Dosimetric intercomparison for two Australasian clinical trials using an anthropomorphic phantom

被引:36
作者
Kron, T
Hamilton, C
Roff, M
Denham, J
机构
[1] Newcastle Mater Misericordiae Hosp, Ctr Clin Radiat Res, Waratah, NSW, Australia
[2] Newcastle Mater Misericordiae Hosp, TROG Cent Off, Waratah, NSW, Australia
[3] Univ Newcastle, Sch Math & Phys Sci, Callaghan, NSW, Australia
[4] Univ Newcastle, Fac Med, Callaghan, NSW, Australia
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2002年 / 52卷 / 02期
关键词
quality assurance; multicenter clinical trials; thermoluminescent dosimetry;
D O I
10.1016/S0360-3016(01)02682-7
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Introduction: Many different factors can affect the accurate delivery of dose to the clinical target volume in radiotherapy. This is particularly important in the context of multicenter clinical trials where different equipment and techniques may be used for supposedly identical treatments. A dosimetric intercomparison employing an anthropomorphic phantom (level III dosimetric intercomparison) can be used to check many of the factors that could affect treatment by mimicking the radiotherapy pathway of a patient as closely as possible. Methods and Materials: An anthropomorphic phantom (ART) was taken to 18 radiotherapy centers in Australia and New Zealand and treated for two different treatment scenarios based on current clinical trials of the Trans-Tasman Radiation Oncology Group (TROG): a two-field treatment of a carcinoma of the tonsil (TROG 91.01), and a four-field prostate treatment (TROG 96.01). The dose distribution was assessed in two consecutive treatments using thermoluminescence dosimeters (TLDs) placed throughout the target volume and in "critical" structures such as the lens of the eye or the rectum. The study also included a check of absolute dose calibration in a slab phantom (level I dosimetric intercomparison). The influence of a variety of treatment parameters on the dose homogeneity in the target and the measured dose in the target and the critical organs was evaluated. Results: The dose measurements confirmed that in all participating centers the correct dose was delivered to the ICRU reference point (tonsil: 99.8 +/- 2.3%; prostate: 100.9 +/- 1.9% [1 SD]). Also the absolute dose calibration and the mean dose in the target volume were within the specified action levels of +/- 5% for all participating centers. No influence of shielding, beam modifiers, beam weighting, treatment planning approach (CT, 2D, 3D), and type or equipment used on the dose in the target and its homogeneity could be demonstrated. However, treatment technique and energy used influenced the dose to the critical organs. It was shown that the interpretation of results could be improved by including two complementary treatment scenarios and a level I intercomparison with the level III dosimetric intercomparison. Conclusion: The study demonstrated the feasibility of a level III dosimetric intercomparison service at a cost of approximately $US 1000 per center in Australasia. It confirmed that the dose delivered by all participating centers was as intended in the two treatment scenarios chosen. While this provides reassurance to the oncology community and the general public, the service must be extended to all centers and other potentially more complex treatment scenarios. The present study has built the foundation for this by establishing a baseline and action levels and suggesting improvements in phantom design which will be included in future TROG quality assurance exercises. (C) 2002 Elsevier Science Inc.
引用
收藏
页码:566 / 579
页数:14
相关论文
共 28 条
[1]   Multicentre dosimetry study of mantle treatment in Australia and New Zealand [J].
Amies, C ;
Rose, A ;
Metcalfe, P ;
Barton, M .
RADIOTHERAPY AND ONCOLOGY, 1996, 40 (02) :171-180
[2]  
Bentzen, 1994, Semin Radiat Oncol, V4, P68, DOI 10.1016/S1053-4296(05)80034-7
[3]   DOSIMETRIC PRECISION REQUIREMENTS IN RADIATION-THERAPY [J].
BRAHME, A .
ACTA RADIOLOGICA ONCOLOGY, 1984, 23 (05) :379-391
[4]   A comparative description of three multipurpose phantoms (MPP) for external audits of photon beams in radiotherapy:: the water MPP, the Umea MPP and the EC MPP [J].
Bridier, A ;
Nyström, H ;
Ferreira, I ;
Gomola, I ;
Huyskens, D .
RADIOTHERAPY AND ONCOLOGY, 2000, 55 (03) :285-293
[5]   Planning, delivery, and quality assurance of intensity-modulated radiotherapy using dynamic multileaf collimator: A strategy for large-scale implementation for the treatment of carcinoma of the prostate [J].
Burman, C ;
Chui, CS ;
Kutcher, G ;
Leibel, S ;
Zelefsky, M ;
LoSasso, T ;
Spirou, S ;
Wu, QW ;
Yang, J ;
Stein, J ;
Mohan, R ;
Fuks, Z ;
Ling, CC .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1997, 39 (04) :863-873
[6]   THE EFFECT OF ADJUVANT CHEMOTHERAPY ON COSMESIS AND COMPLICATIONS IN PATIENTS WITH BREAST-CANCER TREATED BY DEFINITIVE IRRADIATION [J].
DANOFF, BF ;
GOODMAN, RL ;
GLICK, JH ;
HALLER, DG ;
PAJAK, TF .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1983, 9 (11) :1625-1630
[7]   Tangential breast irradiation: a multi-centric intercomparison of dose using a mailed phantom and thermoluminescent dosimetry [J].
Davis, JB ;
Miltchev, V .
RADIOTHERAPY AND ONCOLOGY, 1999, 52 (01) :65-68
[8]   Three-dimensional dose distribution of tangential breast irradiation: results of a multicentre phantom dosimetry study [J].
Delancy, G ;
Beckham, W ;
Veness, M ;
Ahern, V ;
Back, M ;
Boyages, J ;
Fox, C ;
Graham, P ;
Jacob, G ;
Lonergan, D ;
Morgan, G ;
Pendlebury, S ;
Yuile, P .
RADIOTHERAPY AND ONCOLOGY, 2000, 57 (01) :61-68
[9]   WHEN AND HOW CAN WE IMPROVE PRECISION IN RADIOTHERAPY [J].
DUTREIX, A .
RADIOTHERAPY AND ONCOLOGY, 1984, 2 (04) :275-292
[10]   Optimization of conformal radiation treatment of prostate cancer: Report of a dose escalation study [J].
Hanks, GE ;
Schultheiss, TE ;
Hanlon, AL ;
Hunt, M ;
Lee, WR ;
Epstein, BE ;
Coia, LR .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1997, 37 (03) :543-550