Improving Quality of Patient Care by Improving Daily Practice in Radiation Oncology

Unanticipated hospital admissions during or soon after radiation therapy: Incidence and predictive factors

“…Almost all cases undergo 3-dimensional-based treatment planning, and we have an aggressive peer review program for image segmentation, treatment approaches, dose-volume parameters, etc. 12 Curative cases are typically treated at 2 Gy per fraction, often with concurrent chemotherapy, and palliative cases often receive 3 to 4 Gy per fraction, with fairly typical total doses and techniques. For example, typical planned total doses in the curative setting for various disease sites (excluding CyberKnife cases) are: head and neck cancers (70 Gy), non-small cell lung cancer (60-74 Gy), breast cancer (42-50 Gy; plus an electron boost of ≈ 10 Gy), GI cancer (45-54 Gy), gynecological cancer (45-50 Gy external plus brachytherapy), brain cancer (54-60 Gy), and genitourinary cancer (70-79 Gy).…”

Improved robotic stereotactic body radiation therapy plan quality and planning efficacy for organ-confined prostate cancer utilizing overlap-volume histogram-driven planning methodology

“…Several studies indicated that the plan quality of inverse planning in terms of organ sparing and target coverage relies heavily on planner experience and available planning time [6,7]. Thus, an efficient and planner-experience independent planning approach to robotic SBRT is in great need.…”

Predictors of breast radiotherapy plan modifications: Quality assurance rounds in a large cancer centre

“…Since then, several more reports have corroborated the <10% major modifications of peer-reviewed RT plans. In a University of North Carolina Hospitals study of 105 patients, 3% and 5% of their reviewed cases received a ''major'' or a ''minor change'' status respectively, after weekly chart rounds [18]. Using the aforementioned RANZCR audit tool, 8 of 208 (3.8%) of reviewed patients had a recommended change in management, including 6 (2.9%) with target volume coverage, 1 (0.5%) with dose prescription, and 1 (0.5%) involving a fractionation schedule [11].…”