ESTRO 2025 - Abstract Book

S2379

Interdisciplinary – Other

ESTRO 2025

Results Between June 2023 to October 2023 in total 353 patients with 530 treatment plans were enrolled in the study: 168 patients with 265 plans in the single-step peer-review and 185 patients with 265 plans in the two-step peer-review. The ratio between 3D conformal versus intensity modulated plans was not significantly different (0.18 versus 0.20) and there were slightly more re-irradiation type I cases in the two-step peer-review compared to the single-step peer-review (12% versus 8%). A significant increase in requests for contour and treatment concept changes after contouring peer review compared to the single-step peer-review was found (16% versus 5%, p<0.001). The proportion of plan rejections requiring dose distribution modification was comparable between the two peer-review strategies (1.1% (2-step) versus 1.9% (1-step), p=0.15). The total peer-review times were 1.7 times longer in the two-step peer-review (3.66 min per case) compared to the one-step peer-review (2.09 min per case). More time (28%) was spent on cases that were not approved compared to approved cases. The most requests for revisions in contours and treatment concept came from senior radiation oncologists, while the highest frequency of requests for dose distribution revisions was from medical physicists (figure 2). Survey results showed a strong preference for the two-step peer review process among both medical physicists and clinicians.