Head and Neck Cancer (HNC) is an aggressive, challenging, and genetically complex cancer that carries a poor prognosis. Only some patients benefit from chemotherapy and surgery, while radiation is the chief treatment that can potentially cure or offer long-term disease control. HNC is prevalent in the Windsor region due to high rates of smoking and alcohol use, and low rates of HPV vaccination. Radiotherapy requires subspecialty expertise, and currently only half of the 14 Regional Cancer Centers in Ontario are authorized to treat HNCs. In 2015, Windsor Regional Cancer Center (WRCC) developed an internal HNC radiation treatment planning peer review Quality Assurance (QA). In 2019, a joint Radiation Oncologist Peer Review (ROPR) was created with the London Regional Cancer Center (LRCC). During weekly QA rounds, HNC being treated in London and Windsor is discussed prior to radiation, including changing treatment plans.

This study will investigate what the collaborative QA between the two cancer programs has achieved. Information will be collected on HNC patient radiation treatment planning peer review data at WRCC between 2015 and 2021, including radiation dose planned and received, recommendations, and compliance. Patient age, gender, diagnosis, and cancer stage will also be collected in the most recent two years. We will compare outcomes of our internal ROPR from 2015 to 2019, to that of the collaborative ROPR between LRCC and WRCC in the most recent two years. We hypothesize an improvement in HNC patients’ outcomes, including locoregional control, overall survival, quality of life, and decreased toxicity.