PMID- 37179034 OWN - NLM STAT- MEDLINE DCOM- 20230925 LR - 20230927 IS - 1879-355X (Electronic) IS - 0360-3016 (Linking) VI - 117 IP - 3 DP - 2023 Nov 1 TI - A Quality Control Study on Involved Node Radiation Therapy in the European Organisation for Research and Treatment of Cancer/Lymphoma Study Association/Fondazione Italiana Linfomi H10 Trial on Stages I and II Hodgkin Lymphoma: Lessons Learned. PG - 664-674 LID - S0360-3016(23)00455-8 [pii] LID - 10.1016/j.ijrobp.2023.05.011 [doi] AB - PURPOSE: Involved node radiation therapy (INRT) was introduced in the European Organisation for Research and Treatment of Cancer/Lymphoma Study Association/Fondazione Italiana Linfomi H10 trial, a large multicenter trial in early-stage Hodgkin Lymphoma. The present study aimed to evaluate the quality of INRT in this trial. METHODS AND MATERIALS: A retrospective, descriptive study was initiated to evaluate INRT in a representative sample encompassing approximately 10% of all irradiated patients in the H10 trial. Sampling was stratified by academic group, year of treatment, size of the treatment center, and treatment arm, and it was done proportional to the size of the strata. The sample was completed for all patients with known recurrences to enable future research on relapse patterns. Radiation therapy principle, target volume delineation and coverage, and applied technique and dose were evaluated using the EORTC Radiation Therapy Quality Assurance platform. Each case was reviewed by 2 reviewers and, in case of disagreement also by an adjudicator for a consensus evaluation. RESULTS: Data were retrieved for 66 of 1294 irradiated patients (5.1%). Data collection and analysis were hampered more than anticipated by changes in archiving of diagnostic imaging and treatment planning systems during the running period of the trial. A review could be performed on 61 patients. The INRT principle was applied in 86.6%. Overall, 88.5% of cases were treated according to protocol. Unacceptable variations were predominately due to geographic misses of the target volume delineations. The rate of unacceptable variations decreased during trial recruitment. CONCLUSIONS: The principle of INRT was applied in most of the reviewed patients. Almost 90% of the evaluated patients were treated according to the protocol. The present results should, however, be interpreted with caution because the number of patients evaluated was limited. Individual case reviews should be done in a prospective fashion in future trials. Radiation therapy Quality Assurance tailored to the clinical trial objectives is strongly recommended. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Aleman, Berthe M P AU - Aleman BMP AD - Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, Netherlands. Electronic address: b.aleman@nki.nl. FAU - Ricardi, Umberto AU - Ricardi U AD - Department of Oncology, University of Turin, Turin, Italy. FAU - van der Maazen, Richard W M AU - van der Maazen RWM AD - Department of Radiotherapy, Radboud University Medical Centre, Nijmegen, Netherlands. FAU - Meijnders, Paul AU - Meijnders P AD - Department of Radiotherapy, Iridium Network, Centre for Oncological Research of the University of Antwerp, Antwerp, Belgium. FAU - Beijert, Max AU - Beijert M AD - Department of Radiotherapy, University Medical Center Groningen, Groningen, Netherlands. FAU - Boros, Angela AU - Boros A AD - Radiation Oncology Department, Center Hospitalier Lyon Sud, Pierre Benite, France. FAU - Izar, Francoise AU - Izar F AD - Department of Radiotherapy, Institut universitaire du cancer de Toulouse, Toulouse, France. FAU - Janus, Cecile P M AU - Janus CPM AD - Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, Netherlands. FAU - Levis, Mario AU - Levis M AD - Department of Oncology, University of Turin, Turin, Italy. FAU - Martin, Valentine AU - Martin V AD - Department of Radiotherapy, Institut Gustave Roussy, Villejuif, France. FAU - Specht, Lena AU - Specht L AD - Department of Oncology, Rigshospitalet, University of Copenhagen, Denmark. FAU - Corning, Coreen AU - Corning C AD - The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium. FAU - Clementel, Enrico AU - Clementel E AD - The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium. FAU - Raemaekers, John M AU - Raemaekers JM AD - Department of Internal Medicine, Rijnstate Hospital, Arnhem, Netherlands. FAU - Andre, Marc P AU - Andre MP AD - Department of Hematology, CHU UCL Namur, Yvoir, Belgium. FAU - Federico, Massimo AU - Federico M AD - CHIMOMO Department, University of Modena and Reggio Emilia, Modena, Italy. FAU - Fortpied, Catherine AU - Fortpied C AD - The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium. FAU - Girinsky, Theodore AU - Girinsky T AD - Department of Radiotherapy, Institut Gustave Roussy, Villejuif, France. LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20230512 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 - *Hodgkin Disease/drug therapy/radiotherapy/pathology MH - Retrospective Studies MH - Neoplasm Recurrence, Local/drug therapy MH - Radiotherapy Planning, Computer-Assisted/methods MH - Antineoplastic Combined Chemotherapy Protocols/therapeutic use EDAT- 2023/05/14 01:07 MHDA- 2023/09/25 06:42 CRDT- 2023/05/13 19:30 PHST- 2023/01/04 00:00 [received] PHST- 2023/04/29 00:00 [revised] PHST- 2023/05/05 00:00 [accepted] PHST- 2023/09/25 06:42 [medline] PHST- 2023/05/14 01:07 [pubmed] PHST- 2023/05/13 19:30 [entrez] AID - S0360-3016(23)00455-8 [pii] AID - 10.1016/j.ijrobp.2023.05.011 [doi] PST - ppublish SO - Int J Radiat Oncol Biol Phys. 2023 Nov 1;117(3):664-674. doi: 10.1016/j.ijrobp.2023.05.011. Epub 2023 May 12.