Report dose-to-medium in clinical trials where available; a consensus from the Global Harmonisation Group to maximize consistency

Stephen F Kry; Jessica Lye; Catharine H Clark; Nicolaus Andratschke; Alexis Dimitriadis; David Followill; Rebecca Howell; Mohammad Hussein; Masayori Ishikawa; Satoshi Kito; Tomas Kron; Jonny Lee; Jeff Michalski; Angelo Filippo Monti; Nick Reynaert; Paige Taylor; Karen Venables; Ying Xiao; Joerg Lehmann

doi:10.1016/j.radonc.2021.03.006

Report dose-to-medium in clinical trials where available; a consensus from the Global Harmonisation Group to maximize consistency

Radiother Oncol. 2021 Jun:159:106-111. doi: 10.1016/j.radonc.2021.03.006. Epub 2021 Mar 17.

Authors

Stephen F Kry¹, Jessica Lye², Catharine H Clark³, Nicolaus Andratschke⁴, Alexis Dimitriadis⁵, David Followill⁶, Rebecca Howell⁷, Mohammad Hussein⁸, Masayori Ishikawa⁹, Satoshi Kito¹⁰, Tomas Kron¹¹, Jonny Lee¹², Jeff Michalski¹³, Angelo Filippo Monti¹⁴, Nick Reynaert¹⁵, Paige Taylor⁶, Karen Venables¹², Ying Xiao¹⁶, Joerg Lehmann¹⁷

Affiliations

¹ Imaging and Radiation Oncology Core, The University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: [email protected].
² Australian Clinical Dosimetry Service, Australian Radiation Protection and Nuclear Safety Agency, Melbourne, Australia; Olivia Newton-John Cancer Research and Wellness Centre, Melbourne, Australia.
³ NIHR Radiotherapy Trials Quality Assurance Group, University College London Hospital, University College London, National Physical Laboratory, UK.
⁴ European Organisation for Research and Treatment of Cancer Radiotherapy Quality Assurance Group, University Hospital of Zurich, University of Zurich, Switzerland.
⁵ Dosimetry and Medical Radiation Physics Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria.
⁶ Imaging and Radiation Oncology Core, The University of Texas MD Anderson Cancer Center, Houston, USA.
⁷ Radiation Dosimetry Services, The University of Texas MD Anderson Cancer Center, Houston, USA.
⁸ National Physical Laboratory, UK.
⁹ Japan Clinical Oncology Group, Faculty of Health Sciences, Hokkaido University, Japan.
¹⁰ Japan Clinical Oncology Group, Department of Radiation Oncology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Japan.
¹¹ Trans Tasman Radiation Oncology Group (TROG), Newcastle, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia.
¹² NIHR Radiotherapy Trials Quality Assurance Group, Mount Vernon Cancer Centre, Northwood, UK.
¹³ Imaging and Radiation Oncology Core, Washington University School of Medicine, St. Louis, USA.
¹⁴ European Organisation for Research and Treatment of Cancer (EORTC), Department of Medical Physics, ASST GOM Niguarda Hospital, Milan, Italy.
¹⁵ European Organisation for Research and Treatment of Cancer, Medical Physics Department, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium.
¹⁶ Imaging and Radiation Oncology Core, University of Pennsylvania, Philadelphia, USA.
¹⁷ Trans Tasman Radiation Oncology Group (TROG), Newcastle, Australia; Radiation Oncology Department, Calvary Mater Newcastle, Australia; School of Mathematical and Physical Sciences, University of Newcastle, Australia; Institute of Medical Physics, University of Sydney, Australia.

PMID: 33741471
DOI: 10.1016/j.radonc.2021.03.006

Abstract

Purpose: To promote consistency in clinical trials by recommending a uniform framework as it relates to radiation transport and dose calculation in water versus in medium.

Methods: The Global Quality Assurance of Radiation Therapy Clinical Trials Harmonisation Group (GHG; www.rtqaharmonization.org) compared the differences between dose to water in water (D_w,w), dose to water in medium (D_w,m), and dose to medium in medium (D_m,m). This was done based on a review of historical frameworks, existing literature and standards, clinical issues in the context of clinical trials, and the trajectory of radiation dose calculations. Based on these factors, recommendations were developed.

Results: No framework was found to be ideal or perfect given the history, complexity, and current status of radiation therapy. Nevertheless, based on the evidence available, the GHG established a recommendation preferring dose to medium in medium (D_m,m).

Conclusions: Dose to medium in medium (D_m,m) is the preferred dose calculation and reporting framework. If an institution's planning system can only calculate dose to water in water (D_w,w), this is acceptable.

Keywords: Clinical trial; Dose calculation; Dose to medium, Dose to water; GHG; Radiation dosage.

Publication types

Review

MeSH terms

Consensus
Humans
Monte Carlo Method
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted*
Water*

Substances

Water