Multi-centre evaluation of variation in cumulative dose assessment in reirradiation scenarios
Hardcastle, N. (University of Wollongong)
Ceylan, C. (University of Yeditepe)
Hoffmann, Lucien (Aarhus University)
Pérez-Alija, Jaime (Institut de Recerca Sant Pau)
Palmer, C. (NHS Foundation Trust)
Placidi, Lorenzo (Fondazione Policlinico Universitario "A. Gemelli" IRCCS)
Popovic, M. (McGill University Health Centre)
Thompson, C. (Leeds Teaching Hospitals NHS Trust)
Vasquez Osorio, E. (The University of Manchester)
Jackson, A. (Memorial Sloan Kettering Cancer Center)
Mayo, C. (University of Michigan)
Aarberg, A.E. (Haukeland University Hospital)
Ayadi, M. (Centre Léon Bérard)
Belosi, F. (University Hospital and University of Zurich)
Davey, A. (The University of Manchester)
Dupuis, P. (Centre Léon Bérard)
Handley, J.C. (The Christie NHS Foundation Trust)
Hemminger, T. (Brainlab Corporate Services GmbH)
Kelly, C. (St Luke's Radiation Oncology Network)
Michailidou, C. (German Oncology Center)
Muscat, S. (Portsmouth Hospitals University NHS Trust)
Murrell, D.H. (London Health Sciences Centre)
Rønde, H.S. (Aarhus University Hospital)
Selby, A. (South West Wales Cancer Centre)
Skopidou, T. (Guy's and St Thomas' NHS Foundation Trust)
Solomou, N. (NHS Foundation Trust)
Stroom, J. (Champalimaud Centre for the Unknown)
West, N.S. (Northern Centre for Cancer Care)
Zaila, Ali (King Faisal Specialist Hospital and Research Center (KFSHRC))
Appelt, Ane L. (University of Leeds)
Universitat Autònoma de Barcelona. Departament de Medicina

Data:	2024
Resum:	Background and Purpose: Safe reirradiation relies on assessment of cumulative doses to organs at risk (OARs) across multiple treatments. Different clinical pathways can result in inconsistent estimates. Here, we quantified the consistency of cumulative dose to OARs across multi-centre clinical pathways. Material and Methods: We provided DICOM planning CT, structures and doses for two reirradiation cases: head & neck (HN) and lung. Participants followed their standard pathway to assess the cumulative physical and EQD2 doses (with provided α/β values), and submitted DVH metrics and a description of their pathways. Participants could also submit physical dose distributions from Course 1 mapped onto the CT of Course 2 using their best available tools. To assess isolated impact of image registrations, a single observer accumulated each submitted spatially mapped physical dose for every participating centre. Results: Cumulative dose assessment was performed by 24 participants. Pathways included rigid (n = 15), or deformable (n = 5) image registration-based 3D dose summation, visual inspection of isodose line contours (n = 1), or summation of dose metrics extracted from each course (n = 3). Largest variations were observed in near-maximum cumulative doses (25. 4 - 41. 8 Gy for HN, 2. 4 - 33. 8 Gy for lung OARs), with lower variations in volume/dose metrics to large organs. A standardised process involving spatial mapping of the first course dose to the second course CT followed by summation improved consistency for most near-maximum dose metrics in both cases. Conclusion: Large variations highlight the uncertainty in reporting cumulative doses in reirradiation scenarios, with implications for outcome analysis and understanding of published doses. Using a standardised workflow potentially including spatially mapped doses improves consistency in determination of accumulated dose in reirradiation scenarios.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Dose accumulation ; Image registration ; Reirradiation
Publicat a:	Radiotherapy and oncology, Vol. 194 (May 2024) , art. 110184, ISSN 1879-0887

DOI: 10.1016/j.radonc.2024.110184
PMID: 38453055

8 p, 4.0 MB

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