirements were required in this process: (a) An institutional technical survey; (b) IROC (Imaging and Radiation Oncology Core) thoracic phantom end-to-end test; and (c) Contouring and completion of standardized test cases using SBRT for one central and one peripheral lung cancer, compared against the host institution as the standard. The main hypotheses were that unacceptable variation would exist particularly in OAR definition across all centres, and that institutions with limited experience in SBRT would be more likely to violate per-protocol guidelines. RESULTS: Fifteen Canadian centres participated of which 8 were new, and 7 were previously established (>/=2 years SBRT experience), and all successfully completed surveys and IROC phantom testing. Of 30 SBRT test plans, 10 required replanning due to major deviations, with no differences in violations between new and established centres (p = 0.61). Mean contouring errors were highest for brachial plexus in the central (C) case (12.55 +/- 6.62 mm), and vessels in the peripheral (P) case (13.01 +/- 12.55 mm), with the proximal bronchial tree (PBT) (2.82 +/- 0.78 C, 3.27 +/- 1.06 P) as another variable structure. Mean dice coefficients were lowest for plexus (0.37 +/- 0.2 C, 0.37 +/- 0.14 P), PBT (0.77 +/- 0.06 C, 0.75 +/- 0.09 P), vessels (0.69 +/- 0.29 C, 0.64 +/- 0.31 P), and esophagus (0.74 +/- 0.04 C, 0.76 +/- 0.04 P). All plans passed per-protocol planning target volume (PTV) coverage and maximum/volumetric organs-at-risk constraints, although variations existed in dose gradients within and outside the target. CONCLUSIONS: Clear differences exist in both contouring and planning with lung SBRT, regardless of centre experience. Such an exercise is important for studies that rely on high precision radiotherapy, and to ensure that implications on trial quality and outcomes are as optimal as possible. CI - (c) 2022 The Author(s). FAU - Swaminath, Anand AU - Swaminath A AD - Juravinski Cancer Centre, McMaster University, Department of Oncology, 699 Concession Street, Hamilton, ON L8V 5C2, Canada. FAU - Wierzbicki, Marcin AU - Wierzbicki M AD - Juravinski Cancer Centre, McMaster University, Department of Medical Physics, 699 Concession Street, Hamilton, ON L8V 5C2, Canada. FAU - Parpia, Sameer AU - Parpia S AD - Ontario Clinical Oncology Group, McMaster University, Department of Oncology, 699 Concession Street, Hamilton, ON L8V 5C2, Canada. FAU - Kundapur, Vijayananda AU - Kundapur V AD - Saskatchewan Cancer Agency, University of Saskatchewan, Department of Radiation Oncology, 20 Campus Drive, Saskatoon, SK S7N 4H4, Canada. FAU - Faria, Sergio AU - Faria S AD - Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec, Canada. FAU - Ahmed, Naseer AU - Ahmed N AD - Department of Radiology, Section of Radiation Oncology, Rady Faculty of Health Sciences, University of Manitoba and CancerCare Manitoba Research Institute, Winnipeg, Manitoba, Canada. FAU - Bujold, Alexis AU - Bujold A AD - Departement de Radio-oncologie Clinique-Enseignement-Recherche, Centre integre universitaire de soins et services sociaux de l'Est-de-l'Ile-de-Montreal - Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada. FAU - Hirmiz, Khalid AU - Hirmiz K AD - Department of Radiation Oncology, Windsor Regional Cancer Centre, Windsor, Ontario, Canada. FAU - Owen, Timothy AU - Owen T AD - Department of Oncology, Queen's University, Cancer Centre of Southeast Ontario at Kingston Health Sciences Centre, Kingston, Ontario, Canada. FAU - Leong, Nelson AU - Leong N AD - Allan Blair Cancer Centre, Department of Radiation Oncology, University of Saskatchewan, Regina, Saskatchewan, Canada. FAU - Ramchandar, Kevin AU - Ramchandar K AD - Department of Oncology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada. FAU - Filion, Edith AU - Filion E AD - Radiation Oncology Department, Centre Hospitalier de l'Universite de Montreal, Notre Dame Hospital, Montreal, Quebec, Canada. FAU - Lau, Harold AU - Lau H AD - Department of Oncology, University of Calgary, Calgary, Alberta, Canada. FAU - Thompson, Robert AU - Thompson R AD - Department of Radiation Oncology, Dalhousie University, Saint John, New Brunswick, Canada. FAU - Yaremko, Brian AU - Yaremko B AD - Department of Radiation Oncology, Western University, London, Ontario, Canada. FAU - Gabos, Zsolt AU - Gabos Z AD - Department of Oncology, University of Alberta, Edmonton, Alberta, Canada. FAU - Mehiri, Selma AU - Mehiri S AD - Departement de Radio-oncologie, CISSS Monteregie, Hopital Charles Lemoyne, Montreal, Quebec, Canada. FAU - Wright, James R AU - Wright JR AD - Juravinski Cancer Centre, McMaster University, Department of Oncology, 699 Concession Street, Hamilton, ON L8V 5C2, Canada. FAU - Tsakiridis, Theodoros K AU - Tsakiridis TK AD - Juravinski Cancer Centre, McMaster University, Department of Oncology, 699 Concession Street, Hamilton, ON L8V 5C2, Canada. FAU - Cline, Kathryn AU - Cline K AD - Ontario Clinical Oncology Group, McMaster University, Department of Oncology, 699 Concession Street, Hamilton, ON L8V 5C2, Canada. FAU - Whelan, Timothy J AU - Whelan TJ AD - Juravinski Cancer Centre, McMaster University, Department of Oncology, 699 Concession Street, Hamilton, ON L8V 5C2, Canada. LA - eng PT - Journal Article DEP - 20221013 PL - Ireland TA - Clin Transl Radiat Oncol JT - Clinical and translational radiation oncology JID - 101713416 PMC - PMC9579727 OTO - NOTNLM OT - Lung cancer OT - Quality assurance OT - Stereotactic Radiotherapy COIS- The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2022/10/25 06:00 MHDA- 2022/10/25 06:01 PMCR- 2022/10/13 CRDT- 2022/10/24 03:58 PHST- 2022/08/02 00:00 [received] PHST- 2022/10/08 00:00 [revised] PHST- 2022/10/08 00:00 [accepted] PHST- 2022/10/24 03:58 [entrez] PHST- 2022/10/25 06:00 [pubmed] PHST- 2022/10/25 06:01 [medline] PHST- 2022/10/13 00:00 [pmc-release] AID - S2405-6308(22)00086-6 [pii] AID - 10.1016/j.ctro.2022.10.002 [doi] PST - epublish SO - Clin Transl Radiat Oncol. 2022 Oct 13;37:145-152. doi: 10.1016/j.ctro.2022.10.002. eCollection 2022 Nov.