Our department has developed protocols with recommended dose constraints for dose volume histograms (DVH) for each group of definitive radiotherapy based on the best available evidence.
We have developed a colour coding system to indicate when constraints are meeting objectives (green),
being slightly outside of objectives (yellow) and being moderately beyond planning objectives (red).
We performed a quality audit to evaluate the number of times these DVH/OAR dose constraints are accepted in yellow or red constraints across all radiotherapy groups.
This is being performed to...
Methods and materials
All definitive radiotherapy DVH reports generated for the first 6 month of 2017 were collected through Mosaiq (radiation oncology information system) reports.
For each radiotherapy group the overridden dose constraints were evaluated and categorized to major variation (red) or minor variation (yellow).
Mosaiq was searched for any documented reason for accepting these variations by the treating radiation oncologist.
Follow up documents/assessments in Mosaiq were searched for grade 3 or 4 acute or subacute radiotherapy toxicity (up to 6months post treatment) for all patients in our...
617 patients with DVH documents generated for definitive radiotherapy plans in the first 6 months of 2017 were assessed in Mosaiq.
11 patients were excluded as 7 did not complete the course of radiotherapy and 4 were converted to palliative plans as not safe to proceed with radical radiotherapy.
8 patients in genitourinary group had 2 separate plans,
one for external beam radiotherapy (EBRT) and one for stereotactic body radiotherapy (SBRT) boost,
therefore a total of 614 plans were assessed.
There were 210 plans (34%)...
one third of definitive plans in our department were accepted with at least one major protocol variation of the recommended OAR dose constraints.
This was correlated with higher rates of grade 3 acute and subacute toxicities especially in lung group where there is a good protocol adherence but protocol deviation would result in a high rate of Grade 3 acute and subacute toxicity.
Major protocol variation in other groups was observed,
more frequently in H&N group.
This study can act as a benchmark...