title: Does a central review platform improve the quality of radiotherapy for rectal cancer? Results of a national quality assurance project.
abstract: OBJECTIVE
  Quality assurance (QA) for radiation treatment has become a priority since poorly delivered radiotherapy can negatively influence patient outcome. Within a national project we evaluated the feasibility of a central review platform and its role in improving uniformity of clinical target volume (CTV) delineation in daily practice.
  
  
  METHODS
  All Belgian radiotherapy departments were invited to participate and were asked to upload CTVs for rectal cancer treatment onto a secured server. These were centrally reviewed and feedback was given per e-mail. For each five consecutive patients per centre, the overlap parameter dice coefficient (DC) and the volumetric parameters volumetric ratio (RV) and commonly contoured volume (VCC) were calculated.
  
  
  RESULTS
  Twenty departments submitted 1224 eligible cases of which 909 were modified (74.3%). There was a significant increase in RV and VCC between the first ten patients per centre and the others. This was not seen for DC. Statistical analysis did not show a further significant improvement in delineation over the entire review period.
  
  
  CONCLUSIONS
  Central review was feasible and increased the uniformity in CTV delineation in the first ten rectal cancer patients per centre. The observations in this study can be used to optimize future QA initiatives.
authors.affiliation: Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Belgium; Department of Oncology, KU Leuven, Belgium.
authors.forename: Ines
authors.initials: I
authors.lastname: Joye
authors.affiliation: Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Belgium; Department of Oncology, KU Leuven, Belgium.
authors.forename: Maarten
authors.initials: M
authors.lastname: Lambrecht
authors.affiliation: Department of Research, Belgian Cancer Registry, Brussels, Belgium.
authors.forename: David
authors.initials: D
authors.lastname: Jegou
authors.affiliation: Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Belgium; Department of Oncology, KU Leuven, Belgium.
authors.forename: Eszter
authors.initials: E
authors.lastname: Hortobágyi
authors.affiliation: Department of Radiation Oncology, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Pierre
authors.initials: P
authors.lastname: Scalliet
authors.affiliation: Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Belgium; Department of Oncology, KU Leuven, Belgium. Electronic address: karin.haustermans@uzleuven.be.
authors.forename: Karin
authors.initials: K
authors.lastname: Haustermans
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011785:Quality Assurance, Health Care; D018787:Radiation Oncology / Q000458:organization & administration / Q000592:standards*; D011878:Radiotherapy / Q000592:standards; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods / Q000592:standards*; D012004:Rectal Neoplasms / Q000532:radiotherapy*; D055815:Young Adult
keywords: Central review; Quality assurance; Radiotherapy; Rectal cancer; Target delineation