Evidence map›Paper›PMID 32070386›Full record

Trial reportRadiation oncology (London, England)2020

Radiotherapy quality assurance for mesorectum treatment planning within the multi-center phase II STAR-TReC trial: Dutch results.

Roy P J van den Ende, Femke P Peters, Ernst Harderwijk, Heidi Rütten, Liza Bouwmans, Maaike Berbee, Richard A M Canters, Georgiana Stoian, Kim Compagner, Tom Rozema and 10 more

Registry-linked trialAbstract readClinical Trial, Phase IIMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Radiation oncology (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02945566 (STAR-TREC), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02945566 phase2 / phase3active not recruitingnot on this map

STAR-TREC: Can we Save the Rectum by Watchful Waiting or TransAnal Surgery Following (Chemo)Radiotherapy Versus Total Mesorectal Excision for Early REctal Cancer?

TypeinterventionalSponsorUniversity of BirminghamRan2017 to 2028Enrolled380ConditionsAdenocarcinoma of the RectumArmsStandard TME surgery, Long course concurrent chemoradiation with capecitabine and radiotherapy, Short course radiotherapy
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Roy P J van den EndeDepartment of Radiation Oncology, Leiden University Medical Center, P.O. Box 9600 2300, RC, Leiden, the Netherlands. r.p.j.van_den_ende@lumc.nl.ORCID http://orcid.org/0000-0002-0233-4229
Femke P PetersDepartment of Radiation Oncology, Leiden University Medical Center, P.O. Box 9600 2300, RC, Leiden, the Netherlands.
Ernst HarderwijkDepartment of Radiation Oncology, Leiden University Medical Center, P.O. Box 9600 2300, RC, Leiden, the Netherlands.
Heidi RüttenDepartment of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands.
Liza BouwmansDepartment of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands.
Maaike BerbeeDepartment of Radiation Oncology, Maastricht University Medical Center, Maastricht, the Netherlands.
Richard A M CantersDepartment of Radiation Oncology, Maastricht University Medical Center, Maastricht, the Netherlands.
Georgiana StoianDepartment of Radiation Oncology, Isala Clinics, Zwolle, the Netherlands.
Kim CompagnerDepartment of Radiation Oncology, Isala Clinics, Zwolle, the Netherlands.
Tom RozemaDepartment of Radiation Oncology, Verbeeten Institute, Tilburg, the Netherlands.
Mariska de SmetDepartment of Radiation Oncology, Verbeeten Institute, Tilburg, the Netherlands.
Martijn P W IntvenDepartment of Radiotherapy, University Medical Center Utrecht, Utrecht, the Netherlands.
Rob H N TijssenDepartment of Radiotherapy, University Medical Center Utrecht, Utrecht, the Netherlands.
Jacqueline TheuwsDepartment of Radiation Oncology, Catharina Hospital, Eindhoven, the Netherlands.
Paul van HaarenDepartment of Radiation Oncology, Catharina Hospital, Eindhoven, the Netherlands.
Baukelien van TriestDepartment of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
Dave EekhoutDepartment of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
Corrie A M MarijnenDepartment of Radiation Oncology, Leiden University Medical Center, P.O. Box 9600 2300, RC, Leiden, the Netherlands.
Uulke A van der HeideDepartment of Radiation Oncology, Leiden University Medical Center, P.O. Box 9600 2300, RC, Leiden, the Netherlands.
Ellen M KerkhofDepartment of Radiation Oncology, Leiden University Medical Center, P.O. Box 9600 2300, RC, Leiden, the Netherlands.

Funding

KWF Kankerbestrijding UL2013-6311
6 · The paper itself

Abstract

backgroundThe STAR-TReC trial is an international multi-center, randomized, phase II study assessing the feasibility of short-course radiotherapy or long-course chemoradiotherapy as an alternative to total mesorectal excision surgery. A new target volume is used for both (chemo)radiotherapy arms which includes only the mesorectum. The treatment planning QA revealed substantial variation in dose to organs at risk (OAR) between centers. Therefore, the aim of this study was to determine the treatment plan variability in terms of dose to OAR and assess the effect of a national study group meeting on the quality and variability of treatment plans for mesorectum-only planning for rectal cancer.

methodsEight centers produced 25 × 2 Gy treatment plans for five cases. The OAR were the bowel cavity, bladder and femoral heads. A study group meeting for the participating centers was organized to discuss the planning results. At the meeting, the values of the treatment plan DVH parameters were distributed among centers so that results could be compared. Subsequently, the centers were invited to perform replanning if they considered this to be necessary.

resultsAll treatment plans, both initial planning and replanning, fulfilled the target constraints. Dose to OAR varied considerably for the initial planning, especially for dose levels below 20 Gy, indicating that there was room for trade-offs between the defined OAR. Five centers performed replanning for all cases. One center did not perform replanning at all and two centers performed replanning on two and three cases, respectively. On average, replanning reduced the bowel cavity V20Gy by 12.6%, bowel cavity V10Gy by 22.0%, bladder V35Gy by 14.7% and bladder V10Gy by 10.8%. In 26/30 replanned cases the V10Gy of both the bowel cavity and bladder was lower, indicating an overall lower dose to these OAR instead of a different trade-off. In addition, the bowel cavity V10Gy and V20Gy showed more similarity between centers.

conclusionsDose to OAR varied considerably between centers, especially for dose levels below 20 Gy. The study group meeting and the distribution of the initial planning results among centers resulted in lower dose to the defined OAR and reduced variability between centers after replanning.

trial registrationThe STAR-TReC trial, ClinicalTrials.gov Identifier: NCT02945566. Registered 26 October 2016, https://clinicaltrials.gov/ct2/show/NCT02945566).

Indexed as

HumansNetherlandsOrgans at RiskOrgan Sparing TreatmentsQuality Assurance, Health CareRadiotherapy DosageRadiotherapy, Intensity-ModulatedRadiotherapy Planning, Computer-AssistedRectal NeoplasmsRectumQuality assuranceRadiotherapyRectal neoplasmsTreatment planning

Identifiers

PMID32070386
PMCPMC7027245

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.