Peer review quality assurance in stereotactic body radiotherapy planning: the impact of case volume

IF 0.3 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Radiotherapy in Practice Pub Date : 2022-05-20 DOI:10.1017/S1460396922000152

M. Huo, L. Morley, L. Dawson, J. Bissonnette, J. Helou, M. Giuliani, A. Berlin, D. Shultz, A. Hosni, A. Shessel, J. Waldron, A. Barry

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引用次数: 0

Abstract

Abstract Purpose: Peer review is an essential quality assurance component of radiation therapy planning. A growing body of literature has demonstrated substantial rates of suggested plan changes resulting from peer review. There remains a paucity of data on the impact of peer review rounds for stereotactic body radiation therapy (SBRT). We therefore aim to evaluate the outcomes of peer review in this specific patient cohort. Methods and materials: We conducted a retrospective review of all SBRT cases that underwent peer review from July 2015 to June 2018 at a single institution. Weekly peer review rounds are grouped according to cancer subsite and attended by radiation oncologists, medical physicists and medical radiation technologists. We prospectively compiled ‘learning moments’, defined as cases with suggested changes or where an educational discussion occurred beyond routine management, and critical errors, defined as errors which could alter clinical outcomes, recorded prospectively during peer review. Plan changes implemented after peer review were documented. Results: Nine hundred thirty-four SBRT cases were included. The most common treatment sites were lung (518, 55%), liver (196, 21%) and spine (119, 13%). Learning moments were identified in 161 cases (17%) and translated into plan changes in 28 cases (3%). Two critical errors (0.2%) were identified: an inadequate planning target volume margin and an incorrect image set used for contouring. There was a statistically significantly higher rate of learning moments for lower-volume SBRT sites (defined as ≤30 cases/year) versus higher-volume SBRT sites (29% vs 16%, respectively; p = 0.001). Conclusions: Peer review for SBRT cases revealed a low rate of critical errors, but did result in implemented plan changes in 3% of cases, and either educational discussion or suggestions of plan changes in 17% of cases. All SBRT sites appear to benefit from peer review, though lower-volume sites may require particular attention.

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立体定向身体放射治疗计划中的同行评审质量保证：病例数量的影响

摘要目的：同行评审是放射治疗计划的一个重要质量保证组成部分。越来越多的文献表明，由于同行评审，建议的计划变更率相当高。关于立体定向身体放射治疗（SBRT）的同行评审回合的影响，仍然缺乏数据。因此，我们旨在评估这一特定患者队列中同行评审的结果。方法和材料：我们对2015年7月至2018年6月在一家机构接受同行评审的所有SBRT病例进行了回顾性审查。每周的同行评审根据癌症子网站分组，辐射肿瘤学家、医学物理学家和医学辐射技术人员参加。我们前瞻性地汇编了“学习时刻”和关键错误，前者被定义为有建议的改变或在常规管理之外进行教育讨论的情况，后者被定义为可能改变临床结果的错误，在同行评审期间前瞻性地记录。对同行评审后实施的计划变更进行了记录。结果：包括934例SBRT病例。最常见的治疗部位是肺（518，55%）、肝（196，21%）和脊柱（119，13%）。161例（17%）发现了学习时刻，28例（3%）将其转化为计划变更。确定了两个关键错误（0.2%）：规划目标体积裕度不足和用于轮廓绘制的图像集不正确。低容量SBRT站点（定义为≤30例/年）与高容量SBRT（分别为29%和16%；p=0.001）的学习时刻率在统计学上显著较高。结论：SBRT病例的同行评审显示关键错误率较低，但在3%的病例中确实导致了实施计划的改变，在17%的案例中，教育讨论或计划变更建议。所有SBRT网站似乎都受益于同行评审，尽管数量较低的网站可能需要特别关注。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Radiotherapy in Practice RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

0.80

自引率

0.00%

发文量

期刊介绍： Journal of Radiotherapy in Practice is a peer-reviewed journal covering all of the current modalities specific to clinical oncology and radiotherapy. The journal aims to publish research from a wide range of styles and encourage debate and the exchange of information and opinion from within the field of radiotherapy practice and clinical oncology. The journal also aims to encourage technical evaluations and case studies as well as equipment reviews that will be of interest to an international radiotherapy audience.