随机丹麦乳腺癌组Skagen试验中2705个治疗方案的质量评估

IF 5.3 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology Pub Date : 2025-09-15 DOI:10.1016/j.radonc.2025.111142

M.S. Thomsen , E.L. Lorenzen , J. Alsner , S.L. Krogh , E.S. Yates , M. Berg , K.I. Dybvik , K. Boye , C. Kirkove , I. Jensen , M.M.B. Nielsen , V. Tømmerås , P. Schilling , S. Makocki , M.P. Hasler , K. Andersen , L. Stick , M.-B. Jensen , B.V. Offersen , on behalf of the DBCG RT Committee

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引用次数: 0

摘要

目的：基于前瞻性上传的治疗方案，对DBCG Skagen试验1中的放射治疗（RT）进行全面分析。方法：2015年至2021年，2963例乳腺癌患者在保乳手术（BCS）或乳房切除术后进行辅助局部区域乳腺癌放疗，随机分为50 Gy/25组和40 Gy/15组。肿瘤床强化为同步整合强化（SIB）。所描绘的结构体积符合ESTRO指南。剂量学数据来自个体治疗方案。结果：分析了来自4个国家14个中心的2705名患者的RT治疗计划，对应于每个方案患者的94% %。总的来说，1407人有BCS， 1298人有乳房切除术，437人有SIB。随机化是平衡的：1329(50 Gy) vs 1376（40 Gy）。根据ESTRO指南，所有平面图都有目标体积描述。在描述的体积和每个随机化组的中心间变化方面没有观察到显著差异。对方案约束的依从性普遍较高，然而，与40 Gy计划相比，50 Gy计划中的“热点”剂量依从性更高，因为40 Gy组的高剂量限制更严格。每个随机分组组的最小目标容量覆盖率相似。83%（ %）患者采用呼吸门控技术。当按侧边性和呼吸技术划分亚组时，与有门控计划相比，无门控计划检测到明显更高的肺和心脏剂量。结论：DBCG Skagen试验1记录了高度的方案依从性。在两个随机分组的治疗方案中没有观察到差异。

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Quality assessment of 2705 treatment plans in the randomised Danish Breast Cancer Group Skagen trial 1

Purpose

Based on prospectively uploaded treatment plans, a comprehensive analysis of the radiation therapy (RT) in the DBCG Skagen trial 1 is presented.

Methods

From 2015 to 2021, 2963 breast cancer patients referred to adjuvant locoregional breast cancer RT after breast conserving surgery (BCS) or mastectomy were randomised to 50 Gy/25 fractions versus 40 Gy/15 fractions. Tumour-bed boost was simultaneous integrated boost (SIB). Delineated structure volumes were per ESTRO guidelines. Dosimetric data were obtained from the individual treatment plans.

Results

RT treatment plans from 2705 patients treated at 14 centres in 4 countries were analysed corresponding to 94 % of the per protocol patients. Overall, 1407 had BCS, 1298 had mastectomy, and 437 had SIB. The randomisation was balanced: 1329 (50 Gy) versus 1376 (40 Gy). All plans had target volume delineations per ESTRO guidelines. No significant differences were observed regarding delineated volumes nor regarding inter-centre variations per randomisation arm. Compliance to protocol constraints was generally high, however, the “hot-spot” dose compliance was higher in 50 Gy plans compared to 40 Gy plans due to stricter high dose constraints for the 40 Gy arm. The minimum coverage of target volumes was similar per randomisation arms. Respiratory gating technique was used in 83 % of the patients. When divided into subgroups per laterality and breathing technique, significantly higher lung and heart doses were detected in non-gated compared to gated plans.

Conclusion

A high degree of protocol compliance was documented in the DBCG Skagen trial 1. No differences were observed among the treatment plans in the two randomisation arms.

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来源期刊

Radiotherapy and Oncology 医学-核医学

CiteScore

10.30

自引率

10.50%

发文量

2445

审稿时长

45 days

期刊介绍： Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.