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Importance of patient examination to clinical quality assurance in head and neck radiation oncology
Author(s) -
Rosenthal David I.,
Asper Joshua A.,
Barker Jerry L.,
Garden Adam S.,
Chao K. S. Clifford,
Morrison William H.,
Weber Randal S.,
Ang K. Kian
Publication year - 2006
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20446
Subject(s) - head and neck cancer , medicine , radiation oncologist , radiation therapy , radiation oncology , head and neck , physical examination , quality assurance , oncology , radiology , medical physics , surgery , pathology , external quality assessment
Abstract 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 findings Conclusions. 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. © 2006 Wiley Periodicals, Inc. Head Neck, 2006