| 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 |
