Implementation of peer-review quality rounds for gynecologic brachytherapy in a high-volume academic center.
Brachytherapy
; 19(6): 881-888, 2020.
Article
in En
| MEDLINE
| ID: mdl-31917179
ABSTRACT
PURPOSE:
While peer review is critical for quality and safety in radiotherapy, there are neither formal guidelines nor format examples for brachytherapy (BT) peer review. We report on a gynecologic BT peer-review method implemented at a high-volume academic center. METHODS AND MATERIALS We analyzed discussions at bimonthly gynecologic BT peer-review rounds between July and December 2018. Rounds consisted of 2-5 attending physicians with gynecologic BT expertise, 1-2 BT physicists, and trainees. Peer-review targets included clinical case review, contours, implant technique, dose/fractionation, and target/organ-at-risk (OAR) dosimetry. The projected/final target and OAR dosimetry were analyzed.RESULTS:
55 separate implants from 44 patients were reviewed. Implants were mostly reviewed after the first BT fraction (n = 16, 29%) or at another time point during BT (n = 20, 36%). One (2%) implant was presented prospectively. The applicator type and BT technique were reviewed for all implants. Dose/fractionation was evaluated for 46 implants (84%); contours were discussed for 21 (38%). Target and OAR dosimetry were reviewed for 54 (98%) and 28 implants (51%), respectively. Six cases (11%) underwent minor changes to the applicator type to improve target and/or OAR dosimetry. One case (2%) had a major change recommended to the dose/fractionation.CONCLUSIONS:
Gynecologic BT peer review may enhance BT quality by allowing for implant optimization and formal review of challenging cases, ultimately improving medical decision-making and team communication. Peer review should be implemented in centers offering gynecologic BT.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Peer Review
/
Brachytherapy
/
Radiation Oncology
/
Genital Neoplasms, Female
Type of study:
Etiology_studies
/
Guideline
/
Prognostic_studies
/
Qualitative_research
Limits:
Female
/
Humans
Language:
En
Journal:
Brachytherapy
Journal subject:
RADIOTERAPIA
Year:
2020
Document type:
Article
Affiliation country:
Canada