Jean L Wright1, Sue S Yom2, Musaddiq J Awan3, Samantha Dawes4, Benjamin Fischer-Valuck5, Randi Kudner6, Raymond Mailhot Vega7, George Rodrigues8. 1. Johns Hopkins University, Baltimore, Maryland. 2. University of California, San Francisco, California. 3. Medical College of Wisconsin, Milwaukee, Wisconsin. 4. American Society for Radiation Oncology, Arlington, Virginia. Electronic address: Samantha.Dawes@astro.org. 5. Emory University, Atlanta, Georgia. 6. American Society for Radiation Oncology, Arlington, Virginia. 7. University of Florida, Jacksonville, Florida. 8. London Health Sciences Centre, London, ON, Canada.
Abstract
PURPOSE: The comprehensive identification and delineation of organs at risk (OARs) are vital to the quality of radiation therapy treatment planning and the safety of treatment delivery. This guidance aims to improve the consistency of ontouring OARs in external beam radiation therapy treatment planning by providing a single standardized resource for information regarding specific OARs to be contoured for each disease site. The guidance is organized in table format as a quality assurance tool for practices and a training resource for residents and other radiation oncology students (see supplementary materials). METHODS AND MATERIALS: The Task Force formulated recommendations based on clinical practice and consensus. The draft manuscript was peer reviewed by 16 reviewers, the American Society for Radiation Oncology (ASTRO) legal counsel, and ASTRO's Multidisciplinary Quality Assurance Subcommittee and revised accordingly. The recommendations were posted on the ASTRO website for public comment in June 2018 for a 6-week period. The final document was approved by the ASTRO Board of Directors in August 2018. RESULTS: Standardization improves patient safety, efficiency, and accuracy in radiation oncology treatment. This consensus guidance represents an ASTRO quality initiative to provide recommendations for the standardization of normal tissue contouring that is performed during external beam treatment planning for each anatomic treatment site. Table 1 defines 2 sets of structures for anatomic sites: Those that are recommended in all adult definitive cases and may assist with organ selection for palliative cases, and those that should be considered on a case-by-case basis depending on the specific clinical scenario. Table 2 outlines some of the resources available to define the parameters of general OAR tissue delineation. CONCLUSIONS: Using this paper in conjunction with resources that define tissue parameters and published dose constraints will enable practices to develop a consistent approach to normal tissue evaluation and dose documentation.
PURPOSE: The comprehensive identification and delineation of organs at risk (OARs) are vital to the quality of radiation therapy treatment planning and the safety of treatment delivery. This guidance aims to improve the consistency of ontouring OARs in external beam radiation therapy treatment planning by providing a single standardized resource for information regarding specific OARs to be contoured for each disease site. The guidance is organized in table format as a quality assurance tool for practices and a training resource for residents and other radiation oncology students (see supplementary materials). METHODS AND MATERIALS: The Task Force formulated recommendations based on clinical practice and consensus. The draft manuscript was peer reviewed by 16 reviewers, the American Society for Radiation Oncology (ASTRO) legal counsel, and ASTRO's Multidisciplinary Quality Assurance Subcommittee and revised accordingly. The recommendations were posted on the ASTRO website for public comment in June 2018 for a 6-week period. The final document was approved by the ASTRO Board of Directors in August 2018. RESULTS: Standardization improves patient safety, efficiency, and accuracy in radiation oncology treatment. This consensus guidance represents an ASTRO quality initiative to provide recommendations for the standardization of normal tissue contouring that is performed during external beam treatment planning for each anatomic treatment site. Table 1 defines 2 sets of structures for anatomic sites: Those that are recommended in all adult definitive cases and may assist with organ selection for palliative cases, and those that should be considered on a case-by-case basis depending on the specific clinical scenario. Table 2 outlines some of the resources available to define the parameters of general OAR tissue delineation. CONCLUSIONS: Using this paper in conjunction with resources that define tissue parameters and published dose constraints will enable practices to develop a consistent approach to normal tissue evaluation and dose documentation.
Authors: Elizabeth Huynh; Ahmed Hosny; Christian Guthier; Danielle S Bitterman; Steven F Petit; Daphne A Haas-Kogan; Benjamin Kann; Hugo J W L Aerts; Raymond H Mak Journal: Nat Rev Clin Oncol Date: 2020-08-25 Impact factor: 66.675
Authors: Asma Amjad; Jiaofeng Xu; Dan Thill; Colleen Lawton; William Hall; Musaddiq J Awan; Monica Shukla; Beth A Erickson; X Allen Li Journal: Med Phys Date: 2022-02-07 Impact factor: 4.071
Authors: Lydia J Wilson; Abigail Bryce-Atkinson; Andrew Green; Yimei Li; Thomas E Merchant; Marcel van Herk; Eliana Vasquez Osorio; Austin M Faught; Marianne C Aznar Journal: Phys Med Date: 2022-05-21 Impact factor: 3.119
Authors: Gabrielle W Peters; Jacqueline R Kelly; Jason M Beckta; Marney White; Lawrence B Marks; Eric Ford; Suzanne B Evans Journal: Adv Radiat Oncol Date: 2020-11-03
Authors: Caroline Olsson; Tufve Nyholm; Elinore Wieslander; Eva Onjukka; Adalsteinn Gunnlaugsson; Johan Reizenstein; Stefan Johnsson; Ingrid Kristensen; Johan Skönevik; Magnus Karlsson; Ulf Isacsson; Anna Flejmer; Edvard Abel; Fredrik Nordström; Leif Nyström; Kjell Bergfeldt; Björn Zackrisson; Alexander Valdman Journal: Phys Imaging Radiat Oncol Date: 2019-09-23
Authors: William Tyler Turchan; Ritu Arya; Robert Hight; Hania Al-Hallaq; Michael Dominello; Dan Joyce; Bradley P McCabe; Anne R McCall; Eugenia Perevalova; Christopher Stepaniak; Kamil Yenice; Jay Burmeister; Daniel W Golden Journal: J Appl Clin Med Phys Date: 2020-09-28 Impact factor: 2.243