Quality control of involved-field radiotherapy in patients with advanced Hodgkin’s lymphoma (EORTC 20884)

Purpose: To evaluate the impact of the quality of involved-field radiotherapy (IFRT) on clinical outcome in patients with advanced Hodgkin’s lymphoma (HL) in complete remission (CR) after six to eight cycles of mechlorethamine, vincristine, procarbazine, prednisone-doxorubicin, bleomycin, and vinbla...

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Veröffentlicht in:International journal of radiation oncology, biology, physics biology, physics, 2005-11, Vol.63 (4), p.1184-1190
Hauptverfasser: Aleman, Berthe M.P., Girinsky, Théodore, van der Maazen, Richard W.M., Strijk, Simon, Meijnders, Paul, Bortolus, Roberto, Olofsen-van Acht, Manouk J.J., Lybeert, Marnix L.M., Lievens, Yolande, Eghbali, Houchingue, Noordijk, Evert M., Tomšič, Radka, Meerwaldt, Jacobus H., Poortmans, Philip M.P., Smit, Wilma G.J.M., Pinna, Antonella, Henry-Amar, Michel, Raemaekers, John M.M.
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container_end_page 1190
container_issue 4
container_start_page 1184
container_title International journal of radiation oncology, biology, physics
container_volume 63
creator Aleman, Berthe M.P.
Girinsky, Théodore
van der Maazen, Richard W.M.
Strijk, Simon
Meijnders, Paul
Bortolus, Roberto
Olofsen-van Acht, Manouk J.J.
Lybeert, Marnix L.M.
Lievens, Yolande
Eghbali, Houchingue
Noordijk, Evert M.
Tomšič, Radka
Meerwaldt, Jacobus H.
Poortmans, Philip M.P.
Smit, Wilma G.J.M.
Pinna, Antonella
Henry-Amar, Michel
Raemaekers, John M.M.
description Purpose: To evaluate the impact of the quality of involved-field radiotherapy (IFRT) on clinical outcome in patients with advanced Hodgkin’s lymphoma (HL) in complete remission (CR) after six to eight cycles of mechlorethamine, vincristine, procarbazine, prednisone-doxorubicin, bleomycin, and vinblastine (MOPP-ABV) chemotherapy. Methods and Materials: A retrospective review of clinical and radiologic data, radiation charts, simulator films, and megavoltage (MV) photographs was performed. IFRT consisted of 24 Gy to all initially involved nodal areas and 16–24 Gy to all initially involved extranodal sites. Major violations were defined as no or only partial irradiation of an originally involved area, or a total dose
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Methods and Materials: A retrospective review of clinical and radiologic data, radiation charts, simulator films, and megavoltage (MV) photographs was performed. IFRT consisted of 24 Gy to all initially involved nodal areas and 16–24 Gy to all initially involved extranodal sites. Major violations were defined as no or only partial irradiation of an originally involved area, or a total dose &lt;90% of the prescribed dose. Results: Of the 739 patients who were enrolled in the trial between 1989 and 2000, 57% achieved a CR; 152 of 172 patients randomized to IFRT actually received radiotherapy; and in 135 patients, quality control was performed. The overall major violation rate was 47%, predominantly concerning target volumes. The total dose was correct in 81% of the patients. After a median follow-up of 6.5 years, there was no difference in cumulative failure rate between patients with or without major violations. There was no relationship between incidence or site of relapse and major protocol violations. Conclusion: In advanced-stage HL patients in complete remission after six to eight cycles of MOPP-ABV, the outcome was not influenced by violation of the radiotherapy protocol.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2005.03.044</identifier><identifier>PMID: 15936157</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject><![CDATA[Advanced Hodgkin’s lymphoma ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Bleomycin ; Bleomycin - administration & dosage ; Chemotherapy ; Clinical trials ; Combined Modality Therapy ; Combined modality treatment ; Data processing ; Doxorubicin - administration & dosage ; Hodgkin Disease - drug therapy ; Hodgkin Disease - pathology ; Hodgkin Disease - radiotherapy ; Hodgkin's disease ; Humans ; Lymphatic Irradiation - standards ; Mechlorethamine ; Mechlorethamine - administration & dosage ; Prednisone - administration & dosage ; procarbazine ; Procarbazine - administration & dosage ; Quality assurance ; Quality Control ; Radiation ; Radiotherapy ; Radiotherapy Dosage ; Randomized Controlled Trials as Topic ; Remission ; Remission Induction ; Retrospective Studies ; Vinblastine ; Vinblastine - administration & dosage ; Vincristine ; Vincristine - administration & dosage]]></subject><ispartof>International journal of radiation oncology, biology, physics, 2005-11, Vol.63 (4), p.1184-1190</ispartof><rights>2005 Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c391t-d3b0559fe9e909323456fcfd0a65c0c0a191dcdf81781f205958fff0f48a08033</citedby><cites>FETCH-LOGICAL-c391t-d3b0559fe9e909323456fcfd0a65c0c0a191dcdf81781f205958fff0f48a08033</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijrobp.2005.03.044$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15936157$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aleman, Berthe M.P.</creatorcontrib><creatorcontrib>Girinsky, Théodore</creatorcontrib><creatorcontrib>van der Maazen, Richard W.M.</creatorcontrib><creatorcontrib>Strijk, Simon</creatorcontrib><creatorcontrib>Meijnders, Paul</creatorcontrib><creatorcontrib>Bortolus, Roberto</creatorcontrib><creatorcontrib>Olofsen-van Acht, Manouk J.J.</creatorcontrib><creatorcontrib>Lybeert, Marnix L.M.</creatorcontrib><creatorcontrib>Lievens, Yolande</creatorcontrib><creatorcontrib>Eghbali, Houchingue</creatorcontrib><creatorcontrib>Noordijk, Evert M.</creatorcontrib><creatorcontrib>Tomšič, Radka</creatorcontrib><creatorcontrib>Meerwaldt, Jacobus H.</creatorcontrib><creatorcontrib>Poortmans, Philip M.P.</creatorcontrib><creatorcontrib>Smit, Wilma G.J.M.</creatorcontrib><creatorcontrib>Pinna, Antonella</creatorcontrib><creatorcontrib>Henry-Amar, Michel</creatorcontrib><creatorcontrib>Raemaekers, John M.M.</creatorcontrib><creatorcontrib>European Organization for Research</creatorcontrib><creatorcontrib>Treatment of Cancer (EORTC) Lymphoma Group</creatorcontrib><title>Quality control of involved-field radiotherapy in patients with advanced Hodgkin’s lymphoma (EORTC 20884)</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose: To evaluate the impact of the quality of involved-field radiotherapy (IFRT) on clinical outcome in patients with advanced Hodgkin’s lymphoma (HL) in complete remission (CR) after six to eight cycles of mechlorethamine, vincristine, procarbazine, prednisone-doxorubicin, bleomycin, and vinblastine (MOPP-ABV) chemotherapy. Methods and Materials: A retrospective review of clinical and radiologic data, radiation charts, simulator films, and megavoltage (MV) photographs was performed. IFRT consisted of 24 Gy to all initially involved nodal areas and 16–24 Gy to all initially involved extranodal sites. Major violations were defined as no or only partial irradiation of an originally involved area, or a total dose &lt;90% of the prescribed dose. Results: Of the 739 patients who were enrolled in the trial between 1989 and 2000, 57% achieved a CR; 152 of 172 patients randomized to IFRT actually received radiotherapy; and in 135 patients, quality control was performed. The overall major violation rate was 47%, predominantly concerning target volumes. The total dose was correct in 81% of the patients. After a median follow-up of 6.5 years, there was no difference in cumulative failure rate between patients with or without major violations. 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Methods and Materials: A retrospective review of clinical and radiologic data, radiation charts, simulator films, and megavoltage (MV) photographs was performed. IFRT consisted of 24 Gy to all initially involved nodal areas and 16–24 Gy to all initially involved extranodal sites. Major violations were defined as no or only partial irradiation of an originally involved area, or a total dose &lt;90% of the prescribed dose. Results: Of the 739 patients who were enrolled in the trial between 1989 and 2000, 57% achieved a CR; 152 of 172 patients randomized to IFRT actually received radiotherapy; and in 135 patients, quality control was performed. The overall major violation rate was 47%, predominantly concerning target volumes. The total dose was correct in 81% of the patients. After a median follow-up of 6.5 years, there was no difference in cumulative failure rate between patients with or without major violations. 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subjects Advanced Hodgkin’s lymphoma
Antineoplastic Combined Chemotherapy Protocols - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Bleomycin
Bleomycin - administration & dosage
Chemotherapy
Clinical trials
Combined Modality Therapy
Combined modality treatment
Data processing
Doxorubicin - administration & dosage
Hodgkin Disease - drug therapy
Hodgkin Disease - pathology
Hodgkin Disease - radiotherapy
Hodgkin's disease
Humans
Lymphatic Irradiation - standards
Mechlorethamine
Mechlorethamine - administration & dosage
Prednisone - administration & dosage
procarbazine
Procarbazine - administration & dosage
Quality assurance
Quality Control
Radiation
Radiotherapy
Radiotherapy Dosage
Randomized Controlled Trials as Topic
Remission
Remission Induction
Retrospective Studies
Vinblastine
Vinblastine - administration & dosage
Vincristine
Vincristine - administration & dosage
title Quality control of involved-field radiotherapy in patients with advanced Hodgkin’s lymphoma (EORTC 20884)
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