Hearing what isn't said.
The Study: Of course, we all practice at the Best Cancer Center Ever (BCCE, pronounced “beeshee”), and that’s usually within a tight bubble. While we do our best at QuadShot to include radiation details in practice-changing trials, many authors fail to report important nuances of how they plan their treatments. This study investigates the effect of a targeted treatment planning intervention to improve the collective quality of head and neck treatment plans in the Netherlands. They started with a challenging node(+) tonsillar cancer case and asked each of 15 centers to provide optimal treatment plans. While targets were uniformly covered, there was significant variation in organ-at-risk (OAR) dosimetry due to variation in approaches. The anonymized plans from each center were then sent out to all the centers to evaluate. In fact, the paper includes a nice list of treatment planning pearls from what were deemed the best of the BCCE’s who provided the most optimal plans. This resulted in a significant reduction not only in variation across centers but also in OAR doses at large, and this was maintained years after the intervention with intermittent benchmarking.
TBL: A targeted intervention to benchmark radiation treatment plans and share planning knowledge across centers resulted in reduced variation and improved absolute OAR dosimetry. | Verbakel, Int J Radiat Oncol Biol Phys 2019