title: Quality assurance for the EORTC 22071-26071 study: dummy run prospective analysis.
abstract: OBJECTIVE
  The phase III 22071-26071 trial was designed to evaluate the addition of panitumumab to adjuvant chemotherapy plus intensity modulated radiotherapy (IMRT) in locally advanced resected squamous cell head and neck cancer. We report the results of the dummy run (DR) performed to detect deviations from protocol guidelines.
  
  
  METHODS
  DR datasets consisting of target volumes, organs at risk (OAR) and treatment plans were digitally uploaded, then compared with reference contours and protocol guidelines by six central reviewers. Summary statistics and analyses of potential correlations between delineations and plan characteristics were performed.
  
  
  RESULTS
  Of 23 datasets, 20 (87.0%) GTVs were evaluated as acceptable/borderline, along with 13 (56.5%) CTVs and 10 (43.5%) PTVs. All PTV dose requirements were met by 73.9% of cases. Dose constraints were met for 65.2-100% of mandatory OARs. Statistically significant correlations were observed between the subjective acceptability of contours and the ability to meet dose constraints for all OARs (p ≤ 0.01) except for the parotids and spinal cord. Ipsilateral parotid doses correlated significantly with CTV and PTV volumes (p ≤ 0.05).
  
  
  CONCLUSIONS
  The observed wide variations in treatment planning, despite strict guidelines, confirms the complexity of development and quality assurance of IMRT-based multicentre studies for head and neck cancer.
authors.affiliation: Department of Radiation Oncology, Cross Cancer Institute, 11560 University Avenue, T6G 1Z2, Edmonton, AB, Canada. alysa@ualberta.ca.
authors.forename: Alysa
authors.initials: A
authors.lastname: Fairchild
authors.affiliation: Department of Radiation Oncology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands. j.a.langendijk@umcg.nl.
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Langendijk
authors.affiliation: Department of Radiation Oncology, University Hospital Leuven, KU Leuven, Leuven, Belgium. Sandra.nuyts@uzleuven.be.
authors.forename: Sandra
authors.initials: S
authors.lastname: Nuyts
authors.affiliation: Department of Radiation Oncology, Ipswich Hospital, Ipswich, UK. Christopher.scrase@ipswichhospital.nhs.uk.
authors.forename: Christopher
authors.initials: C
authors.lastname: Scrase
authors.affiliation: Department of Radiotherapy, CHU Charleroi, Charleroi, Belgium. tomsej@chu-charleroi.be.|EORTC Quality Assurance in Radiotherapy Team, Brussels, Belgium. tomsej@chu-charleroi.be.
authors.forename: Milan
authors.initials: M
authors.lastname: Tomsej
authors.affiliation: Department of Radiotherapy, Catharina Hospital, Eindhoven, The Netherlands. danny.schuring@catharinaziekenhuis.nl.
authors.forename: Danny
authors.initials: D
authors.lastname: Schuring
authors.affiliation: Department of Radiation Oncology, University Hospital of Liege, Liege, Belgium. akos.gulyban@gmail.com.
authors.forename: Akos
authors.initials: A
authors.lastname: Gulyban
authors.affiliation: Department of Experimental Oncology, Cross Cancer Institute, Edmonton, Canada. sunitaghosh@albertahealthservices.ca.
authors.forename: Sunita
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: EORTC Quality Assurance in Radiotherapy Team, Brussels, Belgium. damien.weber@psi.ch.|Centre for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland. damien.weber@psi.ch.
authors.forename: Damien C
authors.initials: DC
authors.lastname: Weber
authors.affiliation: Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany. wilfried.budach@med.uni-duesseldorf.de.
authors.forename: Wilfried
authors.initials: W
authors.lastname: Budach
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods; D019983:Guideline Adherence; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D058958:Organs at Risk; D000077544:Panitumumab; D017410:Practice Guidelines as Topic / Q000592:standards*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000592:standards*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D000077195:Squamous Cell Carcinoma of Head and Neck
chemical_list: D000911:Antibodies, Monoclonal; D000077544:Panitumumab