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PRELIMINARY RESULTS OF A QUALITY CONTROL STUDY ON INVOLVED NODE RADIOTHERAPY IN THE EORTC/LYSA/FIL H10 TRIAL ON STAGES I/II HODGKIN LYMPHOMA

2019; Wiley; Volume: 37; Issue: S2 Linguagem: Inglês

10.1002/hon.166_2631

1099-1069

Berthe M.P. Aleman, Umberto Ricardi, Richard W. van der Maazen, Paul Meijnders, Max Beijert, A. Boros, F. Izar, Cècile P.M. Janus, Mario Levis, V. Martin, Lena Specht, C. Corning, E. Clementel, Catherine Fortpied, John Raemaekers, Marc André, Massimo Federico, T. Girinsky,

Lymphoma Diagnosis and Treatment

Introduction: Recently, the final results of EORTC/LYSA/FIL H10 trial on early Positron Emission Tomography (PET) response–adapted treatment in stage I and II Hodgkin Lymphoma were published. In this trial a new radiotherapy concept was introduced: Involved Node Radiotherapy (INRT). The aim of the current study was to evaluate the quality of INRT in a large multicenter trial in a representative sample of patients. Methods: Approximately 70% of 1950 patients enrolled in H10 were treated with INRT. The aim of this retrospective and descriptive study was to evaluate INRT in a representative sample (~10% of all irradiated patients). To obtain a representative sample, sampling was stratified by study group, year of treatment, size of treatment center, treatment arm and it was done proportional to the size of the strata. Because of the retrospective data collection difficulties with retrieval of the data was anticipated for 1/3 of the patients. The sample was completed with all patients with known recurrences to enable future evaluation of pattern of relapse in relation to the field. A feasibility questionnaire was mailed to centers from which cases were sampled. The VODCA (Visualisation and Organisation of Data for Cancer Analysis) software, was used to perform the quality control. Most important items that were scored for each case were radiotherapy principle, delineation and coverage of the target volume and applied technique and -dose. Each case was reviewed by 2 reviewers and in case of disagreement an adjudicator was invited to review the case, in order to come to a conclusion. Results: The sample consisted of 219 patients. The feasibility questionnaire showed that centers indicated that uploading the data would be possible for 134 cases. Data collection was, however, hampered by changes in radiology and treatment planning systems during the running period of the trial, significantly more than anticipated. Currently, data were retrieved for 52 patients. Preliminary review results are available for 34 patients. All evaluated patients were treated according to the INRT principle. Approximately 80% of cases were treated according to the protocol. Major deviations were mostly caused by definite or likely misses in target volume delineation. Conclusions: The preliminary results of the current analysis show that principle of INRT was applied to all patients evaluated. Approximately 80% of the patients were treated according to the protocol, which is in line with results from other study groups. In future trials, either prospective quality assurance of radiotherapy will be done or data will be collected prospectively to enable quality control. The preliminary results should be interpreted with caution because of the number of patients evaluated and because of the potential bias as the currently available data may not be representative for all patients irradiated in the H10 trial. Keywords: Hodgkin lymphoma (HL).