Evidence map›Paper›PMID 37598723›Full record

ArticleInternational journal of radiation oncology, biology, physics2024

Analysis of Radiation Therapy Quality Assurance in NRG Oncology RTOG 0848.

Leila T Tchelebi, Kathryn A Winter, Ross A Abrams, Howard P Safran, William F Regine, Susan McNulty, Abraham Wu, Kevin L Du, Samantha A Seaward, Shelly X Bian and 8 more

Abstract read
In one paragraph

Article in International journal of radiation oncology, biology, physics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Review
  4. Review
  5. 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

18 authors.

Leila T TchelebiNorthwell, New Hyde Park, New York; Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York. Electronic address: ltchelebi@northwell.edu.
Kathryn A WinterStatistics and Data Management Center, NRG Oncology, Philadelphia, Pennsylvania.
Ross A AbramsDepartment of Radiation Oncology, Rush University Medical Center, Chicago, Illinois.
Howard P SafranDepartment of Hematology & Oncology, Rhode Island Hospital, Providence, Rhode Island.
William F RegineDepartment of Radiation Oncology, University of Maryland/Greenebaum Cancer Center, Baltimore, Maryland.
Susan McNultyDepartment of Clinical Research, NRG Oncology/IROC, Philadelphia, Pennsylvania.
Abraham WuDepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Kevin L DuDepartment of Radiation Oncology, Yale School of Medicine, Smilow Cancer Hospital, New Haven, Connecticut.
Samantha A SeawardDepartment of Radiation Oncology, Kaiser Permanente NCI Community Oncology Research Program, Vallejo, California.
Shelly X BianDepartment of Radiation Oncology, USC / Norris Comprehensive Cancer Center, Los Angeles, California.
Raid AljumailyDepartment of Hematology & Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Anand ShivnaniDepartment of Radiation Oncology, The US Oncology Network, McKinney, Texas.
Jeanna L KnobleDepartment of Hematology & Oncology, Columbus NCI Community Oncology Research Program, Columbus, Ohio.
Todd S CrocenziDepartment of Hematology & Oncology, Providence Portland Medical Center, Portland, Oregon.
Thomas A DiPetrilloDepartment of Radiation Oncology, Rhode Island Hospital, Providence, RI.
Kevin S RoofDepartment of Radiation Oncology, Novant Health Presbyterian Center, Charlotte, North Carolina.
Christopher H CraneDepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY.
Karyn A GoodmanDepartment of Radiation Oncology, Mount Sinai Hospital, New York, New York. Electronic address: karyn.goodman@mountsinai.org.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
NRG Oncology Network Group Operations Center - GY9 BIQSFP Reports/BudgetsU10CA180868 · NCI · NRG ONCOLOGY FOUNDATION, INC. · PI NORMAN WOLMARK · 2014 to 2026
$206.8M
Statistics CoreU10CA180822 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Mei-Yin C Polley · 2014 to 2026
$146.4M
NRG Oncology NCORP Research Base-BIQSFPUG1CA189867 · NCI · NRG ONCOLOGY FOUNDATION, INC. · PI Deborah Watkins Bruner, Lisa A. Kachnic · 2014 to 2026
$140.5M
IROC: Enhancing local enrolling site radiological data capture capabilities for NCTN trialsU24CA180803 · NCI · AMERICAN COLLEGE OF RADIOLOGY · PI Thomas J. FitzGerald, MICHAEL V KNOPP · 2014 to 2026
$116.2M
Network Lead Academic Participating Site: Memorial Sloan Kettering Cancer CenterUG1CA233290 · NCI · SLOAN-KETTERING INST CAN RESEARCH · PI CAROL AGHAJANIAN, Darren Feldman · 2019 to 2026
$10.2M
NCI NIH HHS P30 CA008748NCI NIH HHS U10 CA180822NCI NIH HHS U10 CA180868NCI NIH HHS U24 CA180803NCI NIH HHS UG1 CA189867NCI NIH HHS UG1 CA233290
6 · The paper itself

Abstract

purposeNRG/Radiation Therapy Oncology Group 0848 is a 2-step randomized trial to evaluate the benefit of the addition of concurrent fluoropyrimidine and radiation therapy (RT) after adjuvant chemotherapy (second step) for patients with resected pancreatic head adenocarcinoma. Real-time quality assurance (QA) was performed on each patient who underwent RT. This analysis aims to evaluate adherence to protocol-specified contouring and treatment planning and to report the types and frequencies of deviations requiring revisions. METHODS AND MATERIALS: In addition to a web-based contouring atlas, the protocol outlined step-by-step instructions for generating the clinical treatment volume through the creation of specific regions of interest. The planning target volume was a uniform 0.5 cm clinical treatment volume expansion. One of 2 radiation oncology study chairs independently reviewed each plan. Plans with unacceptable deviations were returned for revision and resubmitted until approved. Treatment started after final approval of the RT plan.

resultsFrom 2014 to 2018, 354 patients were enrolled in the second randomization. Of these, 160 patients received RT and were included in the QA analysis. Resubmissions were more common for patients planned with 3-dimensional conformal RT (43%) than with intensity modulated RT (31%). In total, at least 1 resubmission of the treatment plan was required for 33% of patients. Among patients requiring resubmission, most only needed 1 resubmission (87%). The most common reasons for resubmission were unacceptable deviations with respect to the preoperative gross target volume (60.7%) and the pancreaticojejunostomy (47.5%).

conclusionOne-third of patients required resubmission to meet protocol compliance criteria, demonstrating the continued need for expending resources on real-time, pretreatment QA in trials evaluating the use of RT, particularly for pancreas cancer. Rigorous QA is critically important for clinical trials involving RT to ensure that the true effect of RT is assessed. Moreover, RT QA serves as an educational process through providing feedback from specialists to practicing radiation oncologists on best practices.

Indexed as

Radiation OncologyRadiotherapy, ConformalRadiotherapy, Intensity-ModulatedHumansPancreatic NeoplasmsRadiotherapy DosageRadiotherapy Planning, Computer-Assisted

Identifiers

PMID37598723
PMCPMC10843017

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Registered trials

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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.