Methods and Materials:
All closed pediatric trials from the COG website (which also includes
the Pediatric Oncology Group [POG] and the Children’s Cancer Group
[CCG]) were queried from inception until January 2022 (a 30-year
period) and included if radiation was used. A sampling of European
studies was included, based on international protocols actively
recruiting patients from 2016-2017 in the Netherlands. The European
trials were comprised of the International Society of Paediatric
Oncology (SIOP), European and American Osteosarcoma Studies (EURAMOS),
German Society of Pediatric Oncology and Hematology (GPOH), Dutch
Childhood Oncology Group (DCOG), EWING2008, and European Paediatric Soft
tissue sarcoma Study Group (EpSSG). Trial OAR dose constraints were
reviewed, including both conventionally fractionated constraints with
photons or protons, and radiosurgery (SRS) constraints.
Dose constraints were compared in three ways. First, graphical scatter
plot overviews of all values were created for each organ to facilitate
an overall comparison of heterogeneity. Second, for a more quantitative
comparison of high dose constraints between pediatric US and European
groups, Dmax (maximum dose) or the dose to a volume ≤ 20% was compared.
Third, specific commonly used OARs were investigated for variability in
the volume percent constraints. OAR constraint data was visualized by
building an interactive web application. This website application
renders OAR constraint data in both plot and table format based on the
pediatric group, protocol, date enrollment started, dose, volume, and
number of trials with the same constraint. Users may apply filters to
display associated data.