(Saturday, 4/4/2020) [Mountain Time (GMT-6)]
Purpose: Radiation therapy plans undergo numerous quality assurance checks throughout the planning process to ensure that the plan is safe, effective, and deliverable. Despite these checks, some plans will require a modification during the course of treatment to fix an error in the plan. Unfortunately, our clinic does not currently track the percentage of plans in our system that require modification or know the underlying causes of these errors. The goal of this study is to develop a framework for identifying plans which required modification in our clinic and then perform a root cause analysis on each so that we can better understand and address the issues that cause them.
Methods: A script implemented in the Aria Unified Reporting Application (AURA) was utilized to identify plans that were treated and required a plan modification throughout the course of treatment. A manual investigation of each of these plans was performed to categorize each plan modification, including whether the modification was preventable or not, whether there was a dosimetric error, and whether there were any adverse effects on the patient (eg. treatment delay).
Results: Preliminary results were obtained on plan modifications occurring in a single calendar month. These results indicate that up to five percent of plans that passed all pre-treatment checks still required a plan modification, but that none of the planning errors resulted in a dosimetric error.
Conclusion: Five percent of plans requiring a plan modification is higher than initially anticipated. However, further investigation is needed to determine whether these plan modifications were preventable or the result of a normal change in patient anatomy throughout the course of treatment.
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