Does a peer review group consensus process for MR-Linac patients affect clinical care? Evaluation of impact and feasibility

Autor: Yew Sin, Vikneswary Batumalai, Jeremy de Leon, Eugene Leong, Kasri Rahim, Farshad Kasraei, Charles Tran, Tommy Liang, Katrina Biggerstaff, Michael G. Jameson, Nicole Hug, Kathryn Hird, Hendrick Tan
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Clinical and Translational Radiation Oncology, Vol 48, Iss , Pp 100816- (2024)
Druh dokumentu: article
ISSN: 2405-6308
DOI: 10.1016/j.ctro.2024.100816
Popis: Background and purpose: Peer review is an important component of quality assurance in radiotherapy. To our knowledge, there are no studies reporting on the feasibility and outcomes of the peer review process for magnetic resonance (MR) guided radiotherapy (MRgRT) on the MR linear accelerator (MR-Linac) despite the planning complexity involved and its evolving clinical indications. This study aimed to quantify the rate of change in treatment plans post-peer review and the time and resources required. Materials and methods: Fifty-five cases presented at weekly MR-Linac peer review meetings across two centres from 8 June to 21 September 2023 were prospectively collected. Cases were analysed to determine the rate and extent of plan changes based on the Peer Review Audit Tool for radiation oncology (PRAT) developed by the Royal Australian and New Zealand College of Radiologists (RANZCR). Results: Peer review resulted in changes to 36.4 % of treatment plans (n = 20), with 3.6 % (n = 2) having major changes requiring deferment of treatment. The most frequent changes were to organs at risk (OAR) volumes involving both delineation and increased OAR sparing (16.4 %, n = 9), total dose and fractionation (10.9 %, n = 6) and target volume dose coverage (5.5 %, n = 3). Patients with SBRT plans (39.1 % cf 22.2 %), oligometastatic/oligoprogressive sites (38.1 % cf 30.7 %) and reirradiation cases (41.2 % cf 34.2 %) had higher rates of change. Cases took a mean of 7 min (range 2–15 minutes) to discuss. Conclusion: The high rates of plan changes support the value of peer review in MRgRT. We recommend, where possible that all MRgRT cases, particularly those involving SBRT plans, oligometastatic/oligoprogressive sites, and/or reirradiation, be subject to peer review.
Databáze: Directory of Open Access Journals