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- W2758219782 abstract "To investigate the impact of radiation treatment clinical trial quality assurance (RTQA) on treatment outcomes in a phase III trial for advanced head and neck cancer. Our hypothesis is that treatments with lower quality have worse outcomes. RTQA for NRG/RTOG 0522 included initial institution credentialing of RT technologies and individual RT case reviews. The case review processes (including contour and dosimetry evaluations) were performed by radiation oncology and radiation physics co-chairs. RTQA grades (per-protocol, variation acceptable and deviation unacceptable) were given to contouring of target volume (TV), organ at risk (OAR) and dose-volume coverage of targets as defined in the protocol. After removing patients with incomplete RTQA grade data, 767 patients were enrolled in this study. We performed log-rank tests for RTQA grades with patients’ outcomes, including local control, distant control and overall survival, to evaluate the value of the RTQA grades. Two Cox models, with and without RTQA grades data, were established to assess the value of RTQA grades in modeling. C-indices were calculated to evaluate model performance with a 10 folder cross-validation. To get a more reasonable model, per-protocol and variation acceptable were combined into a single acceptablegrade. All the statistics analyses and model development were performed with R (Version 3.3.0). The log-rank test showed that all RTQA scores correlated with local control. The local control of patients with per-protocol was significantly different between the per-protocol and variation acceptable patients in target and OAR contouring (p-value=0.004 and 0.043). For dose-volume grade, the per-protocol patients and variation acceptable patients were significantly different from unacceptable patients in local control, with a p-value=0.020 and 0.006, respectively. The distant control of patients with variation acceptable was significantly different than unacceptable patients (p-value=0.043). There were no correlations between RTQA grades with other outcomes. By incorporating RTQA grades into outcome modeling, the performance of local control model can be improved from 0.62 to 0.63 (c-index). The RTQA grades had no impact on distant control and overall survival. Clinical trial quality assurance grades are related to patients’ control rates in head and neck radiotherapy. It is feasible to incorporate RTQA grades into outcome modeling." @default.
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- W2758219782 date "2017-10-01" @default.
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- W2758219782 title "A Feasibility Study on Incorporating Clinical Trial Quality Assurance Parameters into Outcome Prediction in Head and Neck Radiation Therapy Treatment" @default.
- W2758219782 doi "https://doi.org/10.1016/j.ijrobp.2017.06.1510" @default.
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