RTOG 73-01 and RTOG 0617 established 60 Gray (Gy) in 30 daily fractions over six weeks as the optimal radiotherapy dose and fractionation for the radical treatment of locally advanced non-small cell lung cancer. RTOG 0617 randomised between standard dose 60 Gy and high-dose 74 Gy; survival detriment was noted in the 74 Gy arm, however only half of the cohort received radiation with modern delivery techniques and the impact of unwanted radiation dose to the heart and unintended mediastinal structures remains under investigation. Technological advances now enable radiotherapy dose delivery to the target beyond 60Gy with scope for dose intensification and sparing of the organs at risk. Accurate radiotherapy delivery is a multi-faceted process, and in the United Kingdom, the National Radiotherapy Trials Quality Assurance (RTTQA) Group provides radiotherapy quality assurance (QA) for all National Institute of Health Research Clinical Research Network (NIHR CRN) portfolio studies which involve a radiotherapy component. A key aim of the RTTQA Group is to standardise radiotherapy delivery and reporting across clinical trials. This thesis aims to review the variability in radical lung cancer radiotherapy processes and proposes standardisation of radiotherapy QA processes with a focus on the radical treatment of lung cancer.
|Date of Award||1 Aug 2023|
- The University of Manchester
|Supervisor||Corinne Faivre-Finn (Supervisor) & Peter Hoskin (Supervisor)|
- quality assurance