Vratislav Strnad1, Jean-Michel Hannoun-Levi2, Jose-Luis Guinot3, Kristina Lössl4, Daniela Kauer-Dorner5, Alexandra Resch5, György Kovács6, Tibor Major7, Erik Van Limbergen8. 1. Department of Radiation Oncology, University Hospital Erlangen, Germany. Electronic address: vratislav.strnad@uk-erlangen.de. 2. Department of Radiation Oncology, Centre Antoine Lacassagne, Nice, France. 3. Department of Radiation Oncology, Fundación Instituto Valenciano de Oncología, Valencia, Spain. 4. Department of Radiation Oncology, Inselspital, University of Bern, Switzerland. 5. Department of Radiotherapy and Radiobiology, University Hospital Vienna, Austria. 6. Interdisciplinary Brachytherapy Unit, University of Lübeck, Germany. 7. Department of Radiation Oncology, National Institute of Oncology, Budapest, Hungary. 8. Department of Radiotherapy, University Hospital Gasthuisberg, Leuven, Belgium.
Abstract
OBJECTIVE: The aim was to develop a delineation guideline for target definition for APBI or boost by consensus of the Breast Working Group of GEC-ESTRO. PROPOSED RECOMMENDATIONS: Appropriate delineation of CTV (PTV) with low inter- and intra-observer variability in clinical practice is complex and needs various steps as: (1) Detailed knowledge of primary surgical procedure, of all details of pathology, as well as of preoperative imaging. (2) Definition of tumour localization before breast conserving surgery inside the breast and translation of this information in the postoperative CT imaging data set. (3) Calculation of the size of total safety margins. The size should be at least 2 cm. (4) Definition of the target. (5) Delineation of the target according to defined rules. CONCLUSION: Providing guidelines based on the consensus of a group of experts should make it possible to achieve a reproducible and consistent definition of CTV (PTV) for Accelerated Partial Breast Irradiation (APBI) or boost irradiation after breast conserving closed cavity surgery, and helps to define it after selected cases of oncoplastic surgery.
OBJECTIVE: The aim was to develop a delineation guideline for target definition for APBI or boost by consensus of the Breast Working Group of GEC-ESTRO. PROPOSED RECOMMENDATIONS: Appropriate delineation of CTV (PTV) with low inter- and intra-observer variability in clinical practice is complex and needs various steps as: (1) Detailed knowledge of primary surgical procedure, of all details of pathology, as well as of preoperative imaging. (2) Definition of tumour localization before breast conserving surgery inside the breast and translation of this information in the postoperative CT imaging data set. (3) Calculation of the size of total safety margins. The size should be at least 2 cm. (4) Definition of the target. (5) Delineation of the target according to defined rules. CONCLUSION: Providing guidelines based on the consensus of a group of experts should make it possible to achieve a reproducible and consistent definition of CTV (PTV) for Accelerated Partial Breast Irradiation (APBI) or boost irradiation after breast conserving closed cavity surgery, and helps to define it after selected cases of oncoplastic surgery.
Authors: S Garduño-Sánchez; I Villanego-Beltrán; M Dolores de Las Peñas-Cabrera; J Jaén-Olasolo Journal: Clin Transl Oncol Date: 2021-07-02 Impact factor: 3.405