BERKELEY, CA (UroToday.com) - Image Guided Radiation Therapy (IGRT) is now considered ‘best practice’ in the delivery of prostate radiation therapy.
It involves sophisticated high quality imaging equipment within the radiotherapy treatment room to image the prostate daily prior to treatment, analyse the image, diagnose any field placement errors and intervene if required. Any prostate radiotherapy clinical trial would now have most participating sites utilising IGRT, which adds a layer of complexity to credentialing sites and assuring the quality of IGRT and clinical trials.
The participating sites in the 08.01 PROFIT study represented a cross-section of Australian radiation therapy. Included were large metropolitan sites, regional sites, single linear accelerator sites and both public and private facilities. Additional to this was that there was different equipment at each site and differing experiences with IGRT. Quality assurance (QA) is paramount to the multi-disciplinary radiation oncology team (MDT) and it is recognised that the QA of IGRT is in its infancy within clinical trials. The aim of this study was to illustrate that within a clinical trial across multiple sites QA of IGRT could be undertaken and undertaken successfully if robust checks and balances were applied.
The site credentialing team was tasked with creating a streamlined, effective IGRT QA assessment method. By applying department-centric QA methodologies and broadening their scope, an assessment of IGRT quality was developed that would standardise the approach across all sites. Within the context of a clinical trial this represents a vital starting point which will allow further improvements in IGRT QA.
An interesting observation from our work is that Australian radiation therapists, regardless of site, experience, or imaging modality were able to consistently diagnose field placement error. This is particularly encouraging and illustrates the structured, measured uptake of IGRT across Australia.
IGRT is a vital component in prostate radiation therapy and as such demands similar QA initiatives to dosimetric innovations such as Intensity Modulated Radiation Therapy (IMRT). With careful, diligent planning by the radiation oncology MDT, QA of IGRT can be successfully undertaken both departmentally and in the broader context of a multi-site clinical trial.
Written by:
Mark Middleton, B.App.Sc., Grad. Dip. VET, MBA, FIR as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
UroToday.com Prostate Cancer Section