Proposal for the delineation of neoadjuvant target volumes in oesophageal cancer.
Radiother Oncol
; 156: 102-112, 2021 03.
Article
in En
| MEDLINE
| ID: mdl-33285194
ABSTRACT
PURPOSE:
To define instructions for delineation of target volumes in the neoadjuvant setting in oesophageal cancer. MATERIALS ANDMETHODS:
Radiation oncologists of five European centres participated in the following consensus process [1] revision of published (MEDLINE) and national/institutional delineation guidelines; [2] first delineation round of five cases (patient 1-5) according to national/institutional guidelines; [3] consensus meeting to discuss the results of step 1 and 2, followed by a target volume delineation proposal; [4] circulation of proposed instructions for target volume delineation and atlas for feedback; [5] second delineation round of five new cases (patient 6-10) to peer review and validate (two additional centres) the agreed delineation guidelines and atlas; [6] final consensus on the delineation guidelines depicted in an atlas. Target volumes of the delineation rounds were compared between centres by Dice similarity coefficient (DSC) and maximum/mean undirected Hausdorff distances (Hmax/Hmean).RESULTS:
In the first delineation round, the consistency between centres was moderate (CTVtotal DSC = 0.59-0.88; Hmean = 0.2-0.4 cm). Delineations in the second round were much more consistent. Lowest variability was obtained between centres participating in the consensus meeting (CTVtotal DSC p < 0.050 between rounds for patients 6/7/8/10; Hmean p < 0.050 for patients 7/8/10), compared to validation centres (CTVtotal DSC p < 0.050 between validation and consensus meeting centres for patients 6/7/8; Hmean p < 0.050 for patients 7/10). A proposal for delineation of target volumes and an atlas were generated.CONCLUSION:
We proposed instructions for target volume delineation and an atlas for the neoadjuvant radiation treatment in oesophageal cancer. These will enable a more uniform delineation of patients in clinical practice and clinical trials.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Esophageal Neoplasms
/
Neoadjuvant Therapy
Type of study:
Guideline
Limits:
Humans
Language:
En
Journal:
Radiother Oncol
Year:
2021
Document type:
Article