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Peer Review

Prospective peer review (i.e. "chart rounds") is a central component of a QA program for any academically-oriented Department of Radiation Oncology.  For the management of cancer patients with radiation, various attempts to try to standardize therapy have been made using guidelines for each tumor site.  These guidelines are based on all available evidence including the experience of known experts in the field.  Even then, controversy and disagreement exists and so most guidelines are just that, with many having a set of options for treatment available.  Our peer review process at KU is as follows:

  • Each KU patient (from all sites) has his or her radiation treatment "plan" reviewed by every radiation oncologist in the department at a weekly conference so that feedback can be obtained before treatment is initiated
  • All appropriate imaging is displayed, the targeted volumes are demonstrated, and, finally, the proposed radiation plan designed by the treating physician is shown on a large screen for active discussion
  • Topics which frequently undergo debate are the coverage of the tumor by the appropriate target volume, the tolerance of dose-limiting tissue adjacent to target volumes, the optimal dose and fractionation and sometimes the technique used
  • Available clinical trials are highlighted for each patient presented.  Specific eligibility criteria are reviewed and potential barriers to enrollment are also discussed
  • All KU Radiation Oncology specialists have the ability to log-in remotely from other facilities and participate via telemedicine
  • This conference allows for an unprecedented degree of "fine-tuning" so that treatment can be customized and outcomes can be optimized both for routine and rare cases
  • Multiple published studies have shown that adjustments and changes to the radiation delivery plan are often made due to such conferences and can influence outcomes, including making a difference between cure and recurrence
  • Prospective peer review also serves as an additional "safety net" just to minimize the possibility of a mistake occurring (i.e. it allows our patients to have more than ten radiation oncologists for the price of one!)
Last modified: Dec 31, 2018