Quality assurance of radiotherapy in a clinical trial for lymphoma: individual case review.
BACKGROUND
A multi-institutional clinical trial was conducted for localized lymphoma. This study evaluated whether a quality assurance (QA) program could clarify the source of variation in radiotherapy treatment between the institutions.


METHODS
Two- or three-dimensional treatment planning is required to cover the target volumes adequately and to minimize doses to organs at risk. An original QA tool was used to compare pretreatment images with portal images and dose distribution, concurrently.


RESULTS
In two of the first 12 cases, there was a deviation in the delineation of planning target volume (PTV). The QA committee clarified that there were ambiguities in the definition of PTV The study office distributed a memorandum outlining the definition of PTV in order to reduce deviations. Thereafter, a minor deviation was identified in one of the latter 11 cases.


CONCLUSIONS
This QA program clarified the source of variation, and adapted the policy to reduce these problems.
Shikama
Naoto
N
Department of Radiology, Shinshu University School of Medicine, Matsumoto, Japan. shikama@hsp.md.shinshu-u.ac.jp
Oguchi
Masahiko
M
Isobe
Koichi
K
Nakamura
Katsumasa
K
Tamaki
Yoshio
Y
Hasegawa
Masatoshi
M
Kodaira
Takeshi
T
Sasaki
Shigeru
S
Kagami
Yoshikazu
Y
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000532:radiotherapy*; D011241:Prednisone / Q000008:administration & dosage; D011785:Quality Assurance, Health Care; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods* / Q000592:standards; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone