title: [Database supported electronic retrospective analyses in radiation oncology: establishing a workflow using the example of pancreatic cancer].
abstract: OBJECTIVE
  Especially in the field of radiation oncology, handling a large variety of voluminous datasets from various information systems in different documentation styles efficiently is crucial for patient care and research. To date, conducting retrospective clinical analyses is rather difficult and time consuming. With the example of patients with pancreatic cancer treated with radio-chemotherapy, we performed a therapy evaluation by using an analysis system connected with a documentation system.
  
  
  METHODS
  A total number of 783 patients have been documented into a professional, database-based documentation system. Information about radiation therapy, diagnostic images and dose distributions have been imported into the web-based system.
  
  
  RESULTS
  For 36 patients with disease progression after neoadjuvant chemoradiation, we designed and established an analysis workflow. After an automatic registration of the radiation plans with the follow-up images, the recurrence volumes are segmented manually. Based on these volumes the DVH (dose volume histogram) statistic is calculated, followed by the determination of the dose applied to the region of recurrence. All results are saved in the database and included in statistical calculations.
  
  
  CONCLUSIONS
  The main goal of using an automatic analysis tool is to reduce time and effort conducting clinical analyses, especially with large patient groups. We showed a first approach and use of some existing tools, however manual interaction is still necessary. Further steps need to be taken to enhance automation. Already, it has become apparent that the benefits of digital data management and analysis lie in the central storage of data and reusability of the results. Therefore, we intend to adapt the analysis system to other types of tumors in radiation oncology.
authors.affiliation: Abteilung für Radioonkolgie und Strahlentherapie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland. Kerstin.Kessel@med.uni-heidelberg.de
authors.forename: K A
authors.initials: KA
authors.lastname: Kessel
authors.forename: D
authors.initials: D
authors.lastname: Habermehl
authors.forename: C
authors.initials: C
authors.lastname: Bohn
authors.forename: A
authors.initials: A
authors.lastname: Jäger
authors.forename: R O
authors.initials: RO
authors.lastname: Floca
authors.forename: L
authors.initials: L
authors.lastname: Zhang
authors.forename: N
authors.initials: N
authors.lastname: Bougatf
authors.forename: R
authors.initials: R
authors.lastname: Bendl
authors.forename: J
authors.initials: J
authors.lastname: Debus
authors.forename: S E
authors.initials: SE
authors.lastname: Combs
mesh_terms: D059248:Chemoradiotherapy; D003628:Database Management Systems / Q000458:organization & administration*; D016208:Databases, Factual; D003661:Decision Support Techniques; D018450:Disease Progression; D004282:Documentation / Q000379:methods*; D004307:Dose-Response Relationship, Radiation; D001330:Electronic Data Processing / Q000458:organization & administration; D005858:Germany; D006801:Humans; D008432:Mathematical Computing; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control / Q000532:radiotherapy; D009716:Numerical Analysis, Computer-Assisted; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D018787:Radiation Oncology / Q000458:organization & administration*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D012189:Retrospective Studies; D012984:Software; D016896:Treatment Outcome; D057188:Workflow