Quality assurance in the EORTC randomized trial 22922/10925 investigating the role of irradiation of the internal mammary and medial supraclavicular lymph node chain works.
OBJECTIVE
A quality assurance (QA) program in conjunction with the EORTC trial investigating the role of adjuvant internal mammary and medial supraclavicular irradiation in stage I-III breast cancer is presented. The results of a dummy run procedure and of an individual case review are compared to each other. The effects of recommendations based on QA procedures on the protocol compliance are evaluated.


METHODS
Prior to protocol activation all participating institutes were asked to produce treatment plans according to the guidelines of the protocol based on manual outlines of an average patient. Thereafter, they were asked to provide data on each of their first six randomized patients.


RESULTS
The dummy run provided a lot of information on specific treatment techniques. In the individual case review, additional patient- and tumor-related data were collected, showing the use of anatomic information for treatment planning. A comparison between both procedures revealed that the individual case reports concurred more accurately with protocol guidelines than the dummy run.


CONCLUSIONS
It was observed that the number of systematic protocol deviations was substantially decreased in trial patients compared to the dummy run case. Therefore, it is concluded that this extensive QA program had a positive effect on the consistency of all institutes participating in the trial.
Poortmans
Philip
P
Department of Radiotherapy, Dr. Bernard Verbeeten Instituut, Tilburg, The Netherlands. poortmans.ph@bvi.nl
Kouloulias
Vassilis
V
van Tienhoven
Geertjan
G
Collette
Laurence
L
Struikmans
Henk
H
Venselaar
Jack L M
JL
Van den Bogaert
Walter
W
Davis
J Bernard
JB
Lambin
Philippe
P
D001943:Breast Neoplasms / Q000401:mortality* / Q000532:radiotherapy*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D017410:Practice Guidelines as Topic; D011379:Prognosis; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000592:standards; D011880:Radiotherapy Planning, Computer-Assisted / Q000592:standards* / Q000706:statistics & numerical data*; D018714:Radiotherapy, Adjuvant / Q000592:standards* / Q000706:statistics & numerical data*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome