Qureshi Bilal Mazhar, Mansha Muhammad Atif, Karim Muneeb Uddin, Hafiz Asim, Ali Nasir, Mirkhan Benazir, Shaukat Fatima, Tariq Maria, Abbasi Ahmed Nadeem
The Aga Khan University, Karachi, Pakistan.
J Glob Oncol. 2019 Aug;5:1-7. doi: 10.1200/JGO.19.00039.
To evaluate and report the frequency of changes in radiation therapy treatment plans after peer review in a simulation review meeting once a week.
Between July 1 and August 31, 2016, the radiation plans of 116 patients were discussed in departmental simulation review meetings. All plans were finalized by the primary radiation oncologist before presenting them in the meeting. A team of radiation oncologists reviewed each plan, and their suggestions were documented as no change, major change, minor change, or missing contour. Changes were further classified as changes in clinical target volume, treatment field, or dose. All recommendations were stratified on the basis of treatment intent, site, and technique. Data were analyzed by Statistical Package for the Social Sciences and are presented descriptively.
Out of 116 plans, 26 (22.4%) were recommended for changes. Minor changes were suggested in 15 treatment plans (12.9%) and a major change in 10 (8.6%), and only one plan was suggested for missing contour. The frequency of change recommendations was greater in radical radiation plans than in palliative plans (92.3% 7.7%). The head and neck was the most common treatment site recommended for any changes (42.3%). Most of the changes were recommended in the technique planned with three-dimensional conformal radiation therapy (50%). Clinical target volume (73.1%) was identified as the most frequent parameter suggested for any change, followed by treatment field (19.2%) and dose (0.08%).
Peer review is an important tool that can be used to overcome deficiencies in radiation treatment plans, with a goal of improved and individualized patient care. Our study reports changes in up to a quarter of radiotherapy plans.
评估并报告在每周一次的模拟评审会议上经过同行评审后放射治疗计划的更改频率。
2016年7月1日至8月31日期间，116例患者的放射治疗计划在科室模拟评审会议上进行了讨论。所有计划在提交会议之前均由放射肿瘤学主治医生最终确定。一组放射肿瘤学家对每个计划进行评审，并将他们的建议记录为无更改、重大更改、微小更改或轮廓缺失。更改进一步分为临床靶体积、治疗野或剂量的更改。所有建议均根据治疗目的、部位和技术进行分层。数据采用社会科学统计软件包进行分析，并以描述性方式呈现。
在116个计划中，26个（22.4%）被建议进行更改。15个治疗计划（12.9%）被建议进行微小更改，10个（8.6%）被建议进行重大更改，只有1个计划被建议存在轮廓缺失。根治性放射治疗计划的更改建议频率高于姑息性计划（92.3%对7.7%）。头颈部是建议进行任何更改的最常见治疗部位（42.3%）。大多数更改建议针对三维适形放射治疗计划（50%）。临床靶体积（73.1%）被确定为建议进行任何更改的最常见参数，其次是治疗野（19.2%）和剂量（0.08%）。
同行评审是一种重要工具，可用于克服放射治疗计划中的缺陷，目标是改善并实现个体化患者护理。我们的研究报告了高达四分之一的放射治疗计划发生更改。
