Quality Assurance Peer Review of Head and Neck Contours in a Large Cancer Centre via a Weekly Meeting Approach. Issue 6 (June 2019)

• Record Type: Journal Article
• Authors: Ramasamy, S.; Murray, L.J.; Cardale, K.; Dyker, K.E.; Murray, P.; Sen, M.; Prestwich, R.J.D.
• Is Part Of: Clinical oncology. Volume 31:Issue 6(2019)
• Page Start: 344
• Page End: 351
• Publication Date: 2019-06
• Subjects: Head and neck cancer -- peer review -- quality assurance -- radiotherapy; Oncology -- Periodicals; Tumors -- Periodicals; Cancer -- Treatment -- Periodicals; Radiotherapy -- Periodicals; Neoplasms -- Periodicals; Cancer -- Radiotherapy; Cancer -- Treatment; Oncology; Medical radiology; Radiotherapy; Tumors; Electronic journals; Periodicals; 616.994
• DOI: 10.1016/j.clon.2019.03.001
• Languages: English
• ISSNs: 0936-6555

Abstract

Abstract: Aims: To assess the impact of weekly scheduled peer review of head and neck contours for definitive and adjuvant radiotherapy cases based on rates of recommended changes. Materials and methods: Retrospective analysis of a prospective database. Recommended changes were prospectively classified as 'major' (change in gross tumour volume and/or high-dose clinical target volume, dose/fractionation) or 'minor' (change in intermediate or elective dose clinical target volumes or organs at risk). Univariate analysis to explore associations between recommended changes and tumour site/stage and radical/adjuvant indication. Results: In total, 307/375 (82%) head and neck cases treated with volumetric-modulated arc therapy were prospectively peer reviewed over a 12-month period; 195 (64%) cases received definitive and 112 (36%) received adjuvant radiotherapy. Overall, 43/307 (14.0%) changes were recommended within the peer review meetings. This comprised 27/307 (8.8%) major changes and 16/307 (5.2%) minor changes; 33/43 (77%) changes were in the clinical target volume. Rates of recommended changes were significantly higher for adjuvant versus definitive radiotherapy (odds ratio 2.26, P = 0.014) and for larynx compared with oropharynx (odds ratio 3.02, P = 0.02). There was no overall correlation between clinician experience and rates of change ( P = 0.62). Conclusion: Routine weekly meeting contour-based peer review resulted in a number of major and minor changes to treatment. Compliance was high. Peer review was potentially beneficial for all tumour sites/stages/indications and any degree of clinician experience. Highlights: Aim to assess impact of weekly meeting-based peer review of head and neck contours. Compliance with peer review was high. Contour changes recommended in 14% of cases. Not possible to identify tumour site/treatment indication not requiring peer review.