JOINT RADIATION PLANNING PEER REVIEW IN HEAD AND NECK CANCER: A RETROSPECTIVE ANALYSIS OF QA RECOMMENDATIONS AND PATIENT OUTCOMES
Notice bibliographique
Résumé
Head and neck cancer (HNC) radiation planning peer review is considered an essential component of high-quality care, aimed at improving patient outcomes through structured quality assurance (QA) recommendations. This study examines the impact of QA recommendations according to primary sites and stages, compliance rates, and associations with patient outcomes, including metastasis and mortality as we report our experience with a joint peer review model. A retrospective analysis was conducted on 168 HNC patients treated at one cancer centre and had peer review with another institution between January 2020 and December 2022, analyzing demographics, cancer types, stages, treatment modalities, radiation doses, QA recommendations, compliance, local recurrence, metastasis, and mortality. The QA recommendations were grouped into major, minor, and no changes. A major change was defined as target contouring modification while a minor change was defined as organs-at-risk (OAR) contouring that was unlikely to change patient outcome. The study assessed the distribution of weekly QA recommendations across primary sites and stages, compliance rates, and their impact on patient outcomes. The cohort had a median age of 64.8 years, with 80.6% male and 19.4% female. Smoking history was prevalent in 66.7% of patients, and 57.8% had a history of alcohol use. The most common primary site was the oropharynx (36.6%), followed by larynx (18.9%) and oral cavity (16.5%). Squamous Cell Carcinoma (SCC) was the dominant histology (86.1%). 65.1% of patients received “No Change” recommendations, while 20.5% and 14.5% required major and minor changes, respectively. Overall compliance with QA recommendations was high (92.1%), with major changes having 100% compliance and minor changes having 54.5% compliance. 52.3% of compliant plans had local recurrence, compared to 61.5% in non-compliant plans. There is no statistical correlation between the recurrence rate and compliance to peer review recommendations. At a median follow up of 30 months, 31.3% of patients have died, with the highest mortality rate (35.3%) among those requiring major QA changes. Compliant patients had a higher mortality rate (32.5%) compared to non-compliant patients (23.1%). HNC radiation planning peer review remains a critical component of QA, with recommendations influencing patient outcomes. While compliance was high, minor QA changes had the lowest adherence, potentially impacting recurrence and metastasis rates. Patients requiring major QA revisions experienced longer times before metastasis but had the highest mortality rate, suggesting more advanced stages might have caused disagreement in planning. These findings underscore the role of structured peer review in optimizing HNC treatment and improving long-term patient outcomes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,025 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».