Radiotherapy Treatment Review: A Prospective Evaluation of Concordance between Clinical Specialist Radiation Therapist and Radiation Oncologist in Patient Assessments

Abstract

PurposeThis study assessed the concordance of patient assessments performed during weekly radiotherapy treatment reviews between the breast site clinical specialist radiation therapist (CSRT) and radiation oncologist (RO). Methods and MaterialsA CSRT and RO independently assessed patients attending a breast radiotherapy review clinic and graded their toxicities according to the Common Terminology Criteria for Adverse Events v.3.0. Both observers were blinded to each other’s assessments. The concordance rates and agreement levels, indicated by the Kappa statistics, were calculated with the RO considered as the gold standard. ResultsTwenty-nine consecutive patients were prospectively reviewed over 12 weeks. High concordance occurred between CSRT and RO assessments, with an overall concordance rate of 96% for all evaluated toxicities. The concordance rates for non-zero grade toxicities ranged from 76% to 100%. There was almost perfect agreement between the CSRT and RO in toxicity grading for dermatitis (P < .05), whereas fair agreement was observed for hyperpigmentation (P < .05). Overall, there was increasing agreement between the CSRT and RO assessments over time. ConclusionCommon side effects experienced by patients receiving breast radiotherapy as detected and graded by the CSRT were highly comparable to those of the RO. This study lends support for CSRT involvement in treatment review assessments for this patient population.