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. 2022 Aug;37(4):1036-1042.
doi: 10.1007/s13187-020-01917-9. Epub 2020 Oct 31.

Moving Experience from North America to Developing Country to Approach a Desired Level of Quality Assurance in Head and Neck Radiation Therapy

Issa Mohamad  1 , Ali Hosni  2 , Ramiz Abu-Hijlih  3 , Abdellatif Al Mousa  3 , Dalia Al-Rimawi  4 , Fawzi Abuhijla  3
Affiliations

Moving Experience from North America to Developing Country to Approach a Desired Level of Quality Assurance in Head and Neck Radiation Therapy

Issa Mohamad et al. J Cancer Educ. 2022 Aug.

Abstract

Evidence is lacking correlation between head and neck (HN) radiation oncology fellowship training and quality assurance (QA) round decision for plan modifications. This study was conducted to identify the association between training and changes in QA decisions. From 2007 to 2018, data on HN cancer cases presented at departmental QA rounds were prospectively collected. Then, we retrospectively analyzed the collected data to determine the impact of fellowship training on QA decisions. Cases were divided into pre-fellowship group (January 2007-September 2014) and post-fellowship group (October 2014-December 2018). Multivariable analysis (MVA) evaluated variables that could be associated with decreased frequencies of QA modification rates. From 2007 to 2018, 1266 HN cancer patients were identified; 728 patients were in the pre-fellowship group and 538 patients in the post-fellowship group. On MVA, fellowship training transformed QA decisions from more to less modifications (modified vs. approved; OR, 0.135; 95% CI, 0.076-0.240; p = 0.0001), increased approval rate for advanced T and N categories (T3-4 vs. T0-T2; OR, 0.798; 95% CI, 1.892-4.929; p = 0.0001 and N2-3 vs. N0-1; OR, 0.865; 95% CI, 1.454-3.423; p = 0.0002). By type of modification, fellowship training demonstrated a statistically significant reduction in rates of several types of modification that include target volume definition, target volume delineation, and dose (all p < 0.05). Our study determines the impact of the HN radiation oncology fellowship on decreased QA modification rates.

Keywords: Fellowship; Head and neck cancer; Quality assurance rounds; Training.

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