title: Current calibration, treatment, and treatment planning techniques among institutions participating in the Children's Oncology Group.
abstract: OBJECTIVE
  To report current technology implementation, radiation therapy physics and treatment planning practices, and results of treatment planning exercises among 261 institutions belonging to the Children's Oncology Group (COG).
  
  
  METHODS
  The Radiation Therapy Committee of the newly formed COG mandated that each institution demonstrate basic physics and treatment planning abilities by satisfactorily completing a questionnaire and four treatment planning exercises designed by the Quality Assurance Review Center. The planning cases are (1) a maxillary sinus target volume (for two-dimensional planning), (2) a Hodgkin's disease mantle field (for irregular-field and off-axis dose calculations), (3) a central axis blocked case, and (4) a craniospinal irradiation case. The questionnaire and treatment plans were submitted (as of 1/30/02) by 243 institutions and completed satisfactorily by 233. Data from this questionnaire and analyses of the treatment plans with monitor unit calculations are presented.
  
  
  RESULTS
  Of the 243 clinics responding, 54% use multileaf collimators routinely, 94% use asymmetric jaws routinely, and 13% use dynamic wedges. Nearly all institutions calibrate their linear accelerators following American Association of Physicists in Medicine protocols, currently 16% with TG-51 and 81% with TG-21 protocol. Treatment planning systems are relied on very heavily for all calculations, including monitor units. Techniques and results of each of the treatment planning exercises are presented.
  
  
  CONCLUSIONS
  Together, these data provide a unique compilation of current (2001) radiation therapy practices in institutions treating pediatric patients. Overall, the COG facilities have the equipment and the personnel to perform high-quality radiation therapy. With ongoing quality assurance review, radiation therapy compliance with COG protocols should be high.
authors.affiliation: Quality Assurance Review Center, Providence, RI 02908, USA. MUrie@QARC.org
authors.forename: Marcia
authors.initials: M
authors.lastname: Urie
authors.forename: T J
authors.initials: TJ
authors.lastname: FitzGerald
authors.forename: David
authors.initials: D
authors.lastname: Followill
authors.forename: Fran
authors.initials: F
authors.lastname: Laurie
authors.forename: Robert
authors.initials: R
authors.lastname: Marcus
authors.forename: Jeff
authors.initials: J
authors.lastname: Michalski
mesh_terms: D001921:Brain / Q000528:radiation effects; D002138:Calibration; D002648:Child; D006801:Humans; D009369:Neoplasms / Q000532:radiotherapy*; D010315:Particle Accelerators; D011878:Radiotherapy / Q000379:methods*; D011880:Radiotherapy Planning, Computer-Assisted; D013116:Spinal Cord / Q000528:radiation effects