Ying Sun1, Xiao-Li Yu1, Wei Luo1, Anne W M Lee2, Joseph Tien Seng Wee3, Nancy Lee4, Guan-Qun Zhou1, Ling-Long Tang1, Chang-Juan Tao1, Rui Guo1, Yan-Ping Mao1, Rong Zhang5, Ying Guo6, Jun Ma7. 1. State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China. 2. Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, People's Republic of China. 3. Department of Radiation Oncology, National Cancer Center Singapore, Singapore. 4. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, USA. 5. Imaging Diagnosis and Interventional Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China. 6. Department of Medical Statistics and Epidemiology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China. 7. State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China. Electronic address: majun2@mail.sysucc.org.cn.
Abstract
BACKGROUND AND PURPOSE: To recommend contouring methods and atlas of organs at risk (OARs) for nasopharyngeal carcinoma (NPC) patients receiving intensity-modulated radiotherapy, in order to help reach a consensus on interpretations of OARs delineation. METHODS AND MATERIALS: Two to four contouring methods for the middle ear, inner ear, temporal lobe, parotid gland and spinal cord were identified via systematic literature review; their volumes and dosimetric parameters were compared in 41 patients. Areas under the receiver operating characteristic curves for temporal lobe contouring were compared in 21 patients with unilateral temporal lobe necrosis (TLN). RESULTS: Various contouring methods for the temporal lobe, middle ear, inner ear, parotid gland and spinal cord lead to different volumes and dosimetric parameters (P<0.05). For TLN, D1 of PRV was the most relevant dosimetric parameter and 64Gy was the critical point. We suggest contouring for the temporal lobe, middle ear, inner ear, parotid gland and spinal cord. A CT-MRI fusion atlas comprising 33 OARs was developed. CONCLUSIONS: Different dosimetric parameters may hinder the dosimetric research. The present recommendation and atlas, may help reach a consensus on subjective interpretation of OARs delineation to reduce inter-institutional differences in NPC patients.
BACKGROUND AND PURPOSE: To recommend contouring methods and atlas of organs at risk (OARs) for nasopharyngeal carcinoma (NPC) patients receiving intensity-modulated radiotherapy, in order to help reach a consensus on interpretations of OARs delineation. METHODS AND MATERIALS: Two to four contouring methods for the middle ear, inner ear, temporal lobe, parotid gland and spinal cord were identified via systematic literature review; their volumes and dosimetric parameters were compared in 41 patients. Areas under the receiver operating characteristic curves for temporal lobe contouring were compared in 21 patients with unilateral temporal lobe necrosis (TLN). RESULTS: Various contouring methods for the temporal lobe, middle ear, inner ear, parotid gland and spinal cord lead to different volumes and dosimetric parameters (P<0.05). For TLN, D1 of PRV was the most relevant dosimetric parameter and 64Gy was the critical point. We suggest contouring for the temporal lobe, middle ear, inner ear, parotid gland and spinal cord. A CT-MRI fusion atlas comprising 33 OARs was developed. CONCLUSIONS: Different dosimetric parameters may hinder the dosimetric research. The present recommendation and atlas, may help reach a consensus on subjective interpretation of OARs delineation to reduce inter-institutional differences in NPCpatients.
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