Head and neck radiotherapy quality assurance conference for dedicated review of delineated targets and organs at risk: results of a prospective study

被引:0
|
作者
Farris, J. C. [1 ]
Razavian, N. B. [1 ]
Farris, M. K. [1 ]
Ververs, J. D. [1 ]
Frizzell, B. A. [1 ]
Leyrer, C. M. [1 ]
Allen, L. F. [1 ]
Greven, K. M. [1 ]
Hughes, R. T. [1 ]
机构
[1] Wake Forest Sch Med, Dept Radiat Oncol, Winston Salem, NC 27101 USA
基金
美国国家卫生研究院;
关键词
quality assurance; peer review; head and neck; radiotherapy; radiation; chart rounds; INTENSITY-MODULATED RADIATION; CHART ROUNDS;
D O I
10.1017/S1460396922000309
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: Head and neck (HN) radiotherapy (RT) is complex, involving multiple target and organ at risk (OAR) structures delineated by the radiation oncologist. Site-agnostic peer review after RT plan completion is often inadequate for thorough review of these structures. In-depth review of RT contours is critical to maintain high-quality RT and optimal patient outcomes. Materials and Methods: In August 2020, the HN RT Quality Assurance Conference, a weekly teleconference that included at least one radiation oncology HN specialist, was activated at our institution. Targets and OARs were reviewed in detail prior to RT plan creation. A parallel implementation study recorded patient factors and outcomes of these reviews. A major change was any modification to the high-dose planning target volume (PTV) or the prescription dose/fractionation; a minor change was modification to the intermediate-dose PTV, low-dose PTV, or any OAR. We analysed the results of consecutive RT contour review in the first 20 months since its initiation. Results: A total of 208 patients treated by 8 providers were reviewed: 86.5% from the primary tertiary care hospital and 13.5% from regional practices. A major change was recommended in 14.4% and implemented in 25 of 30 cases (83.3%). A minor change was recommended in 17.3% and implemented in 32 of 36 cases (88.9%). A survey of participants found that all (n = 11) strongly agreed or agreed that the conference was useful. Conclusion: Dedicated review of RT targets/OARs with a HN subspecialist is associated with substantial rates of suggested and implemented modifications to the contours.
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页数:5
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