Quality assurance of radiotherapy for Hodgkin lymphoma

Abstract

Radiotherapy (RT) is a key modality in the treatment of Hodgkin lymphoma (HL). A better understanding of the role of RT in the management of HL is being achieved through clinical trial activities. Large cooperative groups, e.g., the German Hodgkin Study Group (GHSG) or the European Organization for Research and Treatment of Cancer (EORTC), established extensive quality assurance programs within their multicenter trials. The GHSG HD4 trial demonstrated the importance of this. Major protocol violations, with particular reference to the design of the radiation fields, were associated with a statistically significant reduction in freedom from treatment failure. The quality control program in this trial was of retrospective manner post treatment and highlighted two key factors. (1) the need for a real-time quality control program which could influence the actual delivery of treatment and (2) a close cooperation between diagnostic radiology and radiotherapy to use all imaging information for an optimal design of the individual radiotherapy treatment plan as required by the protocol prescriptions. Therefore, new radiotherapy quality assurance programs were initiated including a telemedicine facility using IT-based communication infrastructure for imaging transfer at the Cologne radiotherapy reference center. © 2011 Springer-Verlag Berlin Heidelberg.