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ESTRO-Qualitätsfragebogen
Das
folgende Anschreiben bezieht sich auf dem ERSTO-Qualitätsfragebogen.
Ein ausgeülltes Muster finden Sie HIER
(zum Speichern: rechts-Klick - > Speichern unter...)
The
following covering letter refers
to the ESTRO-Qualityquestionnaire. For additional help you will find a
filled in example HERE (for download:
right-click -> save target as...)
Dear
Colleague,
as
you know, the aim of the ESTRO ESQUIRE PROJECT (Education,
Science and QUality Assurance
for Radiotherapy) is to increase the confidence level
of clinicians for embracing optimised RT treatment regimes by making sure
they can be achieved without an increase in severe side effects. Actions
proposed for this purpose: monitoring the accuracy of the dose (Task 1:EQUAL)
and the side effects (Task 2: REACT), by stepping up education for the
implementation of new technology (Task 3: EDRO) by developing quality
assurance procedures for optimised RT (Task 4: QUASIMODO) and brachytherapy
(interstitial and intracavitary treatment) (Task 6: BRAPHYQS), and establishing
a procedure-based surveillance of quality in treatment and research (Task
5: EPOQART).
The Task 6 of the ESQUIRE Project (BRAPHYQS) concerns the investigation
of methods for improving QA in Brachytherapy (the use of radioactive implants
as opposed to external beam radiotherapy). QA procedures in different
countries in Europe have been analysed and European guidelines issued
to be published as a new issue in a series of ESTRO Physics booklets.
A method for a mailed QC system has been developed for checking both dosimetric
and geometric accuracy in brachytherapy departments.
There is now a project about the future of Braphyqs, strongly supported
from the ESTRO Board to continue.
In the treatment of prostate cancer, there is a wide interest in the scientific
community in the role of transperineal interstitial permanent prostate
brachytherapy (TIPPB), a technique which has been recognized to be a good
alternative to radical prostatectomy as well as to conformal radiotherapy
in patients with clinically localised carcinoma. The need to establish
a common language and to update the guidelines for TIPPB is now highly
felt in the European community. The purpose for the new project is to
develop a quality assurance tool which should help the different centres
to understand whether their methodology is reasonably accurate and if
their own results can be compared with those of other centres. Phantoms
will be used to check the reconstruction algorithms and real-patient images
used to check both the skill of the individual physicist to locate seeds
and the skill of the individual radiation oncologist to draw contours.
There is also the intent to draw guidelines for prostate treatment planning
including target definition, imaging and reporting of treatment parameters
so that multi-centric studies can yield valid results and to update the
ESTRO/EAU/EORTC recommendations for TIPPB.
A first step will be a survey of the treatment planning systems (TPSs)
currently in use in the EU and the variants of the planning and implantation
techniques, in order to get a “photograph” of the current
status of the practice of prostate brachytherapy in the European community.
This survey will represent the basis for the developing project
For
this reason, you are kindly asked to fill in the questionnaire enclosed
and to send it back before the end of April 2004 to the following e-mail
address siebert@onco.uni-kiel.de or fax n° 0431/597-3110
Please do not hesitate to contact Dr. F.-A. Siebert to receive further
information
Thank
you in advance for your collaboration
Filling
in Instruction
Fill
in the grey cells, please do not mind about the dimension of the cells
“hospital”
sheet:
Insert the name and the address of the hospital/clinic and the name, the
e-mail address, the telephone and fax number of the corresponding persons.
Insert the name and the version of the Treatment Planning System used
during the planning and the evaluation of the treatment
“dosimetric
data” sheet:
You can find a list of the brachytherapy source commonly available in
EU (both I-125 and Pd-103). For each source used routinely in your centre,
please insert the dosimetrical data/functions used in your TPS for dose
calculation. If the source used routinely in your centre is not mentioned
in the list, please indicate the manufacturer and the model of the source
in the Name source type cells.
Anisotropy function factors (values) = please, indicate the factors
as couples, i.e. (distance-cm;factor),(1.00;0.9680),(2.00;0.9280)………..
“planning”
sheet:
Insert the procedures used routinely in your centre.
DVH file = if it is possible to export the data of the DVH in
a file (.ASCI, .XLS, .TXT, …..)
DVH step at choice : if it is possible to choose the increment
of the rows in the table of the DVH data
For the “planning procedure” (row 32), please remind
the definitions from "Intraoperative planning and evaluation of permanent
prostate brachytherapy: report of the American Brachytherapy Society"
Int J Radiat Oncol Biol Phys. 2001 Dec 1;51(5):1422-30
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Preplanning--Creation
of a plan a few days or weeks before the implant procedure. Intraoperative
planning--Treatment planning in the operating room (OR):
the patient and transrectal ultrasound probe are not moved between
the volume study and the seed insertion procedure. |
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Intraoperative
preplanning--Creation of a plan in the OR just before the
implant procedure, with immediate execution of the plan.
Interactive planning--Stepwise refinement of the treatment
plan using computerized dose calculations derived from image-based
needle position feedback.
Dynamic dose calculation--Constant updating of dose
distribution calculations using continuous deposited seed position
feedback |
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Time
(duration) = time to complete the planning or the volume study
CTV/PTV (definition) = what do you intend as CTV and PTV (for
example, CTV is the pre-implant definition of the prostate gland and the
PTV is an enlargement of the CTV)
CTV margin = margin between the CTV and the PTV
Dosimetrical constraints = the dosimetrical constraints used routinely
during the planning (for example for the CTV, V100 > 100%). Please
remind that Dn is the calculated dose administered to
n percent of the target/organ at risk and Vn is the volume (%) of the
target/organ at risk that receives n percentage of the prescription dose
Prescription Dose = the dose that the oncologist intends to deliver
to the target
“implant
sheet”:
Insert the procedures used routinely in your centre.
Type of anesthesia = if patient dependent, please indicate also
the most frequently used
Implant duration = time to complete the implant (from the first
needle to the last one or to the eventual cystoscopy)
Type of implant = indicate the technique to guide the needle
insertion
US equipment = indicate the model and the manufacturer of the
US equipment
Stepper unit = indicate the model and the manufacturer of the
US equipment; answer yes or no depending of the characteristics of the
unit. Specify whether it is placed on a table or stabilized on the floor
Fixation needles = answer yes or no depending of the use of fixation
needles during the implant
Radioprotection = indicate if the level of radioactivity is measured
at the end of the implant close to the patient, in the OR (to find any
lost seeds) or if only the number of remaining seeds is checked
Calibration seed checking = answer yes or no depending of the calibration
seed checking is always performed or never
“evaluation”
sheet:
Insert the procedures used routinely in your centre
…..availability-use = indicate if there is the availability
and if you use it in two separated column (C and D)
Dosimetrical parameters = the dosimetrical parameters you collect
and analyse after the post-plan. Please remind that Dn is the calculated
dose administered to n percent of the target/organ at risk and Vn is the
volume (%) of the target/organ at risk that receives n percentage of the
prescription dose.
Implant evaluation = indicate your dosimetrical parameter limits
to judge an implant as adequate, acceptable or inadequate.
In case of an inadequate implant = indicate how you manage a
patient with an inadequate implant
Post-plan timing = time between the implant and the post-plan
scan
“personnel”
sheet:
Insert “yes” or “x” in the column of the corresponding
operator involved in each specific procedure
“patient
selection” sheet:
indication for seminal vesicles biopsies &/or lymph node staging:
indicate the prognostic factors (decision tree) and thresholds that determine
their indication
selection criteria for the association of hormonal therapy: timing:
in relationship with the implant
“follow-up”
sheet
most common therapy/ies for urinary or rectal symptoms: please
feel free to include your estimate of the efficacy of the symptomatic
treatments that you usually recommend
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