Impact of consensus guidelines on delineation of primary tumor clinical target volume (CTVp) for head and neck cancer: Results of a national review project.


Journal

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
ISSN: 1879-0887
Titre abrégé: Radiother Oncol
Pays: Ireland
ID NLM: 8407192

Informations de publication

Date de publication:
12 2023
Historique:
received: 15 06 2023
revised: 31 08 2023
accepted: 12 09 2023
medline: 28 11 2023
pubmed: 23 9 2023
entrez: 22 9 2023
Statut: ppublish

Résumé

A significant interobserver variability (IOV) for clinical target volume of the primary tumor (CTVp) delineation was shown in a previous national review project. Since then, international expert consensus guidelines (CG) for the delineation of CTVp were published. The aim of this follow-up study was to 1) objectify the extent of implementation of the CG, 2) assess its impact on delineation quality and consistency, 3) identify any remaining ambiguities. All Belgian RT departments were invited to complete an online survey and submit CTVp for 5 reference cases. Organs at risk and GTV of the primary tumor were predefined. Margins, volumes, IOV between all participating centers (IOV 17 RT centers completed both survey and delineations, of which 88% had implemented CG. Median DSC Implementation of consensus guidelines for CTVp delineation is already fairly advanced on a national level, resulting in significantly increased delineation uniformity. The accompanying substantial decrease of CTV receiving high dose RT calls for caution and correct interpretation of CG. Clarification of the existing guidelines seems appropriate especially for oropharyngeal and hypopharyngeal carcinoma.

Sections du résumé

BACKGROUND AND PURPOSE
A significant interobserver variability (IOV) for clinical target volume of the primary tumor (CTVp) delineation was shown in a previous national review project. Since then, international expert consensus guidelines (CG) for the delineation of CTVp were published. The aim of this follow-up study was to 1) objectify the extent of implementation of the CG, 2) assess its impact on delineation quality and consistency, 3) identify any remaining ambiguities.
MATERIALS AND METHODS
All Belgian RT departments were invited to complete an online survey and submit CTVp for 5 reference cases. Organs at risk and GTV of the primary tumor were predefined. Margins, volumes, IOV between all participating centers (IOV
RESULTS
17 RT centers completed both survey and delineations, of which 88% had implemented CG. Median DSC
CONCLUSION
Implementation of consensus guidelines for CTVp delineation is already fairly advanced on a national level, resulting in significantly increased delineation uniformity. The accompanying substantial decrease of CTV receiving high dose RT calls for caution and correct interpretation of CG. Clarification of the existing guidelines seems appropriate especially for oropharyngeal and hypopharyngeal carcinoma.

Identifiants

pubmed: 37739317
pii: S0167-8140(23)89809-7
doi: 10.1016/j.radonc.2023.109915
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

109915

Informations de copyright

Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Heleen Bollen reports financial support was provided by Research Foundation Flanders. Sandra Nuyts reports financial support was provided by Research Foundation Flanders.

Auteurs

Heleen Bollen (H)

KU Leuven, Dept. Oncology, Laboratory of Experimental Radiotherapy, & UZ Leuven, Radiation Oncology, B-3000, Leuven, Belgium. Electronic address: heleen.bollen@uzleuven.be.

Akos Gulyban (A)

Medical Physics department, Institut Jules Bordet, Brussels, Belgium; Radiophysics and MRI physics laboratory, Faculty of Medicine, Free University of Bruxelles (ULB), Brussels, Belgium.

Sandra Nuyts (S)

KU Leuven, Dept. Oncology, Laboratory of Experimental Radiotherapy, & UZ Leuven, Radiation Oncology, B-3000, Leuven, Belgium.

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