Quality of reporting on thoracic radiotherapy technique in prospective lung cancer trials: A systematic review

BACKGROUND: The aim of this study is to assess the quality of reporting of thoracic (T) RT technique for curative intent treatment in prospective lung cancer trials. METHODS: We searched MEDLINE for eligible trials published from 1996 to 2016. We assessed the included trials’ reports on whether they reported the RT dose prescription method; RT dose-planning procedures; algorithm for tissue inhomogeneity dose corrections; organs at risk dose constraints; target volume definition, simulation and/or motion management procedures; treatment verification procedures; total RT dose; fractionation schedule; conduct of quality assurance as well as presence or absence of deviations in RT treatment planning and delivery adequately. We performed univariable and multivariable logistic regression to determine the factors that may influence the quality of reporting. RESULTS: We found 85 eligible trial reports. Target volume definition, total RT dose, and fractionation schedules were reported adequately in more than 90% of the included trials. Algorithm for tissue inhomogeneity dose corrections, simulation and verification procedures, presence or absence of deviations in RT treatment planning and delivery were reported adequately in less than 20% of the included trials. Twenty-three trials (27%) reported 7 criteria or more adequately. Both univariable and multivariable logistic regression showed that trials with RT focused research question were more likely to have adequate quality in reporting (judged as adequate reporting in 7 criteria or more) than trials with non-RT focused question (odds ratio 4.11, 95% confidence interval 1.10 to 15.43, P value = .04). CONCLUSION: There is significant variability in the quality of reporting on thoracic radiotherapy treatment in prospective lung cancer trials. Future research should focus on developing consensus guidelines to standardize the reporting of radiotherapy technique in clinical trials.