A peer review of pediatric radiation therapy planning: results and prospects

Timely identification, analysis, and prevention of potential errors in radiotherapy are crucial for successful comprehensive treatment. The aim of this study – to establish a system of peer review of radiation therapy plans in pediatric practice prior to treatment initiation in order to avoid possible major errors in treatment planning as well as to assess and improve the quality of radiation therapy, and consequently, treatment outcomes of pediatric patients. In study established a 42 % utilization rate for radiation therapy in pediatric practice. Here, we present the results of a peer review of 589 radiation therapy plans in children conducted from 2019 to 2024, with 43.3 % of them requiring corrections. It was demonstrated that the most significant challenge in ensuring the quality of radiation therapy remained target volume delineation: the most common errors were related to target contouring (36.7 %), less frequently to organs-at-risk contouring (2.3 %), and dose prescription (5.4 %). Radiation therapy planning was most difficult in patients with Hodgkin lymphoma (55.2 % of errors) and those requiring craniospinal irradiation (39.5 % of errors). A peer review of radiation therapy plans resulted in a significant (p < 0.001) reduction of errors: from 51.1 % at first review to 23.6 % after the fourth one. These numbers confirm the educational value of the peer review system and its role in furthering professional development of specialists. A peer review of radiation therapy plans in children is an important tool for improving the quality of treatment and minimizing associated risks. The results of our study emphasize the importance of continuing and expanding the use of radiotherapy planning so that to ensure high quality care and reduce risks for patients.