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Best-Practice Guidelines for Radiation Treatment Plan Physics Review: Report of a Provincial Working Group

A Rink1*, G Salomons2, A Vandermeer3, L Conroy1, D Granville4, J Gaul5, T Mutanga6, M Paudel7, R Jiang8, J Bissonnette1, J Kraus Himmelmann9, H Keller1, (1) The Princess Margaret Cancer Centre, University Health Network, Toronto, ON, CA, (2) Cancer Center of Southeastern Ontario, Kingston, ON, CA, (3) R.S. McLaughlin Durham Regional Cancer Centre, Oshawa, ON, CA, (4) The Ottawa Hospital, Ottawa, ON, CA, (5) Windsor Regional Hospital, Windsor, ON, CA, (6) Credit Valley Hospital and Trillium Health Centre, Mississauga, ON, CA, (7) Sunnybrook Odette Cancer Center, University of Toronto, Toronto, ON, CA, (8) Grand River Hospital, Kitchener, ON, CA, (9) Cancer Care Ontario


(Sunday, 7/12/2020)   [Eastern Time (GMT-4)]

Room: AAPM ePoster Library

Purpose: We generated best practice guidelines to facilitate standardization of physics plan review in preparation for the introduction of a provincial quality based procedure (QBP) funding model.

Methods: A working group of eleven medical physicists with external beam (EBRT) and brachytherapy (BT) background was assembled, representing eight different institutions from both academic and community centers. The group conducted a literature review on existing guidelines and peer reviewed publications to create a list of best practice recommendations in the form of Key Quality Indicators (KQIs). In the absence of published recommendations, clinical experience and expertise of the group members informed the guidelines. The proposed guidelines were cross-compared to the report of AAPM Task Group 275 (TG275) for validation.

Results: A list of thirty-three KQIs was generated. The KQIs belonged to one of the following categories: infrastructure (8), combined EBRT and BT (16), EBRT only (3), BT only (3), and documentation (3). With the exception of one KQI that had a percentage indicator, all were a binary outcome, allowing for an easy assessment of institutional plan review procedures. There was a significant (27 out of 33) overlap in KQIs for EBRT and BT underscoring the similarity, rather than differences, between the two practices. All checks mentioned in TG275 were either included (explicitly or implicitly) within the recommended KQIs or were intentionally excluded because they were out of scope.

Conclusion: This exercise resulted in the creation of a tool for assessing and improving quality and education of radiation treatment plan physics review and for standardization across different institutions. The similarities with TG275, which was generated using a different approach, suggest that practical plan checking guidelines are feasible and can be applied in diverse clinical environments.


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