Predictors of breast radiotherapy plan modifications: Quality assurance rounds in a large cancer centre

• Published in: Radiotherapy and oncology 2015-01, Vol.114 (1), p.17-21
• Main Authors: Lymberiou, Timothy, Galuszka, Susanne, Lee, Grace, Xu, Wei, Fyles, Anthony, Su, Susie, Purdie, Thomas G, Catton, Pamela, Chung, Caroline, Dinniwell, Robert, Koch, Anne, Levin, Wilfred, Manchul, Lee, Warde, Padraig, Liu, Fei-Fei
• Format: Article
• Language: English
• Subjects: Adult; Breast cancer; Breast Neoplasms - radiotherapy; Breast Neoplasms - surgery; Cancer Care Facilities - organization & administration; Cancer Care Facilities - standards; Feasibility Studies; Female; Hematology, Oncology and Palliative Medicine; Humans; Lymph Node Excision - methods; Middle Aged; Patient Care Planning - organization & administration; Patient Care Planning - standards; Planning; Prospective Studies; Quality assurance; Quality Assurance, Health Care; Radiotherapy
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/j.radonc.2014.11.042

Abstract Background and purpose This study describes the process and outcomes of breast radiotherapy (RT) quality assurance (QA) rounds, seeking to identify variables associated with plan modifications. Materials and methods Real-time data were prospectively collected over 2 years. Descriptive statistics determined the proportion of cases requiring no (A), minor (B), or major (C) modifications, which were then subjected to univariate and multivariate analyses. Results A total of 2223 breast cancer QA cases were reviewed; 47 cases (2.1%) underwent a minor, and 52 cases (2.3%) required a major modification. Common changes included boost, volume, seroma, and bolus. On univariate analysis, regional nodal irradiation (RNI), tumour size, and axillary node dissection were significantly associated with major modifications. Upon multivariate analysis, the only independent predictor was RNI (OR 2.12, p = 0.0075). For patients with no RNI,