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• W3008177621 abstract "373 Background: The PIVOTALboost trial (ISRCTN80146950) recruits patients with intermediate and high risk, localised prostate cancer; it tests the role of pelvic node radiotherapy and the effectiveness of a focal intra-prostate IMRT boost. Prior to opening to recruitment a contouring QA program was designed aiming to improve consistency in clinical outlining. Methods: Intra-prostatic boosting was a new treatment method for all but 3 trial centers. Guidelines for boost contouring and pelvic node outlining were circulated. Clinicians were sent two different cases with the clinical case description, biopsy details, the diagnostic pre-biopsy multi-parametric MRI (T2W and DWI sequences) and planning CT and MRI scans. They were asked to contour prostate, seminal vesicle (CTVp, CTVpsv), lymph node (CTVn) for 1 case and boost volume (GTVpb) for both cases. The 3 lead trial clinicians contoured the cases independently, agreed on gold standard outlines and criteria for failing the submission. Center’ benchmark case submissions were reviewed and standardized feedback forms returned to each clinician. General issues were addressed during a trial launch workshop. Results: There was good agreement of the contours for CTVp, CTVpsv and CTVn between the 3 lead clinicians for the gold standard; more discussions were required to agree GTVpb. Criteria for re-submission were: contours >6mm beyond or >3mm inside the superior and inferior level, included OARs, excluded SV base or extracapsular extension. In addition, for GTVpb, the wrong segment, extension outside CTVp, outlining abnormalities <5mm in diameter or a volume > or < 50% of the gold standard. 35 center and 54 clinicians submitted outlines: for CTVp/psv 24/54 failed, CTVn 14/54 failed, GTVpb 23/48 failed (6 investigators did not submit a volume). All center passed the re-submission; for the on trial outlining review, 9 centres have not recruited a patient for the on trial review process, 18 passed and 8 failed. Conclusions: Errors and inconsistencies were common in the benchmark outlining exercises for the trial. Individual feedback, guidelines and clinical support has reduced outlining variations without delaying the opening of the trial; it has helped to standardize contouring and engage clinicians in the trial process. Clinical trial information: 80146950." @default.
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• W3008177621 date "2020-02-20" @default.
• W3008177621 modified "2023-10-15" @default.
• W3008177621 title "PIVOTALboost Trial contouring RTQA." @default.
• W3008177621 doi "https://doi.org/10.1200/jco.2020.38.6_suppl.373" @default.
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