Document Detail

The impact of peer review of volume delineation in stereotactic body radiation therapy planning for primary lung cancer: a multicenter quality assurance study.
MedLine Citation:
PMID:  24736076     Owner:  NLM     Status:  In-Data-Review    
INTRODUCTION: Although the value of peer review is increasingly recognized, there is little research documenting its impact in the setting of stereotactic body radiation therapy (SBRT) for lung cancer. This study determines the dosimetric effect of peer review of tumor and normal tissue contouring in lung SBRT planning.
METHODS: Forty anonymized lung SBRT plans were retrospectively evaluated post treatment. Each plan was independently reviewed by two to three radiation oncologists using established institutional guidelines. For each structure, reviewers recorded recommendations for "no change," "minor change," "major change," or "missing contour" and provided a modified or new contour as needed. Dose-volume histograms were analyzed for dosimetric violations.
RESULTS: Among 472 contoured structures evaluated, recommendations from peer review were 107 major change (23%), 176 minor change (37%), 157 no change (33%), and 32 missing (7%). Common major changes involved the skin (n = 20), heart (n = 18), and proximal bronchial tree (n = 15). Dose constraints were not achieved for 25 new or recontoured structures (5%), of which 17 involved the planning target volume (PTV). Among cases with PTV violations, the mean prescription dose coverage to the modified PTVs was 90%, compared with the protocol standard of greater than or equal to 95% coverage. The remaining violations involved the ribs (n = 5), spinal canal (n = 2), and heart (n = 1).
CONCLUSIONS: Peer review of structure contouring resulted in significant changes in lung SBRT plans. Recontouring of several plans revealed violations of dose limits, most often involving inadequate PTV coverage. Peer review, especially of target volume delineation, is warranted to improve consistency and quality in lung SBRT planning.
Andrea C Lo; Mitchell Liu; Elisa Chan; Chad Lund; Pauline T Truong; Shaun Loewen; Jeffrey Cao; Devin Schellenberg; Hannah Carolan; Tanya Berrang; Jonn Wu; Eric Berthelet; Robert Olson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer     Volume:  9     ISSN:  1556-1380     ISO Abbreviation:  J Thorac Oncol     Publication Date:  2014 Apr 
Date Detail:
Created Date:  2014-04-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101274235     Medline TA:  J Thorac Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  527-33     Citation Subset:  IM    
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