title: Impact of the introduction of weekly radiotherapy quality assurance meetings at one UK cancer centre.
abstract: OBJECTIVE
  The complexity of radiotherapy planning is increasing rapidly. Delivery and planning is subject to detailed quality assurance (QA) checks. The weakest link is often the oncologists' delineation of the clinical target volume (CTV). Weekly departmental meetings for radiotherapy QA (RTQA) were introduced into the Royal Wolverhampton Hospital, Wolverhampton, UK, in October 2011. This article describes the impact of this on patient care.
  
  
  METHODS
  CTVs for megavoltage photon radiotherapy courses for all radical, adjuvant and palliative treatments longer than five fractions (with the exception of two field tangential breast treatments not enrolled into clinical trials) were reviewed in the RTQA meeting. Audits were carried out in January 2012 (baseline) and September 2013, each over a 4-week period. Adherence to departmental contouring protocols was assessed and the number of major and minor alterations following peer review were determined.
  
  
  RESULTS
  There was no statistically significant difference for major alterations between the two study groups; 8 alterations in 80 patients (10%) for the baseline audit vs 3 alterations from 72 patients (4.2%) in the second audit (p = 0.17). A trend towards a reduction in alterations following peer review was observed. There has, however, been a change in practice resulting in a reduction in variation in CTV definition within our centre and greater adherence to protocols. There is increasing confidence in the quality and constancy of care delivered.
  
  
  CONCLUSIONS
  Introduction of a weekly QA meeting for target volume definition has facilitated consensus and adoption of departmental clinical guidelines within the unit.
  
  
  CONCLUSIONS
  The weakest areas in radiotherapy are patient selection and definition of the CTV. Engagement in high-quality RTQA is paramount. This article describes the impact of this in one UK cancer centre.
authors.affiliation: 1 The Clatterbridge Cancer Centre, Clatterbridge Road, Bebington, Wirral, UK.
authors.forename: C V
authors.initials: CV
authors.lastname: Brammer
authors.forename: L
authors.initials: L
authors.lastname: Pettit
authors.forename: R
authors.initials: R
authors.lastname: Allerton
authors.forename: M
authors.initials: M
authors.lastname: Churn
authors.forename: M
authors.initials: M
authors.lastname: Joseph
authors.forename: P
authors.initials: P
authors.lastname: Koh
authors.forename: I
authors.initials: I
authors.lastname: Sayers
authors.forename: M
authors.initials: M
authors.lastname: King
mesh_terms: D001943:Breast Neoplasms / Q000532:radiotherapy*; D054869:Clinical Audit; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D058996:Quality Improvement; D011880:Radiotherapy Planning, Computer-Assisted / Q000592:standards*; D012189:Retrospective Studies