ESTRO 2024 - Abstract Book

S5872

RTT - Service evaluation, quality assurance and risk management

ESTRO 2024

The ongoing UK SCOPE2 trial evaluates radiotherapy (RT) dose escalation in oesophageal cancer. An accompanying, robust RT quality assurance (RTQA) programme includes on-trial individual case review (ICR) performed by a number of RTQA clinical oncologists (COs) to enable timely review and distribute workload, but introduces the risk of inter reviewer variation. Here we evaluate patterns of approval within the RTQA team.

Material/Methods:

Successful completion of a pre-accrual benchmarking process was mandated for all centres.

For ICRs, prospective review (prior to RT start, PR) was undertaken for each centre’s 1st submission, plus high-dose cases submitted pending formal safety review. Additional PRs were undertaken at the RTQA team’s discretion, most commonly if issues with prior submissions had been observed. Timely retrospective review (within 2 weeks of RT start, TRR) was also undertaken for a random 10% sample. Target volume delineation (TVD) was assessed using predefined criteria and the SCOPE2 radiotherapy planning guidance document (RPGD) by a senior CO (sCO), or by a junior CO supervised by a sCO (joint review, JR). ICRs were allocated on a rota basis. Resubmission was requested at the reviewer’s discretion, usually due to an identified significant unacceptable variation (UV) from protocol. Dialogue with the submitting centre was sought before ICR approval/resubmission request where appropriate. Review outcomes were recorded, and resubmissions excluded from our study.

Statistical analysis was performed using SPSS v.28 (IBM Corp Armonk, NY, USA).

Results:

To date, 117 submissions have been reviewed by 9 COs. Distribution of reviews and outcomes by sCO are shown in the table below.