Impact of Multiprofessional Radiotherapy Peer Review on Multidisciplinary Team Meeting Staging in Head and Neck...

Area of Science:

• Oncology
• Radiology
• Quality Assurance

Background:

• Multidisciplinary team meetings (MDMs) are standard for cancer staging.
• Established quality assurance (QA) for MDM-recorded cancer staging is lacking.
• Radiotherapy peer review is a recommended QA process.

Purpose of the Study:

• To compare cancer staging between multiprofessional radiotherapy peer review (including radiologists) and referring MDMs.
• To evaluate the impact of diagnostic-to-treatment intervals on cancer staging.
• To assess the role of radiologist input in post-MDM quality assurance.

Main Methods:

• Prospective evaluation of head and neck intensity-modulated radiotherapy (IMRT) cases in peer review (May 2023-April 2024).
• Recording of radiological disease progression (PD) and cancer staging from IMRT-planning scans.
• Comparison of peer review findings with MDM-recorded outcomes.

Main Results:

• 235 IMRT cases were reviewed; 29% of definitive cases showed disease progression.
• 30% of analysable cases were upstaged, with a mean interval of 49 days from diagnosis to IMRT planning.
• Discrepancies led to changes in recommended treatment, including laryngectomy and chemotherapy, and IMRT volume adjustments for 66% of patients.

Conclusions:

• Significant discrepancies in cancer staging between MDMs and radiotherapy peer review exist.
• Protracted diagnostic and treatment pathways can influence final cancer staging.
• Routine radiologist participation in peer review enhances post-MDM quality assurance and clinical management recommendations.