Vincenzo Valentini1, Maria Antonietta Gambacorta2, Brunella Barbaro3, Giuditta Chiloiro4, Claudio Coco5, Prajnan Das6, Francesco Fanfani7, Ines Joye8, Lisa Kachnic9, Philippe Maingon10, Corrie Marijnen11, Samuel Ngan12, Karin Haustermans13. 1. Università Cattolica del Sacro Cuore, Radiation Oncology Department, Rome, Italy. Electronic address: vincenzo.valentini@unicatt.it. 2. Università Cattolica del Sacro Cuore, Radiation Oncology Department, Rome, Italy. Electronic address: magambacorta@rm.unicatt.it. 3. Università Cattolica del Sacro Cuore, Department of Radiological Sciences, Rome, Italy. Electronic address: bbarbaro@rm.unicatt.it. 4. Università Cattolica del Sacro Cuore, Radiation Oncology Department, Rome, Italy. Electronic address: vchiloiro@gmail.com. 5. Università Cattolica del Sacro Cuore, Department of Surgical Science, Rome, Italy. Electronic address: coco_claudio@rm.unicatt.it. 6. University of Texas MD Anderson Cancer Center, Department of Radiation Oncology, Houston, USA. Electronic address: PrajDas@mdanderson.org. 7. University G. D'Annunzio, Gynecologic Oncology Department of Medicine and Aging Sciences, Chieti, Italy. Electronic address: francesco.fanfani@unich.it. 8. KU Leuven - University of Leuven, Department of Oncology and University Hospitals Leuven, Radiation Oncology, Belgium. Electronic address: ines.joye@uzleuven.be. 9. Boston Medical Center, Department of Radiation Oncology, USA. Electronic address: lisa.kachnic@bmc.org. 10. Centre Georges-François Leclerc, Department of Radiation Oncology, Dijon, France. Electronic address: PMaingon@cgfl.fr. 11. Leiden University Medical Center, Department of Radiation Oncology, The Netherlands. Electronic address: c.a.m.marijnen@lumc.nl. 12. Peter MacCallum Cancer Centre, Division of Radiation Oncology and Cancer Imaging, Melbourne, Australia. Electronic address: Sam.Ngan@petermac.org. 13. KU Leuven - University of Leuven, Department of Oncology and University Hospitals Leuven, Radiation Oncology, Belgium. Electronic address: karin.haustermans@uz.kuleuven.ac.be.
Abstract
INTRODUCTION: The delineation of Clinical Target Volume (CTV) is a critical step in radiotherapy. Several guidelines suggest different subvolumes and anatomical boundaries in rectal cancer (RC), potentially leading to a misunderstanding in the CTV definition. International consensus guidelines (CG) are needed to improve uniformity in RC CTV delineation. MATERIAL AND METHODS: The 7 radiation oncologist experts defined a roadmap to produce RC CG. Step 1: revision of the published guidelines. Step 2: selection of RC cases with different clinical stages. Step 3: delineation of cases using Falcon following previously published guidelines. Step 4: meeting in person to discuss the initial delineation outcome, followed by a CTV proposal based on revised and if needed, adapted anatomical boundaries. Step 5: peer review of the agreed consensus. Step 6: peer review meeting to validate the final outcome. Step 7: completion of RC delineation atlases. RESULTS: A new ontology of structure sets was defined and the related table of anatomical boundaries was generated. The major modifications were about the lateral lymph nodes and the ischio-rectal fossa delineation. Seven RC cases were made available online as consultation atlases. CONCLUSION: The definition of international CG for RC delineation endorsed by international experts might support a future homogeneous comparison between clinical trial outcomes.
INTRODUCTION: The delineation of Clinical Target Volume (CTV) is a critical step in radiotherapy. Several guidelines suggest different subvolumes and anatomical boundaries in rectal cancer (RC), potentially leading to a misunderstanding in the CTV definition. International consensus guidelines (CG) are needed to improve uniformity in RC CTV delineation. MATERIAL AND METHODS: The 7 radiation oncologist experts defined a roadmap to produce RC CG. Step 1: revision of the published guidelines. Step 2: selection of RC cases with different clinical stages. Step 3: delineation of cases using Falcon following previously published guidelines. Step 4: meeting in person to discuss the initial delineation outcome, followed by a CTV proposal based on revised and if needed, adapted anatomical boundaries. Step 5: peer review of the agreed consensus. Step 6: peer review meeting to validate the final outcome. Step 7: completion of RC delineation atlases. RESULTS: A new ontology of structure sets was defined and the related table of anatomical boundaries was generated. The major modifications were about the lateral lymph nodes and the ischio-rectal fossa delineation. Seven RC cases were made available online as consultation atlases. CONCLUSION: The definition of international CG for RC delineation endorsed by international experts might support a future homogeneous comparison between clinical trial outcomes.
Authors: Seo Hee Choi; Jee Suk Chang; Hong In Yoon; Dong-Su Jang; Nam Kyu Kim; Joon Seok Lim; Byung So Min; Hyuk Huh; Sang Joon Shin; Joong Bae Ahn; Woong Sub Koom Journal: J Cancer Res Clin Oncol Date: 2018-03-15 Impact factor: 4.553
Authors: Clelia Di Carlo; Maika di Benedetto; Lisa Vicenzi; Sara Costantini; Francesca Cucciarelli; Francesco Fenu; Eleonora Arena; Cristina Mariucci; Maria Montisci; Valeria Panni; Fabiola Patani; Marco Valenti; Andrea Palucci; Luca Burroni; Giovanna Mantello Journal: Front Oncol Date: 2021-07-01 Impact factor: 6.244