Volume perfection.

Top Line: Peer review of radiation plans is common practice.

The Study: The problem is these reviews often occur after treatment has already started making any necessary replanning, well, messy. Because many changes are due to target volume changes (and most commonly for head and neck cases), MSKCC instituted volume rounds where head and neck contours receive peer review prior to radiation planning. Among 511 cases, minor changes were recommended in 75 (15%) and major changes (requiring re-review) in 86 (17%). What’s more, 68 cases (13%) were recommended to receive further work-up or consultations prior to radiation start. Now, this is important for a couple of reasons. Perhaps most importantly, with the use of definitive head and neck radiation likely to rise in the coming years along with the increasing incidence of HPV+ disease and promising comparative data, getting these volumes accurate is crucial. Second, making these corrections prior to planning saves some serious dosimetry resources.

TBL: Nearly one-third of head and neck volumes are recommended to undergo revisions when peer reviewed prior to planning. | Hesse, Adv Radiat Oncol 2022