References of "Radiotherapy & Oncology"
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See detailAnxiety and its time courses during radiotherapy for non-metastatic breast cancer: A longitudinal study
Lewis, Florence; Merckaert, Isabelle; Liénard, Aurore et al

in Radiotherapy & Oncology (2014), 111(2), 276-280

Purpose: To our knowledge, no study has specifically assessed the time course of anxiety during radiotherapy (RT). The objective of this study was to assess anxiety time courses in patients with ... [more ▼]

Purpose: To our knowledge, no study has specifically assessed the time course of anxiety during radiotherapy (RT). The objective of this study was to assess anxiety time courses in patients with nonmetastatic breast cancer. Material and methods: This multicenter, descriptive longitudinal study included 213 consecutive patients with breast cancer who completed visual analog scales (VASs) assessing state anxiety before and after the RT simulation and the first and last five RT sessions. Results: Pre- and post-session anxiety mean levels were highest at the RT simulation (respectively, 2.9 ± 2.9 and 1.6 ± 2.5) and first RT session (respectively, 3.4 ± 2.9 and 2.0 ± 2.4), then declined rapidly. Clinically relevant mean differences (P1 cm on the VAS) between pre- and post-simulation/session VAS scores were found only for the RT simulation ( 1.3 ± 2.7; p < 0.001) and first RT session ( 1.4 ± 2.4; p < 0.001). Five percent to 16% of patients presented clinically relevant anxiety (pre- and post-simulation/session VAS scoresP4 cm) throughout treatment. Conclusions: To optimize care, RT team members should offer all patients appropriate information about treatment at the simulation, check patients’ understanding, and identify patients with clinically relevant anxiety requiring appropriate support throughout RT. [less ▲]

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See detailOrthanc - Lightweight, Scriptable DICOM Server for Medical Image Management in Radiotherapy
JODOGNE, Sébastien ULg; SOBCZAK, Sonia ULg; DEVILLERS, Magali ULg et al

in Radiotherapy & Oncology (2013), 106(2), 488

High-quality radiotherapy (RT) treatment planning requires the combination of information arising from multiple medical imaging modalities. For this reason, RT implies the setup and the management of ... [more ▼]

High-quality radiotherapy (RT) treatment planning requires the combination of information arising from multiple medical imaging modalities. For this reason, RT implies the setup and the management of complex flows of images between the various modalities and software of the hospital. Even though biomedical images are most commonly stored and transferred using the DICOM standard, it remains hard to automatize and optimize these clinical flows that are very specific to each hospital. This stems from the fact that programming the DICOM network protocol requires both a high level of familiarity with the DICOM standard as well as substantial experience in computer programming. This motivates the introduction of the Orthanc software in the medical practice to improve the RT imaging workflow. [less ▲]

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See detailIs it possible to improve radiotherapy team members’ communication skills. A randomized study assessing the efficacy of a 38h communications skills training program
GIBON, Anne-Sophie; MERCKAERT, Isabelle; LIENARD, Aurore et al

in Radiotherapy & Oncology (2013), 109(1), 170177

Background and purpose: Optimizing communication between radiotherapy team members and patients and between colleagues requires training. This study applies a randomized controlled design to assess the ... [more ▼]

Background and purpose: Optimizing communication between radiotherapy team members and patients and between colleagues requires training. This study applies a randomized controlled design to assess the efficacy of a 38-h communication skills training program. Material and methods: Four radiotherapy teams were randomly assigned either to a training program or to a waiting list. Team members’ communication skills and their self-efficacy to communicate in the context of an encounter with a simulated patient were the primary endpoints. These encounters were scheduled at the baseline and after training for the training group, and at the baseline and four months later for the waiting list group. Encounters were audiotaped and transcribed. Transcripts were analyzed with content analysis software (LaComm) and by an independent rater. Results: Eighty team members were included in the study. Compared to untrained team members, trained team members used more turns of speech with content oriented toward available resources in the team (relative rate [RR] = 1.38; p = 0.023), more assessment utterances (RR = 1.69; p < 0.001), more empathy (RR = 4.05; p = 0.037), more negotiation (RR = 2.34; p = 0.021) and more emotional words (RR = 1.32; p = 0.030), and their self-efficacy to communicate increased (p = 0.024 and p = 0.008, respectively). Conclusions: The training program was effective in improving team members’ communication skills and their self-efficacy to communicate in the context of an encounter with a simulated patient. Future study should assess the effect of this training program on communication with actual patients and their satisfaction. Moreover a cost-benefit analysis is needed, before implementing such an intensive training program on a broader scale. [less ▲]

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See detailQuality assurance of the EORTC 22043-30041 trial in post-operative radiotherapy in prostate cancer: Results of the Dummy Run procedure
Fenton, P. A.; Hurkmans, C.; GULYBAN, Akos ULg et al

in Radiotherapy & Oncology (2013)

Background and purpose: The EORTC 22043-30041 trial investigates the role of the addition of androgen suppression to post-operative radiotherapy in patients who have undergone radical prostatectomy. As ... [more ▼]

Background and purpose: The EORTC 22043-30041 trial investigates the role of the addition of androgen suppression to post-operative radiotherapy in patients who have undergone radical prostatectomy. As part of the quality assurance of radiotherapy (QART) a Dummy Run (DR) procedure was performed. Materials and method: The protocol included detailed and published delineation guidelines. Participating institutions digitally submitted radiotherapy treatment volumes and a treatment plan for a standard clinical case. Submissions were centrally reviewed using the VODCA software platform. Results: Thirty-eight submissions from thirty-one institutions were reviewed. Six were accepted without comments. Twenty-three were accepted with comments on one or more items: target volume delineation (22), OAR delineation (23), planning and dosimetry (3) or treatment verification (1). Nine submissions were rejected requiring resubmission, seven for target volume delineation reasons alone. Intervention to highlight the importance of delineation guidelines was made prior to the entry of the first patient in the trial. After this, a lower percentage of resubmissions was required. Conclusions: The EORTC 22043-30041 Dummy Run highlights the need for timely and effective QART in clinical trials. The variation in target volume and OAR definition demonstrates that clinical guidelines and radiotherapy protocols are not a substitute for QART procedures. Early intervention in response to the Dummy Run improved protocol understanding. © 2013 Elsevier Ireland Ltd. All rights reserved. [less ▲]

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See detailQuality assurance in the EORTC 22033-26033/CE5 phase III randomized trial for low grade glioma: The digital individual case review
Fairchild, A.; Weber, D. C.; Bar-Deroma, R. et al

in Radiotherapy & Oncology (2012), 103(3), 287-292

Introduction: The phase III EORTC 22033-26033/NCIC CE5 intergroup trial compares 50.4 Gy radiotherapy with up-front temozolomide in previously untreated low-grade glioma. We describe the digital EORTC ... [more ▼]

Introduction: The phase III EORTC 22033-26033/NCIC CE5 intergroup trial compares 50.4 Gy radiotherapy with up-front temozolomide in previously untreated low-grade glioma. We describe the digital EORTC individual case review (ICR) performed to evaluate protocol radiotherapy (RT) compliance. Methods: Fifty-eight institutions were asked to submit 1-2 randomly selected cases. Digital ICR datasets were uploaded to the EORTC server and accessed by three central reviewers. Twenty-seven parameters were analysed including volume delineation, treatment planning, organ at risk (OAR) dosimetry and verification. Consensus reviews were collated and summary statistics calculated. Results: Fifty-seven of seventy-two requested datasets from forty-eight institutions were technically usable. 31/57 received a major deviation for at least one section. Relocation accuracy was according to protocol in 45. Just over 30% had acceptable target volumes. OAR contours were missing in an average of 25% of cases. Up to one-third of those present were incorrectly drawn while dosimetry was largely protocol compliant. Beam energy was acceptable in 97% and 48 patients had per protocol beam arrangements. Conclusions: Digital RT plan submission and review within the EORTC 22033-26033 ICR provide a solid foundation for future quality assurance procedures. Strict evaluation resulted in overall grades of minor and major deviation for 37% and 32%, respectively. © 2012 Elsevier Ireland Ltd. All rights reserved. [less ▲]

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See detailEP-1420 ADAPTIVE CLINICAL COMMISSIONING OF MONACO VMAT: MAXIMIZING EFFICACY WITHOUT SACRIFICING SAFETY
GULYBAN, Akos ULg; Oltenau, A. M. L.; Vercauteren, T. et al

in Radiotherapy & Oncology (2012), 103

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See detailOC-0501 IRRADIATION OF THE LEFT VENTRICLE OF THE HEART IS CORRELATED WITH POST-TREATMENT DYSPNEA IN NSCLC PATIENTS
Nalbantov, G.; De Ruysscher, Dirk; Vandecasteele, K. et al

in Radiotherapy & Oncology (2012), 103

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See detailEORTC Radiation Oncology Group quality assurance platform: Establishment of a digital central review facility
Fairchild, A.; Aird, E.; Fenton, P. A. et al

in Radiotherapy & Oncology (2012), 103(3), 279-286

Objective: Quality assurance (QA) in clinical trials is essential to ensure treatment is safely and effectively delivered. As QA requirements have increased in complexity in parallel with evolution of ... [more ▼]

Objective: Quality assurance (QA) in clinical trials is essential to ensure treatment is safely and effectively delivered. As QA requirements have increased in complexity in parallel with evolution of radiation therapy (RT) delivery, a need to facilitate digital data exchange emerged. Our objective is to present the platform developed for the integration and standardization of QART activities across all EORTC trials involving RT. Methods: The following essential requirements were identified: secure and easy access without on-site software installation; integration within the existing EORTC clinical remote data capture system; and the ability to both customize the platform to specific studies and adapt to future needs. After retrospective testing within several clinical trials, the platform was introduced in phases to participating sites and QART study reviewers. Results: The resulting QA platform, integrating RT analysis software installed at EORTC Headquarters, permits timely, secure, and fully digital central DICOM-RT based data review. Participating sites submit data through a standard secure upload webpage. Supplemental information is submitted in parallel through web-based forms. An internal quality check by the QART office verifies data consistency, formatting, and anonymization. QART reviewers have remote access through a terminal server. Reviewers evaluate submissions for protocol compliance through an online evaluation matrix. Comments are collected by the coordinating centre and institutions are informed of the results. Conclusions: This web-based central review platform facilitates rapid, extensive, and prospective QART review. This reduces the risk that trial outcomes are compromised through inadequate radiotherapy and facilitates correlation of results with clinical outcomes. © 2012 Elsevier Ireland Ltd. All rights reserved. [less ▲]

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See detail139 DOES QUALITY OF RADIOTHERAPY PREDICT OUTCOMES OF MULTICENTRE CLINICAL TRIALS? THE EORTC RADIATION ONCOLOGY GROUP EXPERIENCE.
Fairchild, Alysa; Collette, Laurence; Hurkmans, Coen W. et al

in Radiotherapy & Oncology (2012), 102

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See detail182 oral EORTC RADIOTHERAPY QUALITY ASSURANCE PLATFORM: ESTABLISHMENT OF AN INTEGRATED CENTRAL REVIEW FACILITY
GULYBAN, Akos ULg; Fenton, Paul A.; Fairchild, Alysa et al

in Radiotherapy & Oncology (2011), 99

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See detailQuality assurance for prospective EORTC radiation oncology trials: The challenges of advanced technology in a multicenter international setting
Weber, D. C.; Poortmans, P. M. P.; Hurkmans, C. W. et al

in Radiotherapy & Oncology (2011), 100(1), 150-156

The European Organization for the Research and Treatment of Cancer (EORTC) is a pan-European structure charged with improving cancer treatment through the testing of new therapeutic strategies in phases I ... [more ▼]

The European Organization for the Research and Treatment of Cancer (EORTC) is a pan-European structure charged with improving cancer treatment through the testing of new therapeutic strategies in phases I-III clinical studies. Properly conducted trials in radiation oncology are required to demonstrate superiority of a new treatment over the current standard. The Radiation Oncology Group (ROG) has initiated a complex quality assurance (QA) program to ensure safe and effective treatment delivery. Most modern trials are multicenter and multidisciplinary, further increasing the importance of early, strict and consistent QA in radiotherapy (RT). QART measures confirm whether a site possesses minimum staff and equipment for participation. Dummy runs, reviews of patient treatment plans and complex dosimetry checks verify the ability of an institution to comply with the protocol. Data required for evaluation are increasingly exchanged digitally, allowing detailed plan reconstruction, evaluation of target volume delineation and recalculation of dose-volume parameters for comparison against predefined standards. The five tiers of QA implemented in EORTC trials are reviewed, along with past, current and future QART initiatives. As substantial human and financial resources are increasingly invested in QART, the importance of cost-benefit analysis of QA and its impact on clinical outcome cannot be overstated. © 2011 Elsevier Ltd. All rights reserved. [less ▲]

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See detail392 poster INTERNATIONAL IMRT CREDENTIALING BY PHYSICAL PHANTOM IRRADIATION: THE EORTC ROG EXPERIENCE
Fairchild, Alysa; GULYBAN, Akos ULg; Denis, J. M. et al

in Radiotherapy & Oncology (2011), 99

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See detail69 speaker 3D DOSIMETRY SYSTEMS-GELS, EPIDS AND OTHERS
Duchateau, Michael; Verellen, D.; Depuydt, T. et al

in Radiotherapy & Oncology (2011), 99

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See detailEVALUATION OF THE AUTOMATIC IMAGE REGISTRATION FEATURES OF A KV CONE-BEAM CT IMAGING SYSTEM
JANVARY, Zsolt Levente ULg; JANSEN, Nicolas ULg; MATHOT, Michel ULg et al

in Radiotherapy & Oncology (2010), 96(supp 1),

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See detailSCREENIN G AND PREDICTING MALNUTRITION IN lUNG CANCER PATIENTS: DEVELOPING NEW TOOLS.
BARTHELEMY, Nicole ULg; Donneau, Anne-Françoise ULg; Haterte, Stéphanie ULg et al

in Radiotherapy & Oncology (2010, September), 96(supp 1), 378

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See detailDummy run and conformity indices in the ongoing EORTC low-grade glioma trial 22033-26033: First evaluation of quality of radiotherapy planning
Musat, E.; Roelofs, E.; Bar-Deroma, R. et al

in Radiotherapy & Oncology (2010), 95(2), 218-224

Purpose: Early assessment of radiotherapy (RT) quality in the ongoing EORTC trial comparing primary temozolomide versus RT in low-grade gliomas. Materials and methods: RT plans provided for dummy cases ... [more ▼]

Purpose: Early assessment of radiotherapy (RT) quality in the ongoing EORTC trial comparing primary temozolomide versus RT in low-grade gliomas. Materials and methods: RT plans provided for dummy cases were evaluated and compared against expert plans. We analysed: (1) tumour and organs-at-risk delineation, (2) geometric and dosimetric characteristics, (3) planning parameters, compliance with dose prescription and Dmax for OAR (4) indices: RTOG conformity index (CI), coverage factor (CF), tissue protection factor (PF); conformity number (CN = PF× CF); dose homogeneity in PTV (U). Results: Forty-one RT plans were evaluated. Only two (5%) centres were requested to repeat CTV-PTV delineations. Three (7%) plans had a significant under-dosage and dose homogeneity in one deviated > 10%. Dose distribution was good with mean values of 1.5, 1, 0.68, and 0.68 (ideal values = 1) for CI, CF, PF, and CN, respectively. CI and CN strongly correlated with PF and they correlated with PTV. Planning with more beams seems to increase PTV Dmin, improving CF. U correlated with PTV Dmax. Conclusion: Preliminary results of the dummy run procedure indicate that most centres conformed to protocol requirements. To quantify plan quality we recommend systematic calculation of U and either CI or CN, both of which measure the amount of irradiated normal brain tissue. © 2010 Elsevier Ireland Ltd. All rights reserved. [less ▲]

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See detailQuality assurance in the 22991 EORTC ROG trial in localized prostate cancer: Dummy run and individual case review
Matzinger, O.; Poortmans, P.; Giraud, J.-Y. et al

in Radiotherapy & Oncology (2009), 90(3), 285-290

Introduction: EORTC trial 22991 was designed to evaluate the addition of concomitant and adjuvant short-term hormonal treatments to curative radiotherapy in terms of disease-free survival for patients ... [more ▼]

Introduction: EORTC trial 22991 was designed to evaluate the addition of concomitant and adjuvant short-term hormonal treatments to curative radiotherapy in terms of disease-free survival for patients with intermediate risk localized prostate cancer. In order to assess the compliance to the 3D conformal radiotherapy protocol guidelines, all participating centres were requested to participate in a dummy run procedure. An individual case review was performed for the largest recruiting centres as well. Materials and methods: CT-data of an eligible prostate cancer patient were sent to 30 centres including a description of the clinical case. The investigator was requested to delineate the volumes of interest and to perform treatment planning according to the protocol. Thereafter, the investigators of the 12 most actively recruiting centres were requested to provide data on five randomly selected patients for an individual case review. Results: Volume delineation varied significantly between investigators. Dose constraints for organs at risk (rectum, bladder, hips) were difficult to meet. In the individual case review, no major protocol deviations were observed, but a number of dose reporting problems were documented for centres using IMRT. Conclusions: Overall, results of this quality assurance program were satisfactory. The efficacy of the combination of a dummy run procedure with an individual case review is confirmed in this study, as none of the evaluated patient files harboured a major protocol deviation. Quality assurance remains a very important tool in radiotherapy to increase the reliability of the trial results. Special attention should be given when designing quality assurance programs for more complex irradiation techniques. © 2008 Elsevier Ireland Ltd. All rights reserved. [less ▲]

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See detailEORTC-ROG expert opinion: Radiotherapy volume and treatment guidelines for neoadjuvant radiation of adenocarcinomas of the gastroesophageal junction and the stomach
Matzinger, O.; Gerber, E.; Bernstein, Z. et al

in Radiotherapy & Oncology (2009), 92(2), 164-175

Purpose: The Gastro-Intestinal Working Party of the EORTC Radiation Oncology Group (GIWP-ROG) developed guidelines for target volume definition in neoadjuvant radiation of adenocarcinomas of the ... [more ▼]

Purpose: The Gastro-Intestinal Working Party of the EORTC Radiation Oncology Group (GIWP-ROG) developed guidelines for target volume definition in neoadjuvant radiation of adenocarcinomas of the gastroesophageal junction (GEJ) and the stomach. Methods and materials: Guidelines about the definition of the clinical target volume (CTV) are based on a systematic literature review of the location and frequency of local recurrences and lymph node involvement in adenocarcinomas of the GEJ and the stomach. Therefore, MEDLINE was searched up to August 2008. Guidelines concerning prescription, planning and treatment delivery are based on a consensus between the members of the GIWP-ROG. Results: In order to support a curative resection of GEJ and gastric cancer, an individualized preoperative treatment volume based on tumour location has to include the primary tumour and the draining regional lymph nodes area. Therefore we recommend to use the 2nd English Edition of the Japanese Classification of Gastric Carcinoma of the Japanese Gastric Cancer Association which developed the concept of assigning tumours of the GEJ and the stomach to anatomically defined sub-sites corresponding respectively to a distinct lymphatic spread pattern. Conclusion: The GIWP-ROG defined guidelines for preoperative irradiation of adenocarcinomas of the GEJ and the stomach to reduce variability in the framework of future clinical trials. © 2009 Elsevier Ireland Ltd. All rights reserved. [less ▲]

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See detailLong-term follow-up reveals low toxicity of radiosurgery for vestibular schwannoma
Rutten, Isabelle; Baumert, B. G.; Seidel, Laurence ULg et al

in Radiotherapy & Oncology (2007), 82(1), 83-89

AIM: The long-term effects of radiosurgery of vestibular schwannomas were investigated in a group of consecutively treated patients. METHODS AND MATERIALS: Between 1995 and 2001, 26 patients (median age ... [more ▼]

AIM: The long-term effects of radiosurgery of vestibular schwannomas were investigated in a group of consecutively treated patients. METHODS AND MATERIALS: Between 1995 and 2001, 26 patients (median age: 67, range: 30-82) with a vestibular schwannoma were treated by Linac-based stereotactic radiosurgery (SRS). The median follow-up was 49 months (16-85 months). Only progressive tumours were treated. The median size of tumours was 18 mm (range 9-30 mm). Before SRS, 11 patients had a useful hearing (Gardner-Robertson classes 1 and 2). Single doses of 10-14 Gy were prescribed at the 80% isodose at the tumour margin. The follow-up consisted of regular imaging with MRI the first 3-6 months after the intervention, followed by additional yearly MRIs, a hearing test and a neurological examination. RESULT: The 5-year-probability of tumour control (defined as stabilization or decrease in size) was 95%. Five-year-probability of preservation of hearing and facial nerve function was 96% and 100%, respectively. Hearing was preserved in 10 out of 11 patients who had a normal or useful hearing at the time of treatment. Mild and transient trigeminal toxicity occurred in 2 (8%) patients. It appeared to be significantly correlated to the dose used (p=0.044). However, only a tendency to significance could be demonstrated in the relationship between the two factors when using the Cox analysis (hazard ratio=1.7; 95% CI: 0.7-3.9; p=0.23). CONCLUSIONS: With the doses used, our study demonstrates that SRS provides an equivalent tumour control rate when compared to surgery, as well as on a long-term basis, an excellent preservation of the facial and the acoustic nerves. Although no permanent trigeminal toxicity was observed, our data confirm that doses below 14 Gy can avoid transient dysesthesias. [less ▲]

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See detailA new technique of stereotactic permanent breast seed implantation
Jansen, Nicolas ULg; Nickers, Philippe ULg

in Radiotherapy & Oncology (2006, October), 81(Suppl. 1), 249-250

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