对MR-Linac患者的同行评审小组共识过程是否会影响临床护理? 影响和可行性评估
Yew Sin1, Vikneswary Batumalai2,3, Jeremy de Leon2
1University of Notre Dame Australia, School of Medicine, Fremantle, Western Australia, Australia.
Clinical and translational radiation oncology
|August 12, 2024
概括
同行评审对磁共振 (MR) 导向放射治疗 (MRgRT) 计划产生重大影响,其中36.4%的病例需要改变. 这一过程对于质量保证至关重要,特别是在立体体辐射疗法 (SBRT) 和再辐射病例中.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 医疗保健中的质量保证
背景情况:
- 同行评审是放射治疗质量保证的基石.
- 没有先前的研究评估了对MR线性加速器 (MR-Linacs) 的MR导向放射治疗 (MRgRT) 的同行评审的可行性和结果.
- 计划MRgRT是复杂的,其临床应用正在扩大.
研究的目的:
- 在MRgRT中进行同行评审后,量化治疗计划变化率.
- 确定MRgRT同行评审流程所需的时间和资源.
- 评估同行评审对MR-Linac治疗计划的影响.
主要方法:
- 在两个机构中,在15周内 (2023年6月至9月) 收集55例MR-Linac病例.
- 使用放射瘤学同行评审审计工具 (PRAT) 分析治疗计划.
- 评估计划变化,重点关注有风险的器官 (OAR) 量,剂量和目标覆盖范围.
主要成果:
- 36.4%的MRgRT治疗计划需要在同行评审后进行修改.
- 需要推迟治疗的重大变化发生在3.6%的病例中.
- 经常发生的变化包括OAR划分/节约 (16.4%),剂量/分量 (10.9%) 和目标剂量覆盖率 (5.5%).
- 对于SBRT,寡度转移/寡度进展部位和再辐射病例,观察到更高的变化率.
- 每个案件的平均讨论时间为7分钟.
结论:
- 计划修改的高率凸显了MRgRT中同行评审的价值.
- 建议对所有MRgRT病例进行同行评审,特别是SBRT,寡头转移/寡头渐进和再辐射场景.
- 实施同行评审可以提高MRgRT的质量和安全性.
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