A meta-analysis reveals that radiotherapy peer review significantly influences treatment plans, improving patient safety and effectiveness. The study highlights the need for understanding the process and its challenges to encourage wider adoption.
Institutional peer review of radiation therapy resulted in changes to treatment plans in over a quarter of cancer cases, according to a meta-analysis that identified target volume delineation and target dose prescription as the primary areas requiring revision.Peer review of radiotherapy treatment plans can improve patient safety and treatment effectiveness, but the process often encounters implementation challenges due to resource constraints.
Understanding the impact of radiotherapy peer review is crucial to encouraging adoption and optimizing the approach. To evaluate the effect of radiotherapy peer review on treatment plans, researchers conducted a systematic review and meta-analysis of 55 studies, spanning data from January 2000 to May 2024 and 10 countries. Most of the studies (62%) were conducted in North America, followed by Europe (18%), Australia (9%), and Asia (7%). The analysis included 96,444 case audits, with a mean of 1754 cases audited per study. Most studies focused on multiple disease sites (58%), and others focused on individual cancer types, such as head and neck (14 of 55), lung (2 of 55), and breast (2 of 55). Researchers examined various factors influencing recommendation changes from peer review, including cancer type, treatment intent, radiotherapy technique, timing of peer review, and composition of peer review teams. The definition of a major change included treatment plans requiring replanning or resimulation and were often associated with plan rejection or safety concerns.The pooled proportion of any recommended change from peer review occurred in 28% of cases audited; major changes occurred in 12% of cases, though the range across studies varied considerably (from< 1% to 80% of cases). The most frequent reasons for revisions in the treatment plan were target delineation (45%), target dose prescription (33%), organ at risk dose prescription (9%), and organ at risk volume delineation (5%)
RADIATION THERAPY PEER REVIEW TREATMENT PLANS PATIENT SAFETY CANCER
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