title: Quality control of involved field radiotherapy in patients with early-favorable (HD10) and early-unfavorable (HD11) Hodgkin's lymphoma: an analysis of the German Hodgkin Study Group.
abstract: OBJECTIVE
  The German Hodgkin Study Group (GHSG) set up a radiotherapy (RT) reference center within the Department of Radiation Oncology at the University of Cologne to undertake quality assurance of the group's clinical studies. In the HD10 trial (early-favorable stages) and HD11 trial (early-unfavorable stages) all patients received involved field (IF)-RT (30 Gy vs. 20 Gy) within a combined-modality approach. For these patients a central prospective review of all diagnostic imaging was performed by expert radiation oncologists to control disease extension and to define IF treatment volume.
  
  
  METHODS
  On the basis of simulation films, verification films, and radiotherapy case report form (CRF) an expert panel evaluated retrospectively the adequacy of irradiated IF treatment portals according to the RT prescription, applied radiation doses, treatment time, and technical parameters.
  
  
  RESULTS
  Between 1999 and 2006 a total of 825 of 1370 randomized patients of the HD10 trial (60%) and 954 of 1422 patients of the HD11 trial (67%) were evaluated by the panel. Radiotherapy was rated as suboptimal in 47% of all reviewed cases. Although the participating RT centers received a precise RT prescription, most difficulties occurred in the adequate coverage of the IF (40%), followed by technical faults (12%). Deviations from the prescribed single daily dose (1.8-2 Gy), weekly dose, and total reference dose were rare (1%).
  
  
  CONCLUSIONS
  As a consequence of these findings, radiation oncologists were trained on the definition of IF-RT at GHSG meetings and at the annual meetings of the German Society for Therapeutic Radiation Oncology. Possible correlations between RT quality and relapse rate will be investigated.
authors.affiliation: Department of Radiation Oncology, University of Cologne, Cologne, Germany. Hans-Theodor.Eich@medizin.uni-Koeln.de
authors.forename: Hans Theodor
authors.initials: HT
authors.lastname: Eich
authors.forename: Rita
authors.initials: R
authors.lastname: Engenhart-Cabillic
authors.forename: Katja
authors.initials: K
authors.lastname: Hansemann
authors.forename: Peter
authors.initials: P
authors.lastname: Lukas
authors.forename: Angelika
authors.initials: A
authors.lastname: Schneeweiss
authors.forename: Heinrich
authors.initials: H
authors.lastname: Seegenschmiedt
authors.forename: Roman
authors.initials: R
authors.lastname: Skripnitchenko
authors.forename: Susanne
authors.initials: S
authors.lastname: Staar
authors.forename: Normann
authors.initials: N
authors.lastname: Willich
authors.forename: Rolf-Peter
authors.initials: RP
authors.lastname: Müller
mesh_terms: D005858:Germany; D006689:Hodgkin Disease / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D015397:Program Evaluation; D011786:Quality Control; D018787:Radiation Oncology / Q000592:standards; D011879:Radiotherapy Dosage / Q000592:standards; D012189:Retrospective Studies