Evaluation of a Prospective Radiation Oncology Departmental Peer Review Process using Standardized Simulation Directives.

Prospective peer review prior to simulation in radiotherapy identifies actionable change in approximately 18% of procedures, and results in an extremely low, < 1% rate of re-simulation. SSRDs ordered > 1 week before from simulation and gastrointestinal and pelvic sites were at higher risk of requiring modifications during peer review. As departmental processes transition to virtual meeting platforms, more thorough attention is needed to identify patients at higher risk of simulation modifications.