ESTRO 2020 Abstract book

S723 ESTRO 2020

After the daily analyzed, the causes of treatment delays could be resolved with a better redistribution of the LINAC agenda to manage the ambulance transportation problems and, in pelvic tumors patients, a more intense training about bladder, rectum, and dress preparations. Conclusion Applying LM principles is a promising technique to identify sources of waste and streamline workflow in healthcare delivery. Although not all wastes were completely suppressed, they were reduced with LEAN project and if incidents are limited the patients are treated “on time”. The change of pelvic tumors protocol affects all the patients’ treatments. Overall patients’ satisfaction and workflow has improved by 40% with the project implementation. PO-1280 Six-Years Experience Of Peer Review: Analysis of results and lessons learned J. Perez-Alija 1 , N. Jornet 1 , P. Gallego 1 , A. Latorre- Musoll 1 , P. Carrasco de Fez 1 , P. Delgado-Tapia 1 , P. Simon Garcia 1 , A. Ruiz Martinez 1 , M. Adria Mora 1 , M. Lizondo 1 , I. Valverde-Pascual 1 , M. Barcelo-Pages 1 , N. Garcia- Apellaniz 1 , G. Sancho Pardo 2 , J. Craven-Bartle 2 , M. Ribas 1 1 Hospital de la Santa Creu i Sant Pau, Medical Physics, Barcelona, Spain ; 2 Hospital de la Santa Creu i Sant Pau, Radiation Oncology, Barcelona, Spain Purpose or Objective Peer review (PR) is an essential part of a comprehensive quality management system. Quality assurance guidelines recommend radiation oncologists and medical physicists to PR treatment plans before treatment. In March 2013, we established a PR session, using REDCap to register the results. Our study documents and evaluates PR on treatment indication, prescription, volume delineation, and dose distribution during the last six years. Material and Methods We included 5764 treatments that were peer-reviewed from 2013 to 2019. Our PR session started in 2013. Radiation oncologists (RO) and medical physicists (MP) peer-reviewed: treatment indication, prescription, volume delineation, and dose distributions. PR was held the day patients were starting treatment. For treatment indication and prescription, RO agreed to consensus, no consensus, and personal decision. For volume delineation and dose distribution, we agreed to: approved without modification , modification required , modification recommended (no consensus), and considerations for future cases . In May 2017, PR was split into two sessions (volumes- prescription by RO and dosimetry by MP), and it was integrated into the patient clinical pathway. Treatment planning followed the "volume-prescription" PR. Treatment approval followed the "Dose distribution" PR. Differently from "volume" PR, "Dose distribution" PR was a second PR as the treatment plan, performed by a dosimetrist, was reviewed by an MP before this session (changes made in the 1st review were categorized as minor/major/no changes ). In 2018, we merged with another RT department. All decisions were collected in a database. We analyzed the adherence to PR pre and post-2018 and also the decisions taken in the PR sessions. Results Between 2013 and 2019, 8734 patients were treated. A total of 5764 patients (66%) were PR: 50% when a single session was held, 64% when split into two, and 97% after merging with the other department. 7% of PR patients had a change in volume delineation, and 2% were replanned after the "Dose distribution" PR. Table 1 shows a detailed description of the results.

Conclusion PR identified cases that needed corrections in volume definition. The dosimetry PR, even if it was a second review of the treatment plan, identified cases that would benefit from replanning. We attribute the high number of treatment plan modifications in the first dosimetry review to a renewal of dosimetrists during these years; relevant changes are now presented in a weekly session with all the dosimetry team. Dividing PR sessions and integration in the patient pathway increased the percentage of PR patients. Receiving daily feedback from colleagues resulted in a benefit for RO and MP harmonizing prescriptions, volume definition, and treatment planning. PR was a key tool to harmonize practice when merging two departments. PO-1281 Heterogeneity in radiation oncology training, a problem that calls for attention in Latin America J. Faúndez Salazar 1 , D. Martinez Perez 2 , R. Del Castillo Pacora 2 , K. Colqui Ramos 2 , O. Gamboa 3 , M.P. Noreña Gómez 3 , L. Vacaflor Romero 4 , A. Flores Rivera 5 , N. Condori Vasquez 6 , B. Li 7 1 Instituto Nacional del Cáncer, Radiation Oncology Departament, Santiago de Chile, Chile ; 2 Oncosalud - AUNA, Radiation Oncology, Lima, Peru ; 3 Instituto Nacional de Cancerología, Radiation Oncology, Bogota, Colombia ; 4 Instituto Oncológico del Oriente Boliviano, Radiation Oncology, Santa Cruz, Bolivia ; 5 Unidad Médica de Alta Especialidad- IMSS 25, Radiation Oncology, Monterrey, Mexico ; 6 “Universidad de la Republica” UDELAR- Hospital “Dr. Manuel Quintela”, Radiation Oncology, Montevideo, Uruguay ; 7 University of California San Francisco, Radiation Oncology Department, San Francisco, USA Purpose or Objective Radiation is one of the pillars for the treatment of cancer and is indicated in approximately 50-60% of patients diagnosed with cancer. Given the rising demands in cancer care and shortage of radiation oncologists globally, it is crucial that radiation oncology specialists are well trained to ensure access to safe, adequate, and efficacious radiotherapy for their patients. Currently, there does not exist a unified program for training in Latin America, and it remains unknown the similarities or differences between existing residency training programs. Describe the current state of radiation oncology residency training programs in Latin America and construct recommendations to improve the quality of training. Material and Methods Through a descriptive study design, we identified all universities and clinics providing residency training programs in radiation oncology in Latin America. Residents and/or specialists from each center were contacted and