TY - JOUR
T1 - Transparency in quality of radiotherapy for breast cancer in the Netherlands
T2 - a national registration of radiotherapy-parameters
AU - Maliko, Nansi
AU - Stam, Marcel R.
AU - Boersma, Liesbeth J.
AU - Vrancken Peeters, Marie-Jeanne T. F. D.
AU - Wouters, Michel W. J. M.
AU - KleinJan, Eline
AU - Mulder, Maurice
AU - Essers, Marion
AU - Hurkmans, Coen W.
AU - Bijker, Nina
N1 - Funding Information: The creation of NBCA-R was funded by a grant from Quality foundation of the Dutch Federation of Medical Specialists (SKMS) []. Funding Information: H.J.G.D. van den Bongard, MD, PhD: Department of Radiation Oncology, AmsterdamUMC, Amsterdam, The Netherlands. J. H. Maduro, MD PhD: Department of Radiation Oncology, Universitair Medisch Centrum Groningen, The Netherlands. Nicola Russell, MD PhD: Department of Radiation Oncology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Amsterdam, The Netherlands. E.J. Bantema-Joppe, MD PhD: Radiotherapeutisch Instituut Friesland, Leeuwarden, The Netherlands. A.G. Zwanenburg, MD: Department of Radiation Oncology, Isala Klinieken, Zwolle, The Netherlands. B. Wachters, MD: Zuidwest Radiotherapeutisch Instituut?Vlissingen, The Netherlands. H.P. Knol, MD: Department of Radiation Oncology, Noord-West Ziekenhuisgroep Alkmaar, The Netherlands Publisher Copyright: © 2022, The Author(s).
PY - 2022/12/1
Y1 - 2022/12/1
N2 - Background: Radiotherapy (RT) is part of the curative treatment of approximately 70% of breast cancer (BC) patients. Wide practice variation has been reported in RT dose, fractionation and its treatment planning for BC. To decrease this practice variation, it is essential to first gain insight into the current variation in RT treatment between institutes. This paper describes the development of the NABON Breast Cancer Audit-Radiotherapy (NBCA-R), a structural nationwide registry of BC RT data of all BC patients treated with at least surgery and RT. Methods: A working group consisting of representatives of the BC Platform of the Dutch Radiotherapy Society selected a set of dose volume parameters deemed to be surrogate outcome parameters, both for tumour control and toxicity. Two pilot studies were carried out in six RT institutes. In the first pilot study, data were manually entered into a secured web-based system. In the second pilot study, an automatic Digital Imaging and Communications in Medicine (DICOM) RT upload module was created and tested. Results: The NBCA-R dataset was created by selecting RT parameters describing given dose, target volumes, coverage and homogeneity, and dose to organs at risk (OAR). Entering the data was made mandatory for all Dutch RT departments. In the first pilot study (N = 1093), quite some variation was already detected. Application of partial breast irradiation varied from 0 to 17% between the 6 institutes and boost to the tumour bed from 26.5 to 70.2%. For patients treated to the left breast or chest wall only, the average mean heart dose (MHD) varied from 0.80 to 1.82 Gy; for patients treated to the breast/chest wall only, the average mean lung dose (MLD) varied from 2.06 to 3.3 Gy. In the second pilot study 6 departments implemented the DICOM-RT upload module in daily practice. Anonymised data will be available for researchers via a FAIR (Findable, Accessible, Interoperable, Reusable) framework. Conclusions: We have developed a set of RT parameters and implemented registration for all Dutch BC patients. With the use of an automated upload module registration burden will be minimized. Based on the data in the NBCA-R analyses of the practice variation will be done, with the ultimate aim to improve quality of BC RT. Trial registration Retrospectively registered.
AB - Background: Radiotherapy (RT) is part of the curative treatment of approximately 70% of breast cancer (BC) patients. Wide practice variation has been reported in RT dose, fractionation and its treatment planning for BC. To decrease this practice variation, it is essential to first gain insight into the current variation in RT treatment between institutes. This paper describes the development of the NABON Breast Cancer Audit-Radiotherapy (NBCA-R), a structural nationwide registry of BC RT data of all BC patients treated with at least surgery and RT. Methods: A working group consisting of representatives of the BC Platform of the Dutch Radiotherapy Society selected a set of dose volume parameters deemed to be surrogate outcome parameters, both for tumour control and toxicity. Two pilot studies were carried out in six RT institutes. In the first pilot study, data were manually entered into a secured web-based system. In the second pilot study, an automatic Digital Imaging and Communications in Medicine (DICOM) RT upload module was created and tested. Results: The NBCA-R dataset was created by selecting RT parameters describing given dose, target volumes, coverage and homogeneity, and dose to organs at risk (OAR). Entering the data was made mandatory for all Dutch RT departments. In the first pilot study (N = 1093), quite some variation was already detected. Application of partial breast irradiation varied from 0 to 17% between the 6 institutes and boost to the tumour bed from 26.5 to 70.2%. For patients treated to the left breast or chest wall only, the average mean heart dose (MHD) varied from 0.80 to 1.82 Gy; for patients treated to the breast/chest wall only, the average mean lung dose (MLD) varied from 2.06 to 3.3 Gy. In the second pilot study 6 departments implemented the DICOM-RT upload module in daily practice. Anonymised data will be available for researchers via a FAIR (Findable, Accessible, Interoperable, Reusable) framework. Conclusions: We have developed a set of RT parameters and implemented registration for all Dutch BC patients. With the use of an automated upload module registration burden will be minimized. Based on the data in the NBCA-R analyses of the practice variation will be done, with the ultimate aim to improve quality of BC RT. Trial registration Retrospectively registered.
KW - Breast cancer
KW - NABON Breast Cancer Audit
KW - National clinical audit
KW - Quality of care
KW - Radiotherapy
UR - http://www.scopus.com/inward/record.url?scp=85128114384&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s13014-022-02043-0
DO - https://doi.org/10.1186/s13014-022-02043-0
M3 - Article
C2 - 35413924
SN - 1748-717X
VL - 17
JO - Radiation oncology (London, England)
JF - Radiation oncology (London, England)
IS - 1
M1 - 73
ER -