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Radiat Oncol J. 2019 Mar;37(1):60-65. English. Original Article.
Khader JK , Al-Mousa AM , Mohamad IA , Abuhijlih RA , Al-Khatib SA , Alnsour AZ , Asha WA , Ramahi SW , Hosni AA , Abuhijla FJ .
Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan.
Department of Biomedical Physics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Canada.


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.


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%).


Multi-disciplinary standardized QA chart rounds provide a comprehensive and an influential method on RT plans and/ or treatment decisions.

Copyright © 2019. Korean Association of Medical Journal Editors.