Purpose: To promote consistency in global clinical trials by recommending a uniform framework as it relates to radiation transport and dose calculation in water versus in medium.
Methods: The Global Quality Assurance of Radiation Therapy Clinical Trials Harmonisation Group (GHG; www.rtqaharmonization.org) is comprised of 5 primary member organizations: IROC, EORTC, RTTQA, JCOG, and TROG and several observer organizations: IAEA, RDS, ADCS and NPL. The GHG compared the differences between dose to water in water (Dw,w), dose to water in medium (Dw,m), and dose to medium in medium (Dm,m). This was done based on a review of historical frameworks, existing literature and standards, clinical issues in the context of clinical trials, and the trajectory of radiation dose calculations. Based on these factors, recommendations were developed.
Results: No framework was found to be ideal or perfect given the history, complexity, and current status of radiation therapy. Nevertheless, based on the evidence available, the GHG established a recommendation preferring dose to medium in medium (Dm,m). If an institution’s planning system can only calculate dose to water in water (Dw,w), this is acceptable.
Conclusion: Dose to medium in medium (Dm,m) is the preferred dose calculation and reporting framework. Use of this common framework will provide global standardization for clinical trial data reporting and interpretation of trial results.
Not Applicable / None Entered.