Evidence-based guidance for peer review “best practices” in radiation oncology.

180Background: Peer review (PR) is an essential component of quality assurance in radiation oncology practice, endorsed by Canadian cancer agencies as a national standard of quality care. However, reported patterns of care studies indicate that PR practice varies considerably, including which contours (e.g., target volumes, organs at risk (OARs)), which dose parameters (e.g., OAR constraints, homogeneity criteria), which decision making points (e.g., decision to treat, selection of anatomical regions), and which treatment imaging parameters are included in the PR process. Both qualitative and quantitative evidence support the need for guidance on PR best practices. Here we report processes for the establishment of best-practice guidelines/minimal standards for PR. Methods: A comprehensive literature review was done to quantify PR findings for each of 3 cancer streams: head/neck, lung, and breast. This evidence summarized which aspects of radiotherapy plans were most frequently "flagged" at PR. A modified ...