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

Published online by Cambridge University Press:  20 May 2022

Michael Huo Open the ORCID record for Michael Huo [Opens in a new window] ,
Lyndon Morley ,
Laura Dawson ,
Jean-Pierre Bissonnette ,
Joelle Helou ,
Meredith Giuliani ,
Alejandro Berlin ,
David Shultz ,
Ali Hosni  and
Andrea Shessel
...Show all authors
Michael Huo*
Affiliation:
Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
Lyndon Morley
Affiliation:
Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
Laura Dawson
Affiliation:
Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
Jean-Pierre Bissonnette
Affiliation:
Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
Joelle Helou
Affiliation:
Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
Meredith Giuliani
Affiliation:
Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
Alejandro Berlin
Affiliation:
Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
David Shultz
Affiliation:
Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
Ali Hosni
Affiliation:
Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
Andrea Shessel
Affiliation:
Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
John Waldron
Affiliation:
Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
Aisling Barry
Affiliation:
Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
*
Author for correspondence: Michael Huo, Staff Specialist, Department of Radiation Oncology, Ground Floor, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102, Australia. E-mail: michael.huo@health.qld.gov.au
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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.

Keywords

chart roundspeer reviewquality assuranceradiotherapystereotactic radiotherapy
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 22 , 2023 , e46
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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