The atlas of complication incidence: a proposal for a new standard for reporting the results of radiotherapy protocols.
We present a new method of reporting the results of radiotherapy protocols. The dose-volume atlas of complication incidence is a comprehensive and unbiased summary of the dose-volume exposures and complications occurring in patients after treatment. This new tool provides clear and systematic information about the safety of regions of dose-volume exposure previously treated that can be used when considering new treatments. Actuarial and model-dependent versions of the atlas are described. By using the raw data in the appropriate forms of the atlas, logistic regression, Kaplan-Meier, and Cox proportional hazards analysis can be performed, allowing for the independent calculation of dose-volume response. The data required are simple enough that provided compatible definitions of dose, volume, and complications are used, atlases from different protocols are potentially additive, facilitating the meta-analysis of inter-interinstitutional data. If this method were adopted as a standard for reporting the outcome of treatment protocols, a potentially synergistic increase in the utility of each protocol could result.
Jackson
Andrew
A
Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10021, USA. jacksona@mskcc.org
Yorke
Ellen D
ED
Rosenzweig
Kenneth E
KE
D002985:Clinical Protocols; D004064:Digestive System / Q000528:radiation effects; D006801:Humans; D015994:Incidence; D009369:Neoplasms / Q000150:complications / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D014566:Urogenital System / Q000528:radiation effects