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Erschienen in: Strahlentherapie und Onkologie 2/2017

27.09.2016 | Original Article

New quality assurance program integrating “modern radiotherapy” within the German Hodgkin Study Group

verfasst von: J. Kriz, C. Baues, R. Engenhart-Cabillic, U. Haverkamp, K. Herfarth, P. Lukas, H. Schmidberger, S. Marnitz-Schulze, M. Fuchs, A. Engert, Prof. Dr. H. T. Eich

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 2/2017

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Abstract

Introduction

Field design changed substantially from extended-field RT (EF-RT) to involved-field RT (IF-RT) and now to involved-node RT (IN-RT) and involved-site RT (IS-RT) as well as treatment techniques in radiotherapy (RT) of Hodgkin’s lymphoma (HL). The purpose of this article is to demonstrate the establishment of a quality assurance program (QAP) including modern RT techniques and field designs within the German Hodgkin Study Group (GHSG).

Methods

In the era of modern conformal RT, this QAP had to be fundamentally adapted and a new evaluation process has been intensively discussed by the radiotherapeutic expert panel of the GHSG.

Results

The expert panel developed guidelines and criteria to analyse “modern” field designs and treatment techniques. This work is based on a dataset of 11 patients treated within the sixth study generation (HD16–17).

Conclusion

To develop a QAP of “modern RT”, the expert panel defined criteria for analysing current RT procedures. The consensus of a modified QAP in ongoing and future trials is presented. With this schedule, the QAP of the GHSG could serve as a model for other study groups.
Literatur
1.
Zurück zum Zitat Eich HT, Diehl V, Gorgen H, Pabst T, Markova J, Debus J et al (2010) Intensified chemotherapy and dose-reduced involved-field radiotherapy in patients with early unfavorable Hodgkin’s lymphoma: final analysis of the German Hodgkin Study Group HD11 trial. J Clin Oncol 28:4199–4206CrossRefPubMed Eich HT, Diehl V, Gorgen H, Pabst T, Markova J, Debus J et al (2010) Intensified chemotherapy and dose-reduced involved-field radiotherapy in patients with early unfavorable Hodgkin’s lymphoma: final analysis of the German Hodgkin Study Group HD11 trial. J Clin Oncol 28:4199–4206CrossRefPubMed
2.
Zurück zum Zitat Engert A, Plutschow A, Eich HT, Lohri A, Dorken B, Borchmann P et al (2010) Reduced treatment intensity in patients with early-stage Hodgkin’s lymphoma. N Engl J Med 363:640–652CrossRefPubMed Engert A, Plutschow A, Eich HT, Lohri A, Dorken B, Borchmann P et al (2010) Reduced treatment intensity in patients with early-stage Hodgkin’s lymphoma. N Engl J Med 363:640–652CrossRefPubMed
3.
Zurück zum Zitat Engert A, Haverkamp H, Kobe C, Markova J, Renner C, Ho A et al (2012) Reduced intensity of chemotherapy and PET-giuded radiotherapy in patients with advanced stage Hodgkin lymphoma: an open-label, randomised phase 3 trial. Lancet 379:1791–1799CrossRefPubMed Engert A, Haverkamp H, Kobe C, Markova J, Renner C, Ho A et al (2012) Reduced intensity of chemotherapy and PET-giuded radiotherapy in patients with advanced stage Hodgkin lymphoma: an open-label, randomised phase 3 trial. Lancet 379:1791–1799CrossRefPubMed
4.
Zurück zum Zitat Engert A, Schiller P, Josting A et al (2003) Involved-field radiotherapy is equally effective and less toxic compared with extended-field radiotherapy after four cycles of chemotherapy in patients with earlystage unfavorable Hodgkin’s lymphoma: results of the HD8 trial of the German Hodgkin’s Lymphoma Study Group. J Clin Oncol 21:3601–3608CrossRefPubMed Engert A, Schiller P, Josting A et al (2003) Involved-field radiotherapy is equally effective and less toxic compared with extended-field radiotherapy after four cycles of chemotherapy in patients with earlystage unfavorable Hodgkin’s lymphoma: results of the HD8 trial of the German Hodgkin’s Lymphoma Study Group. J Clin Oncol 21:3601–3608CrossRefPubMed
5.
Zurück zum Zitat Girinsky T, van der Maazen R, Specht L et al (2006) Involved-node radiotherapy (INRT) in patients with early Hodgkin lymphoma: concepts and guidelines. Radiother Oncol 79:270–277CrossRefPubMed Girinsky T, van der Maazen R, Specht L et al (2006) Involved-node radiotherapy (INRT) in patients with early Hodgkin lymphoma: concepts and guidelines. Radiother Oncol 79:270–277CrossRefPubMed
6.
Zurück zum Zitat Eich HT, Muller RP, Engenhart-Cabillic R et al (2008) Involved-node radiotherapy in early-stage Hodgkin’s lymphoma. Definition and guidelines of the German Hodgkin Study Group (GHSG). Strahlenther Onkol 184:406–410CrossRefPubMed Eich HT, Muller RP, Engenhart-Cabillic R et al (2008) Involved-node radiotherapy in early-stage Hodgkin’s lymphoma. Definition and guidelines of the German Hodgkin Study Group (GHSG). Strahlenther Onkol 184:406–410CrossRefPubMed
7.
Zurück zum Zitat Specht L, Yahalom J, Illidge T et al (2014) Modern radiotherapy for Hodgkin lymphoma – field and dose guidelines from the International Lymphoma Radiation Oncology Group (ILROG). Int J Radiat Oncol Biol Phys 89(4):854–862CrossRefPubMed Specht L, Yahalom J, Illidge T et al (2014) Modern radiotherapy for Hodgkin lymphoma – field and dose guidelines from the International Lymphoma Radiation Oncology Group (ILROG). Int J Radiat Oncol Biol Phys 89(4):854–862CrossRefPubMed
8.
Zurück zum Zitat Kriz J, Spickermann M, Lehrich P et al (2015) Breath-hold technique in conventional APPA or intensity-modulated radiotherapy for Hodgkin’s lymphoma: comparison of ILROG IS-RT and the GHSG IF-RT. Strahlenther Onkol 191(9):717–725CrossRefPubMed Kriz J, Spickermann M, Lehrich P et al (2015) Breath-hold technique in conventional APPA or intensity-modulated radiotherapy for Hodgkin’s lymphoma: comparison of ILROG IS-RT and the GHSG IF-RT. Strahlenther Onkol 191(9):717–725CrossRefPubMed
9.
Zurück zum Zitat Haverkamp U, Norkus D, Kriz J et al (2014) Optimization by visualization of indices. Strahlenther Onkol 190(11):1053–1059CrossRefPubMed Haverkamp U, Norkus D, Kriz J et al (2014) Optimization by visualization of indices. Strahlenther Onkol 190(11):1053–1059CrossRefPubMed
10.
Zurück zum Zitat Müller RP, Eich HT (2005) The development of quality assurance programs for radiotherapy within the German Hodgkin Study Group (GHSG). Introduction, continuing work, and results of the radiotherapy reference panel. Strahlenther Onkol 181(9):557–566CrossRefPubMed Müller RP, Eich HT (2005) The development of quality assurance programs for radiotherapy within the German Hodgkin Study Group (GHSG). Introduction, continuing work, and results of the radiotherapy reference panel. Strahlenther Onkol 181(9):557–566CrossRefPubMed
11.
Zurück zum Zitat Duhmke E, Diehl V, Loeffler M et al (1996) Randomized trial with early-stage Hodgkin’s disease testing 30 Gy vs. 40 Gy extended field radiotherapy alone. Int J Radiat Oncol Biol Phys 36:305–310CrossRefPubMed Duhmke E, Diehl V, Loeffler M et al (1996) Randomized trial with early-stage Hodgkin’s disease testing 30 Gy vs. 40 Gy extended field radiotherapy alone. Int J Radiat Oncol Biol Phys 36:305–310CrossRefPubMed
12.
Zurück zum Zitat Eich HT, Engenhart-Cabillic R, Hansemann K et al (2008) Quality control of involved field radiotherapy in patients with early-favorable (HD10) and early-unfavorable (HD11) Hodgkin’s lymphoma: an analysis of the German Hodgkin Study Group. Int J Radiat Oncol Biol Phys 71(5):1419–1424CrossRefPubMed Eich HT, Engenhart-Cabillic R, Hansemann K et al (2008) Quality control of involved field radiotherapy in patients with early-favorable (HD10) and early-unfavorable (HD11) Hodgkin’s lymphoma: an analysis of the German Hodgkin Study Group. Int J Radiat Oncol Biol Phys 71(5):1419–1424CrossRefPubMed
13.
Zurück zum Zitat Kriz J, Reinartz G, Dietlein M et al (2015) Relapse analysis of irradiated patients within the HD15 trial of the German Hodgkin Study Group. int J Radiat Oncol Biol Phys 92(1):46–53CrossRefPubMed Kriz J, Reinartz G, Dietlein M et al (2015) Relapse analysis of irradiated patients within the HD15 trial of the German Hodgkin Study Group. int J Radiat Oncol Biol Phys 92(1):46–53CrossRefPubMed
14.
Zurück zum Zitat ICRU Report No. 83 International Commission on Radiation Units and Measurements – Prescribing, Recording, and Reporting Intensity–Modulated Photon-Beam Therapy. ICRU 83; 2010. ICRU Report No. 83 International Commission on Radiation Units and Measurements – Prescribing, Recording, and Reporting Intensity–Modulated Photon-Beam Therapy. ICRU 83; 2010.
15.
Zurück zum Zitat Chera BS, Rodriguez C, Morris CG et al (2009) Dosimetric comparison of three different involved nodal irradiation techniques for stage II Hodgkin’s lymphoma patients: conventional radiotherapy, intensity-modulated radiotherapy, and three-dimensional proton radiotherapy. Int J Radiat Oncol Biol Phys 75:1173–1180CrossRefPubMed Chera BS, Rodriguez C, Morris CG et al (2009) Dosimetric comparison of three different involved nodal irradiation techniques for stage II Hodgkin’s lymphoma patients: conventional radiotherapy, intensity-modulated radiotherapy, and three-dimensional proton radiotherapy. Int J Radiat Oncol Biol Phys 75:1173–1180CrossRefPubMed
16.
Zurück zum Zitat Koeck J, Abo-Madyan Y, Lohr F et al (2012) Radiotherapy for early mediastinal Hodgkin lymphoma according to the German Hodgkin Study Group (GHSG): the roles of intensity-modulated radiotherapy and involved-node radiotherapy. Int J Radiat Oncol Biol Phys 83:268–276CrossRefPubMed Koeck J, Abo-Madyan Y, Lohr F et al (2012) Radiotherapy for early mediastinal Hodgkin lymphoma according to the German Hodgkin Study Group (GHSG): the roles of intensity-modulated radiotherapy and involved-node radiotherapy. Int J Radiat Oncol Biol Phys 83:268–276CrossRefPubMed
17.
Zurück zum Zitat Weber DC, Peguret N, Dipasquale G et al (2009) Involved-node and involved-field volumetric modulated arc vs. fixed beam intensity-modulated radiotherapy for female patients with early-stage supradiaphragmatic Hodgkin lymphoma: a comparative planning study. Int J Radiat Oncol Biol Phys 75:1578–1586CrossRefPubMed Weber DC, Peguret N, Dipasquale G et al (2009) Involved-node and involved-field volumetric modulated arc vs. fixed beam intensity-modulated radiotherapy for female patients with early-stage supradiaphragmatic Hodgkin lymphoma: a comparative planning study. Int J Radiat Oncol Biol Phys 75:1578–1586CrossRefPubMed
Metadaten
Titel
New quality assurance program integrating “modern radiotherapy” within the German Hodgkin Study Group
verfasst von
J. Kriz
C. Baues
R. Engenhart-Cabillic
U. Haverkamp
K. Herfarth
P. Lukas
H. Schmidberger
S. Marnitz-Schulze
M. Fuchs
A. Engert
Prof. Dr. H. T. Eich
Publikationsdatum
27.09.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Strahlentherapie und Onkologie / Ausgabe 2/2017
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-016-1048-y

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