Importance of patient examination to clinical quality assurance in head and neck radiation oncology
Importance of patient examination to clinical quality assurance in head and neck radiation oncology
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DOI：
10.1002/hed.20446
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发表时间：
2006-11-01
影响因子：
2.9
通讯作者：
Ang, K. Kian
中科院分区：
文献类型：
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作者：
Rosenthal, David I.;Asper, Joshua A.;Ang, K. Kian
背景当临床放射肿瘤学的质量保证计划主要集中在治疗的技术方面时，他们往往低估了治疗过程和结果的问题。我们确定了临床同行评议在涉及头颈部检查的头颈部癌症放射治疗中的价值。前瞻性地收集了134例具有初步放射治疗（RT）计划的连续患者的数据。同行评议包括头颈部检查和影像学检查以确认靶定位。同行评议导致66%的患者改变了治疗计划。大多数变化是轻微的，但11%的变化是重大的，并且被认为可能影响治疗结果或正常组织毒性。大多数变化涉及基于物理发现的靶向描绘。RT计划中放射靶点定位的同行评审导致了可能影响约10%患者癌症控制率或并发症的变化。我们建议，头部和颈部放射肿瘤治疗计划的准确性可能会增加由另一个头部和颈部癌症专家，通常是放射肿瘤学家或头部和颈部外科医生，以确认RT靶体积的共同检查。(c)2006 Wiley Periodicals，Inc.
Background. When quality assurance programs in clinical radiation oncology focus mainly on the technical aspects of treatment, they tend to underplay questions of therapeutic process and outcome. We determined the value of clinical peer review in radiation therapy for head and neck cancer that involved head and neck examination.Methods. Data were collected prospectively on 134 consecutive patients with preliminary radiation therapy (RT) plans. Peer review was performed that included head and neck examination and imaging review to confirm target localization.Results. Peer review led to changes in treatment plans for 66% of patients. Most changes were minor, but 11% of changes were major and thought to be of a magnitude that could potentially affect therapeutic outcome or normal tissue toxicity. Most changes involved target delineation based on physical findingsConclusions. Peer review of radiation target localization in RT plans led to changes that could potentially affect rates of cancer control or complication in about 10% of patients. We suggest that the accuracy of head and neck radiation oncology treatment plans might be increased by co-examination by another head and neck cancer specialist, typically a radiation oncologist or head and neck surgeon, to confirm RT target volumes. (c) 2006 Wiley Periodicals, Inc.