ESTRO 2025 - Abstract Book

S2262

Interdisciplinary – Health economics & health services research

ESTRO 2025

248

Proffered Paper A systematic review and meta-analysis on the impact of institutional peer review in radiation oncology Jane Jomy 1,2 , Rachel Lu 2 , Radha Sharma 2 , Ke Xin Lin 2 , David C Chen 2 , Jeff Winter 1 , Srinivas Raman 3 1 Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada. 2 Temerty Faculty of Medicine, University of Toronto, Toronto, Canada. 3 Department of Radiation Oncology, BC Cancer, Vancouver, Canada Purpose/Objective: Radiotherapy peer review is recognized as a key component of institutional quality assurance, though the impact is ill-defined. We conducted the first systematic review and meta-analysis to date to quantify the impact of institutional peer review on treatment plans. Material/Methods: We searched several medical and healthcare databases from January 1, 2000, to May 25, 2024, for papers that report on the impact of institutional radiotherapy peer review on treatment plans. We conducted random-effects meta-analyses of proportions to summarize the rates of any change recommendation and major change recommendation (suggesting re-planning or re-simulation due to safety concerns) following peer review processes. To explore differences in change recommendations dependent on location, radiotherapy intent, technique, and peer review structure characteristics, we conducted analyses of variance. Results: Of 9,487 citations, we identified 55 studies that report on 96,444 case audits in 10 countries across various disease sites. The pooled proportion of any change recommendation was 28% (95%CI=21-35) and major change recommendation was 12% (95%CI=7-18). Proportions of change recommendation were not impacted by any treatment characteristics. The most common reasons for change recommendation include target volume delineation (25/55; 45%), target dose prescription (18/55; 33%), organ at risk dose prescription (5/55; 9%), and organ at risk volume delineation (3/55; 5%). Conclusion: Our review provides evidence that peer review results in treatment plan change recommendations in over one in four patients. The results suggest that some form of peer review may be beneficial for most cases, irrespective of treatment intent or RT technique. Keywords: radiotherapy peer review, meta-analysis References: 1. Lewis PJ, Court LE, Lievens Y, Aggarwal A. Structure and Processes of Existing Practice in Radiotherapy Peer Review: A Systematic Review of the Literature. CLINICAL ONCOLOGY. 2021;33(4):248-60. 2. Martin-Garcia E, Celada-Alvarez F, Pérez-Calatayud MJ, Rodriguez-Pla M, Prato-Carreño O, Farga-Albiol D, et al. 100% peer review in radiation oncology: is it feasible? CLINICAL & TRANSLATIONAL ONCOLOGY. 2020;22(12):2341-9. 3. Reddeman L, Foxcroft S, Gutierrez E, Hart M, Lockhart E, Mendelsohn M, et al. Improving the Quality of Radiation Treatment for Patients in Ontario: Increasing Peer Review Activities on a Jurisdictional Level Using a Change Management Approach. JOURNAL OF ONCOLOGY PRACTICE. 2016;12(1):81.