ESTRO 2024 - Abstract Book

S4777

Physics - Quality assurance and auditing

ESTRO 2024

Clinical Cancer Medicine, Liverpool, United Kingdom. 6 Cardiff University, Division of Cancer and Genetics, School of Medicine, Cardiff, United Kingdom

Purpose/Objective:

A comprehensive radiotherapy quality assurance (RT QA) program is in place for head and neck (H&N) trials and includes reviews of outlining and planning for pre-accrual benchmarking and on-trial individual case reviews. This study aims to assess protocol compliance for outlining and planning benchmark cases, as well as individual case reviews, in order to evaluate QA streamlining strategies for potential reduction in QA workload in future H&N trials. For this purpose, data from the PATHOS trial (a phase III international, multi-centre trial of risk-stratified, reduced intensity adjuvant treatment in patients undergoing transoral surgery for Human Papillomavirus-positive oropharyngeal cancer) has been interrogated.

Material/Methods:

QA processes for the PATHOS trial were streamlined based on centre and Principal Investigator’s (PI) participation in similar H&N trials to minimise repetition and reduce trial-specific QA workload. Where streamlining was not possible, benchmark cases (for both unilateral and bilateral disease) were submitted for central review, as part of the pre-trial QA program. All participants had to undergo on-trial prospective review of their first unilateral and bilateral disease patients recruited. Compliance was reported as per Global Harmonization Group guidelines (https://rtqaharmonization.org/), with any unacceptable variations from protocol requiring resubmission before approval. Contouring was reviewed by experienced trial management group radiation oncologists and planning by a member of the RT QA team to monitor protocol compliance. Outlining and planning QA reports were reviewed and rates of acceptable/unacceptable variations from protocol recorded for both benchmarking and individual case reviews. Impact of streamlining on individual case review results was investigated.

Results:

76 clinicians from 60 centres completed the outlining benchmark cases for PATHOS, with a total of 121 cases submitted. 15 cases from 10 clinicians were streamlined through previous trial participation. 31 centres completed either one or both planning benchmark cases for PATHOS, with a total of 52 cases submitted. 60 plans from 35 centres were streamlined. A summary of the benchmark review variability assessment can be seen in Figure 1.