Eaton, David J;
Brand, Douglas H;
Hava, Natasha;
Harrison, Mark;
Lopes, Andre;
Manoharan, Prakash;
Radhakrishna, Ganesh;
... Hawkins, Maria A; + view all
(2025)
Radiotherapy plan quality assurance in the ABC-07 trial of stereotactic body radiotherapy (SBRT) for locally advanced biliary tract cancer.
Clinical Oncology
, Article 103993. 10.1016/j.clon.2025.103993.
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Abstract
Purpose The ABC-07 phase II randomised controlled trial (ISRCTN: 10639376) investigated the addition of stereotactic body radiotherapy (SBRT) to systemic chemotherapy in locally advanced biliary tract cancers. We report the radiotherapy quality assurance (RTQA) of SBRT treatment plans in the trial. Methods and Materials RTQA was performed before and during accrual, including benchmark contouring and planning cases, along with prospective independent case review (ICR) of the first three patients from each centre randomised to SBRT. Prescription doses were up to 50Gy in 5 fractions or up to 67.5Gy in 15 fractions. Cases were reviewed for segmentation accuracy and plan quality, including target coverage and organ at risk (OAR) constraints met. Results Benchmark cases: 6/17 contouring submissions required revision (35%), and 6/17 planning submissions were revised after feedback on what was achievable by other centres. Prospective ICR: 31/41 cases from all 12 recruiting centres that were randomised to SBRT underwent review in real-time, and the others were reviewed retrospectively. Eight of these prospectively reviewed cases required revisions during the review process (26%, including 7 contouring and 2 planning revisions). 19/41 plans overall (46%) had deviations from trial protocol objectives (even after any revisions), mostly unavoidable target coverage compromise (D95%<90%) because of proximal OARs such as duodenum (17/41) and stomach (6/41). Conclusions Despite rigorous plan QA we encountered variability in segmentation, and plan coverage. Revision rate was reduced between pre-trial and on-trial cases. Radiotherapy doses in the protocol were achievable in many cases, however target coverage was frequently compromised to maintain OAR dose constraints. Such compromises should be prespecified in future studies.
| Type: | Article |
|---|---|
| Title: | Radiotherapy plan quality assurance in the ABC-07 trial of stereotactic body radiotherapy (SBRT) for locally advanced biliary tract cancer |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.clon.2025.103993 |
| Publisher version: | https://doi.org/10.1016/j.clon.2025.103993 |
| Language: | English |
| Additional information: | © 2025 Published by Elsevier Ltd on behalf of The Royal College of Radiologists. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 license (unless stated otherwise) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/ |
| Keywords: | SBRT, radiotherapy planning, biliary tract cancer, plan conformity |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > CRUK Cancer Trials Centre |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10218832 |
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