■同行评审是放射治疗质量保证的重要组成部分。据我们所知,没有研究报告在MR直线加速器(MR-Linac)上进行磁共振(MR)引导放射治疗(MRgRT)的同行评审过程的可行性和结果,尽管涉及计划的复杂性及其不断发展的临床适应症.这项研究旨在量化同行评审后治疗计划的变化率以及所需的时间和资源。
前瞻性地收集了2023年6月8日至9月21日在两个中心每周一次的MR-Linac同行评审会议上提出的55例病例。根据澳大利亚和新西兰皇家放射科医师学院(RANZCR)开发的放射肿瘤学同行评审审核工具(PRAT),对病例进行了分析,以确定计划变更的速率和程度。
■同行评审导致更改了36.4%的治疗计划(n=20),3.6%(n=2)有重大变化,需要推迟治疗。最常见的变化是涉及轮廓和增加的OAR保留的危险器官(OAR)体积(16.4%,n=9),总剂量和分级(10.9%,n=6)和目标体积剂量覆盖率(5.5%,n=3)。有SBRT计划的患者(39.1%参见22.2%),寡转移/寡进展部位(38.1%cf30.7%)和再照射病例(41.2%cf34.2%)的变化率更高。病例平均需要7分钟(范围2-15分钟)来讨论。
■计划变更的高比率支持MRgRT中同行评审的价值。我们建议,在可能的情况下,所有MRgRT病例,特别是那些涉及SBRT计划的,寡转移/寡进展位点,和/或再辐照,要接受同行评审。
UNASSIGNED: Peer review is an important component of quality assurance in radiotherapy. To our knowledge, there are no studies reporting on the feasibility and outcomes of the peer review process for magnetic resonance (MR) guided radiotherapy (MRgRT) on the MR linear accelerator (MR-Linac) despite the planning complexity involved and its evolving clinical indications. This study aimed to quantify the rate of change in treatment plans post-peer review and the time and resources required.
UNASSIGNED: Fifty-five cases presented at weekly MR-Linac peer review meetings across two centres from 8 June to 21 September 2023 were prospectively collected. Cases were analysed to determine the rate and extent of plan changes based on the Peer Review Audit Tool for radiation oncology (PRAT) developed by the Royal Australian and New Zealand College of Radiologists (RANZCR).
UNASSIGNED: Peer review resulted in changes to 36.4 % of treatment plans (n = 20), with 3.6 % (n = 2) having major changes requiring deferment of treatment. The most frequent changes were to organs at risk (OAR) volumes involving both delineation and increased OAR sparing (16.4 %, n = 9), total dose and fractionation (10.9 %, n = 6) and target volume dose coverage (5.5 %, n = 3). Patients with SBRT plans (39.1 % cf 22.2 %), oligometastatic/oligoprogressive sites (38.1 % cf 30.7 %) and reirradiation cases (41.2 % cf 34.2 %) had higher rates of change. Cases took a mean of 7 min (range 2-15 minutes) to discuss.
UNASSIGNED: The high rates of plan changes support the value of peer review in MRgRT. We recommend, where possible that all MRgRT cases, particularly those involving SBRT plans, oligometastatic/oligoprogressive sites, and/or reirradiation, be subject to peer review.