RESUMO
BACKGROUND: Peer review systems within radiation oncology are important to ensure quality radiation care. Several individualized methods for radiation oncology peer review have been described. However, despite the importance of peer review in radiation oncology barriers may exist to its effective implementation in practice. The purpose of this study was to quantify the rate of plan changes based on our group peer review process as well as the quantify amount of time and resources needed for this process. METHODS: Data on cases presented in our institutional group consensus peer review conference were prospectively collected. Cases were then retrospectively analyzed to determine the rate of major change (plan rejection) and any change in plans after presentation as well as the median time of presentation. Univariable logistic regression was used to determine factors associated with major change and any change. RESULTS: There were 73 cases reviewed over a period of 11 weeks. The rate of major change was 8.2% and the rate of any change was 23.3%. The majority of plans (53.4%) were presented in 6-10 min. Overall, the mean time of presentation was 8 min. On univariable logistic regression, volumetric modulated arc therapy plans were less likely to undergo a plan change but otherwise there were no factors significantly associated with major plan change or any type of change. CONCLUSION: Group consensus peer review allows for a large amount of informative clinical and technical data to be presented per case prior to the initiation of radiation treatment in a thorough yet efficient manner to ensure plan quality and patient safety.
Assuntos
Neoplasias/radioterapia , Revisão por Pares/métodos , Garantia da Qualidade dos Cuidados de Saúde/normas , Radioterapia (Especialidade)/normas , Planejamento da Radioterapia Assistida por Computador/métodos , Estudos de Viabilidade , Seguimentos , Humanos , Segurança do Paciente , Prognóstico , Estudos Prospectivos , Dosagem Radioterapêutica , Radioterapia de Intensidade Modulada/métodos , Estudos RetrospectivosRESUMO
This article provides an introduction to radiation therapy as it applies to intracranial tumors. It also provides a review of the natural growth progression of acoustic neuromas and accuracy of tumor size determination. Literature on the use of linear accelerator stereotactic radiosurgery and fractionated radiotherapy in acoustic neuroma management is reviewed and summarized. Specifically, the rates of reported tumor control, hearing preservation, facial and trigeminal nerve complications, and hydrocephalus are analyzed. Although the complication rates associated with linear accelerator therapy are relatively low, hearing preservation is poor and acoustic neuroma control is variable.
Assuntos
Neuroma Acústico/história , Radiocirurgia/história , História do Século XXI , Humanos , Neuroma Acústico/radioterapia , Neuroma Acústico/cirurgiaRESUMO
This article provides an introduction to radiation therapy as it applies to intracranial tumors. It also provides a review of the natural growth progression of acoustic neuromas and accuracy of tumor size determination. Literature on the use of linear accelerator stereotactic radiosurgery and fractionated radiotherapy in acoustic neuroma management is reviewed and summarized. Specifically, the rates of reported tumor control, hearing preservation, facial and trigeminal nerve complications, and hydrocephalus are analyzed. Although the complication rates associated with linear accelerator therapy are relatively low, hearing preservation is poor and acoustic neuroma control is variable.
Assuntos
Neoplasias da Orelha/radioterapia , Neoplasias da Orelha/cirurgia , Neuroma Acústico/radioterapia , Neuroma Acústico/cirurgia , Radiocirurgia/instrumentação , Neoplasias da Orelha/patologia , Humanos , Imageamento por Ressonância Magnética , Neuroma Acústico/patologiaRESUMO
The incidence of carcinoma of the cervix has continuously declined over the past decades because of effective screening. The International Federation of Gynecology and Obstetrics (FIGO) clinical staging, though universally used, is considered inadequate either to determine the type of treatment or to predict treatment outcome. Over the last 10 years, treatment of cervical cancer has become increasingly sophisticated with advances in external beam and brachytherapy in the radiotherapeutic management of this carcinoma. In particular, brachytherapy plays a major role in enhancing both local control and survival. Experience to date suggests that either high-dose-rate (HDR) or low-dose-rate (LDR) brachytherapy, when properly applied, can be effective and give similar rates of local control with minimal complications. This article analyzes the current literature regarding treatment techniques of radiotherapy with special emphasis on brachytherapy integration to optimize radiotherapy treatment outcome.
