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.