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Randomized Controlled Trial
. 2012 Sep;85(1017):e647-53.
doi: 10.1259/bjr/32249628. Epub 2012 Jan 31.

Quality assurance analysis of participating centres' protocol compliance to a UK multicentre hypofractionated breast (FAST) trial

Y Tsang  1 , K Venables, J Yarnold; FAST Trial Management Group
Collaborators, Affiliations
Randomized Controlled Trial

Quality assurance analysis of participating centres' protocol compliance to a UK multicentre hypofractionated breast (FAST) trial

Y Tsang et al. Br J Radiol. 2012 Sep.

Abstract

Objectives: The FAST (FASTer radiotherapy for breast radiotherapy) trial is a UK Phase 2 multicentre randomised clinical trial evaluating a five-fraction schedule of whole-breast radiotherapy following local excision of early breast cancer. The purpose of this quality assurance study was to analyse the radiotherapy planning data in order to confirm compliance with the trial protocol.

Methods: 915 patients were recruited between 2004 and 2007 from 18 centres. The protocol required that all centres should use three-dimensional dose compensations to optimise radiotherapy plans. Planning techniques, maximum dose (D(max)) and dose-volume histograms from treatment plans were evaluated and compared between centres. The homogeneity of plans was tested by creating a cut-off value of 5% for the percentage of breast volume receiving >105% of the prescribed dose.

Results: 672 data sets from 15 centres were available. 93% (624/672) of plans were treated using forward-planned multileaf collimator (MLC) segments, 6% with breast compensators and 1% with inverse-planned MLC segments. 94% (635/672) of patients had a D(max)≤107% of the prescribed dose. 11% (74/672) of plans delivered >105% of the prescribed dose to >5% of the breast volume.

Conclusion: Reviewing the data in this study, 95% of plans submitted by centres complied with the protocol. With the improved breast radiotherapy standards shown in FAST centres, the following recommendations were suggested for future UK breast radiotherapy trials: (i) the minimum, mean and maximum dose to the whole-breast planning target volume (PTV) should be recorded and assessed; (ii) apart from having a D(max)≤107% of the prescribed dose, ≤5% of PTV should a receive dose >105% of the prescription dose.

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Figures

Figure 1
Figure 1
Illustration of a breast CT slice planned with two tangential treatment fields.
Figure 2
Figure 2
Maximum dose (Dmax) distribution for all plans.
Figure 3
Figure 3
Maximum dose (Dmax) distributions according to centre.
Figure 4
Figure 4
Normalised mean differential dose–volume histogram (DVH) plot for the 14 centres.
See this image and copyright information in PMC

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References

    1. Yarnold J, Ashton A, Bliss J, Homewood J, Harper C, Hanson J, et al. Fractionation sensitivity and dose response of late adverse effects in the breast after radiotherapy for early breast cancer: long-term results of a randomised trial. Radiother Oncol 2005;75:9–17 - PubMed
    1. Owen JR, Ashton A, Bliss J, Homewood J, Harper C, Hanson J, et al. Effect of radiotherapy fraction size on tumour control in patients with early-stage breast cancer after local tumour excision: long-term results of a randomised trial. Lancet Oncol 2006;7:467–71 - PubMed
    1. START Trialists' Group The UK standardisation of breast radiotherapy (START) trial A of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet Oncol 2008;9:331–41 - PMC - PubMed
    1. The START Trialists' Group The UK standardisation of breast radiotherapy (START) trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet 2008;371:1098–107 - PMC - PubMed
    1. Whelan TJ, Pignol JP, Levine MN, Julian JA, MacKenzie R, Parpia S, et al. Long-term results of hypofractionated radiation therapy for breast cancer. N Engl J Med 2010;362:513–20 - PubMed

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