PMID- 37037758
OWN - NLM
STAT- MEDLINE
DCOM- 20230703
LR  - 20230703
IS  - 1879-8519 (Electronic)
IS  - 1879-8500 (Linking)
VI  - 13
IP  - 4
DP  - 2023 Jul-Aug
TI  - Toward Systematic Assessment and Improvement of Radiation Therapy Plan Quality of 
      Cooperative Group Trial Submissions: A Report From the Children's Oncology Group.
PG  - e374-e382
LID - S1879-8500(23)00054-1 [pii]
LID - 10.1016/j.prro.2023.02.008 [doi]
AB  - PURPOSE: This study evaluates the quality of plans used for the treatment of 
      patients in the Children's Oncology Group study ACNS1123. Plan quality is 
      quantified based on a scoring system specific to the protocol. In this way, the 
      distribution of plan quality scores is determined that can be used to identify 
      plan quality issues for this study and for future plan quality improvement. 
      METHODS AND MATERIALS: ACNS1123 stratum 1 patients (70) were evaluated. This 
      included 50 photon and 20 proton plans. Digital Imaging and Communications in 
      Medicine (DICOM) structure and dose data were obtained from the Children's 
      Oncology Group. A commercially available plan quality scoring algorithm was used 
      to create a scoring system we designed using the protocol dosimetric 
      requirements. The whole ventricle and boost planning target volumes (PTVs) could 
      earn a maximum of 70 points, whereas the organs at risk could earn 30 points 
      (total maximum score of 100 points). The scoring algorithm adjusted scores based 
      on the difficulty in achieving the structure dose requirements, which depended on 
      the proximity of the PTVs and the dose gradients achieved relative to the organs 
      at risk. The distribution of plan scores was used to determine the mean, median, 
      and range of scores. RESULTS: The median adjusted plan quality scores for the 20 
      proton and 50 photon plans were 83.3 and 86.9, respectively. The range of 
      adjusted scores (maximum to minimum) was 50 points. The average score adjustment 
      was 7.4 points. Photon and proton plans performed almost equally. Average plan 
      quality by individual structure revealed that the brain stem, PTV boost, and 
      cochlea lost the most points. CONCLUSIONS: This report is the first to 
      systematically analyze overall radiation therapy plan quality scores for an 
      entire cohort of patients treated in a cooperative group clinical trial. The 
      methodology demonstrated a large variation in plan quality in this trial. Future 
      clinical trials could potentially use this method to reduce plan quality 
      variability, which may improve outcomes.
CI  - Copyright (c) 2023 American Society for Radiation Oncology. Published by Elsevier 
      Inc. All rights reserved.
FAU - Olch, Arthur J
AU  - Olch AJ
AD  - Department of Radiation Oncology, University of Southern California and 
      Children's Hospital Los Angeles, Los Angeles, California. Electronic address: 
      aolch@chla.usc.edu.
FAU - Gopalakrishnan, Mahesh
AU  - Gopalakrishnan M
AD  - Department of Radiation Oncology, Northwestern Memorial Hospital, Chicago, 
      Illinois.
FAU - Murphy, Erin S
AU  - Murphy ES
AD  - Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio.
FAU - MacDonald, Shannon M
AU  - MacDonald SM
AD  - Department of Radiation Oncology, Massachusetts General Hospital, Boston, 
      Massachusetts.
FAU - Hua, Chia-Ho
AU  - Hua CH
AD  - Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, 
      Tennessee.
LA  - eng
PT  - Journal Article
DEP - 20230409
PL  - United States
TA  - Pract Radiat Oncol
JT  - Practical radiation oncology
JID - 101558279
RN  - 0 (Protons)
SB  - IM
MH  - Humans
MH  - Child
MH  - Radiotherapy Dosage
MH  - *Radiotherapy, Intensity-Modulated/methods
MH  - Radiotherapy Planning, Computer-Assisted/methods
MH  - Protons
MH  - *Proton Therapy/methods
MH  - Organs at Risk
EDAT- 2023/04/11 06:00
MHDA- 2023/07/03 06:42
CRDT- 2023/04/10 22:00
PHST- 2022/12/06 00:00 [received]
PHST- 2023/01/30 00:00 [revised]
PHST- 2023/02/02 00:00 [accepted]
PHST- 2023/07/03 06:42 [medline]
PHST- 2023/04/11 06:00 [pubmed]
PHST- 2023/04/10 22:00 [entrez]
AID - S1879-8500(23)00054-1 [pii]
AID - 10.1016/j.prro.2023.02.008 [doi]
PST - ppublish
SO  - Pract Radiat Oncol. 2023 Jul-Aug;13(4):e374-e382. doi: 
      10.1016/j.prro.2023.02.008. Epub 2023 Apr 9.