Radiat Oncol J.  2019 Mar;37(1):60-65. 10.3857/roj.2019.00080.

Enhancing value of quality assurance rounds in improving radiotherapy management: a retrospective analysis from King Hussein Cancer Center in Jordan

• Khader JK
• Al-Mousa A
• Mohamad IA
• Abuhijlih
• Al-Khatib
• Alnsour AZ
• Asha WA
• Ramahi SW
• Hosni AA
• Abuhijla F

• KMID: 2447553
• DOI: http://doi.org/10.3857/roj.2019.00080

Abstract

PURPOSE
The quality assurance (QA) chart rounds are multidisciplinary meetings to review radiation therapy (RT) treatment plans. This study focus on describing the changes in RT management based on QA round reviews in a single institution.
MATERIALS AND METHODS
After 9 full years of implementation, a retrospective review of all patients whose charts passed through departmental QA chart rounds from 2007 to 2015. The reviewed cases were presented for RT plan review; subcategorized based on decision in QA rounds into: approved, minor modifications or major modifications. Major modification defined as any substantial change which required patient re-simulation orre-planning prior to commencement of RT. Minor modification included treatment plan changes which didn't necessarily require RT re-planning.
RESULTS
Overall 7,149 RT treatment plans for different anatomical sites were reviewed at QA rounds. From these treatment plans, 6,654 (93%) were approved, 144 (2%) required minor modifications, while 351 (5%) required major modifications. Major modification included changes in: selected RT dose (96/351, 27%), target volume definition (127/351, 36%), organs-at-risk contouring (10/351, 3%), dose volume objectives/constraints criteria (90/351, 26%), and intent of treatment (28/351, 8%). The RT plans which required major modification according to the tumor subtype were as follows: head and neck (104/904, 12%), thoracic (12/199, 6%), gastrointestinal (33/687,5%), skin (5/106, 5%), genitourinary (16/359, 4%), breast (104/2387, 4%), central nervous system (36/846, 4%), sarcoma (11/277, 4%), pediatric (7/251, 3%), lymphoma (10/423, 2%), gynecological tumors (2/359, 1%), and others (11/351, 3%).
CONCLUSION
Multi-disciplinary standardized QA chart rounds provide a comprehensive and an influential method on RT plans and/ or treatment decisions.

Keyword

Quality management; Multidisciplinary; Radiotherapy; Peer review

MeSH Terms

Breast
Central Nervous System
Head
Humans
Jordan*
Lymphoma
Methods
Neck
Peer Review
Radiotherapy*
Retrospective Studies*
Sarcoma
Skin