S1503
Interdisciplinary - Quality assurance and risk management
ESTRO 2026
Radiation Oncology. Practical Radiation Oncology 2021; 11(3):e256-e262.
treatment, patient photo). Department B provided automatic case queuing, saved display states, and displayed a vendor-preconfigured subset of ROIS information within the PRM. Results:
DOI:10.1016/j.prro.2020.09.007. Keywords: ILS, Quality, Safety
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Structured peer review of treatment plans in radiation oncology departments: Improving efficiency, accountability and documentation Maximilian Grohmann 1,2 , Cordula Petersen 2 , Manuel Todorovic 2 , Thorsten Frenzel 2 , Renata kazmierczak 2 , Leonie Förster 2 , Manuela Maak 2 , Andrea Baehr 2 , David Krug 2 , Christos Moustakis 1 , Nils Nicolay 1 , Sebastian Schäfer 1 1 Department of Radiation Oncology, University of Leipzig Medical Center, Leipzig, Germany. 2 Department of Radiotherapy and Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Purpose/Objective: Peer review (PR) is a key quality assurance element in radiotherapy (RT), yet its implementation remains heterogeneous and often lacks structured documentation and multidisciplinary participation. We report the implementation and evaluation of two dedicated RTPR solutions in tertiary cancer centers with different treatment planning systems (TPS) and approval workflows, aiming to improve efficiency, traceability, and interdisciplinary accountability while aligning with best practices [1]. Material/Methods: Department A used an in-house Python-based RTPR software for 18 months, whereas department B a TPS- integrated RTPR module for 4 months. In both departments, treatment plans were generated by medical physicists (MPs) and discussed in multidisciplinary meetings including radiation oncologists (ROs), MPs, and radiation therapists (RTTs). The workflows differed regarding physician pre-approval: in department A, plans were presented in the peer-review meeting (PRM) before any physician review, enabling early multidisciplinary input; in department B, plans were pre-approved by the responsible RO and subsequently queued for the PRM.Both systems required classification of review outcomes (accept / reject) with mandatory justifications and structured documentation. While both followed the same principles, technical implementations differed. Department A offered customizable fields, selectable rejection reasons, and additional TPS scripts for optimized visualization (dashboard / beamer view), with radiation oncology information system (ROIS) patient data accessed via a second screen (e.g., diagnosis, prescription, last
Both departments achieved efficient, structured, and traceable PR workflows with mean review times of 2–3 minutes per case. Longer case discussions in department A reflected its multidisciplinary approval process without prior physician review, potentially shortening the overall workflow by replacing sequential reviews with a single combined step. Conversely, pre-approval in department B may help identify and correct issues earlier, reducing discussion time during PRM.The top three rejection categories were identical in both departments— concept modification, target volume modification, and re-optimization requested—suggesting recurring decision patterns. Conclusion: Both structured RTPR solutions proved feasible and effective for multidisciplinary plan review in routine clinical practice. Despite different system architectures and workflows, comparable efficiency and completeness of documentation were achieved. Structured decision logging, mandatory feedback, and automated traceability strengthen accountability and may help reduce inter-observer variability. Based on these complementary experiences, practical recommendations can be derived to guide the design, timing, and documentation standards of peer-review processes in radiotherapy - providing a foundation for future multicenter validation and standardization efforts. References: Abbreviations: RT = Radiotherapy; RO = Radiation Oncologist; MP = Medical Physicist; RTT = Radiation
Therapist; PRM = Peer Review Meeting; TPS = Treatment Planning System; ROIS = Radiation
Oncology Information System[1] Baehr et al., ‘Current practices in peer review in German radiation oncology: a nationwide survey’, doi:10.1007/s00066-025-02444-6 Keywords: peer review,quality assurance,workflow Digital Poster 1049
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