Highlights • Robustness of bladder absorbed dose relative to daily inter-fraction motion. • Systematic (SE) and random errors (RE) of bladder dose surface maps (DSM), DVH/DSH. • DSH and DVH show ...small population SE (<3.4 cm2 and <8.4 cm3 ) at the highest doses. • DSM show mean SE <1 Gy and population SE and RE (<4 and <3 Gy) at the posterior base. • Larger variations are present in the anterior and more cranial portion of bladder.
•New specific set of Hyperthermia treatment Quality Indicators are proposed.•Three structure, five process and two outcome Quality Indicators set were selected.•Average values used as standard ...reference values of hyperthermia quality indicators have been obtained and proposed.•The proposed indicators are available to be investigated and applied by a larger number of the Institutes.
Nowadays, no Quality Indicators (QI) have been proposed for Hyperthermia treatments. Starting from radiotherapy experience, the aim of this work is to adapt radiotherapy indicators to Hyperthermia and to propose a new specific set of QI in Hyperthermia field.
At first, radiotherapy quality indicators published in literature have been adapted to hyperthermia setting. Moreover, new specific indicators for the treatment of hyperthermia have been defined. To obtain the standard reference values of quality indicators, a questionnaire was sent to 7 Italian hyperthermia Institutes with a list of questions on physical and clinical hyperthermia treatment in order to highlight the different therapeutic approaches.
Three structure, five process and two outcome QI were selected. It has been possible to adapt seven indicators from radiotherapy, while three indicators have been defined as new specific indicators for hyperthermia. Average values used as standard reference values have been obtained and proposed.
The survey performed on 7 Italian centres allowed to derive the standard reference value for each indicator. The proposed indicators are available to be investigated and applied by a larger number of Institutes in which hyperthermia treatment is performed in order to monitor the operational procedures and to confirm or modify the reference standard value derived for each indicator.
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