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Implementing Head and Neck Contouring Peer Review without Pathway Delay: The On-demand Approach
C Fong1, P Sanghera1, J Good1
1Hall-Edwards Radiotherapy Research Group, Queen Elizabeth Hospital, Birmingham, UK.
Summary
On-demand peer review for head and neck cancer contour volumes is feasible and efficient. This approach reduces delays in radiotherapy treatment planning, bypassing logistical issues of scheduled meetings.
Area of Science:
- Radiation Oncology
- Medical Physics
- Head and Neck Cancer Treatment
Background:
- Contour volume peer review is crucial for head and neck cancer radiotherapy quality assurance.
- Scheduled weekly peer reviews can introduce delays in treatment initiation.
Purpose of the Study:
- To pilot and assess the feasibility and efficiency of an on-demand peer review process.
- To compare the on-demand approach with a traditional scheduled weekly peer review.
Main Methods:
- Four head and neck clinicians participated in an on-demand peer review pilot (Nov 2016-Apr 2017).
- Cases were submitted voluntarily; outcomes categorized as unchanged, unchanged with variation, minor change, or significant change.
- Time differences to hypothetical weekly meetings and time per review were analyzed.
Main Results:
- On-demand peer review provided an average of two extra working days per case for dosimetrists.
- Case outcomes: 45% unchanged, 16% unchanged with variation, 26% minor change, 13% significant change.
- Significant changes were mainly due to imaging interpretation discrepancies; complex cases showed higher rates of significant change.
Conclusions:
- On-demand peer review for head and neck contour volumes is feasible and efficient.
- This method effectively reduces delays in dosimetry planning and overcomes logistical challenges of fixed meetings.
- An audit is recommended to ensure successful implementation and participation.

