2022 AAPM 64th Annual Meeting
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Session Title: Proton Therapy in Clinical Trials
Question 1: How are patients selected for NHS PBT treatment?
Reference:Neil G Burnet, Ranald I Mackay, Ed Smith, Amy L Chadwick, Gillian A Whitfield, David J Thomson, Matthew Lowe, Norman F Kirkby, Adrian M Crellin and Karen J Kirkby, Proton beam therapy: perspectives on the National Health Service England clinical service and research programme, Br J Radiol. 2020 Mar;93(1107):20190873
Choice A:Insurance cover
Choice B:Indications list
Choice C:Clinician recommendation
Choice D:Direct referral to PBT centre
Question 2: Which of the following is a disadvantage of a model-based approach to patient selection?
Reference:National Cancer Research Institute Clinical and Translational Radiotherapy Research Working Group (CTRad) Proton Beam Clinical Trial Strategy Group, Proton Beam Therapy the Challenges of Delivering High-quality Evidence of Clinical Benefit. Clinical Oncology 30 (2018) 280-284
Choice A:Comparative treatment plans are created for photons and protons
Choice B:Machine resources are allocated based on model predictions
Choice C:Appropriate Normal Tissue Complication Probability (NTCP) models are required
Choice D:Changes to selection criteria can be implemented quickly
Question 3: Which of these measures will not help to avoid bias in proton vs photon trials?
Reference:J. Price *, E. Hall y, C. West z, D. Thomson TORPEdO e A Phase III Trial of Intensity-modulated Proton Beam Therapy Versus Intensity-modulated Radiotherapy for Multi-toxicity Reduction in Oropharyngeal Cancer Clinical Oncology, Volume 32, Issue 2, February 2020, Pages 84-88
Choice A:Centralised randomization, stratified for patient- and tumour-specific factors
Choice B:Centre by centre randomisation
Choice C:Prospective quality assurance of radiotherapy volume delineation and treatment planning
Choice D:Identical organ-at-risk plan optimisation prioritisation parameters for proton and photon plans
Question 4: IROC on-site proton center audits for trial credentialling do NOT include:
Reference:Taylor PA, Lowenstein J, Followill D, Kry SF. The Value of On-Site Proton Audits. Int J Radiat Oncol Biol Phys. 2022 Mar 15;112(4):1004-1011. doi: 10.1016/j.ijrobp.2021.10.145
Choice A:Dose measurements
Choice B:QA program review
Choice C:Contour and plan quality evaluation
Choice D:Clinical practice review
Question 5: Robustness evaluation based on error-scenario dose calculation is routinely used for:
Reference:Yock AD, Mohan R, Flampouri S, et al. Robustness analysis for external beam radiation therapy treatment plans: describing uncertainty scenarios and reporting their dosimetric consequences. Pract Radiat Oncol. 2019;9(4):200-207.https://doi.org/10.1016/J.PRRO.2018.12.002
Choice A:All external radiotherapy modalities
Choice B:Proton plans delivered with pencil beam scanning
Choice C:Proton plans delivered with passive scattering
Choice D:Photon plans
Question 6: Current NCI guidelines for use of protons in clinical trials do NOT include:
Reference:National Cancer Institute. Guidelines for the use of hadron radiation therapy in NCI-sponsored cooperative group clinical trials. Available at: http://irochouston.mdanderson.org/RPC/home_page/Proton_guidelines.htm
Choice A:Monte Carlo dose calculation for heterogenous sites
Choice B:Participation of a proton medical physicist in protocol development
Choice C:Error-scenario based robustness evaluation
Choice D:4D dose calculation for moving targets
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