An on-site audit system for dosimetry credentialing of intensity-modulated radiotherapy in Japanese Clinical Oncology Group (JCOG) clinical trials

Phys Med. 2016 Aug;32(8):987-91. doi: 10.1016/j.ejmp.2016.07.002. Epub 2016 Jul 9.

Abstract

Purpose: This study was undertaken to analyze the results of intensity-modulated radiotherapy (IMRT) dosimetry credentialing using a phantom in the Japanese Clinical Oncology Group clinical trials.

Methods: All measurements were performed on-site. The IMRT phantom consisted of a phantom shell and a module. Two types of structures, including a C-shaped planning target volume (PTV) around a column-shaped organ at risk (OAR), were included in the module. Each participating institution was asked to image, plan, and treat the phantom. A prescription dose of 2Gy should cover 95% of the PTV. The plan should limit the maximum doses to the PTV and OAR to less than 110% and 60%, respectively. The pass criteria were ±3% in terms of chamber dosimetry and a difference in profile position ⩽2mm in the high-dose gradient area of film dosimetry. The positional difference was defined as the largest distance between the measured and calculated positions at doses of 60% or 80%. These tolerances were based on the Japanese Society for Radiation Oncology IMRT guidelines.

Results: Credentialing was performed on a total of 44 treatment machines in 32 institutions from 2009 to 2015. All differences between measured and planned doses at the measurement points of the PTV were within 3%. The means±standard deviations of the positional differences were 1.0±0.4mm and 0.9±0.3mm without and with the phantom shell, respectively.

Conclusions: The dose differences and positional differences met the desired criteria in all institutions.

Keywords: IMRT/VMAT; Multi-institutional clinical trials; On-site dosimetry credentialing.

MeSH terms

  • Clinical Audit*
  • Clinical Trials as Topic*
  • Credentialing*
  • Humans
  • Japan
  • Medical Oncology*
  • Organs at Risk / radiation effects
  • Phantoms, Imaging
  • Radiometry / standards*
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy, Intensity-Modulated / adverse effects
  • Radiotherapy, Intensity-Modulated / standards*