Marianna Trignani1, Angela Argenone2, Saide Di Biase3, Daniela Musio4, Anna Merlotti5, Stefano Ursino6, Ester Orlandi7, Domenico Genovesi3, Almalina Bacigalupo8. 1. Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Chieti, Italy. marianna.trignani@unich.it. 2. Radiation Oncology Department, Istituto Nazionale Tumori-IRCSS-Fondazione G. Pascale, Naples, Italy. 3. Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Chieti, Italy. 4. Radiation Oncology Department, Ospedale Policlinico Umberto I, Rome, Italy. 5. Radiation Oncology Department, Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy. 6. Radiation Oncology Department, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy. 7. Radiation Oncology Department, Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy. 8. Radiation Oncology Department, Ospedale Policlinico San Martino, Università di Genova, Genoa, Italy.
Abstract
BACKGROUND: This study, promoted by Italian Association of Radiotherapy and Clinical Oncology (AIRO) Head and Neck Group, aimed to assess the current national practice of target volume delineation on a case of neck lymph node metastases from unknown primary evaluating inter-observer variability, in a setting of primary radiotherapy. MATERIALS AND METHODS: A case of metastatic neck lymph node from occult primary was proposed to 17 radiation oncologists. A national reference RT center was identified and considered as benchmark. Participants were requested to delineate target volumes. A structured questionnaire was administered. A comparison between following parameters of the CTVs was performed: centroids distances, Dice similarity index (DSI), Jaccard index and mean distance to agreement (MDA). Volume expressed in cubic centimeters and CTVs cranio-caudal extension were evaluated. RESULTS: Sixteen of 17 radiation oncologists recommended three CTVs dose levels. (CTV HD, CTV ID and CTV LD); CTV ID was not delineated by one of the participants and by the reference center. The distance between the reference centroid and the mean centroid of CTVs HD was 1.09 cm (0.36-3.99 cm); for CTV LD, a mean centroids distance of 2.45 (0.27-4.83 cm) was found, and for CTV HD, mean DSI is 0.48 and mean Jaccard index is 0.32 and MDA was 8.89 mm. CTV LD showed a mean DSI of 0.46, mean Jaccard index of 0.31 and MDA of 14.87 when compared to the reference. CONCLUSION: Many aspects concerning treatment optimization of cervical nodes metastases from occult primary remain unclear, and we found a notable heterogeneity of global radiotherapy management reporting discordances both in target volume delineation and volume prescription.
BACKGROUND: This study, promoted by Italian Association of Radiotherapy and Clinical Oncology (AIRO) Head and Neck Group, aimed to assess the current national practice of target volume delineation on a case of neck lymph node metastases from unknown primary evaluating inter-observer variability, in a setting of primary radiotherapy. MATERIALS AND METHODS: A case of metastatic neck lymph node from occult primary was proposed to 17 radiation oncologists. A national reference RT center was identified and considered as benchmark. Participants were requested to delineate target volumes. A structured questionnaire was administered. A comparison between following parameters of the CTVs was performed: centroids distances, Dice similarity index (DSI), Jaccard index and mean distance to agreement (MDA). Volume expressed in cubic centimeters and CTVs cranio-caudal extension were evaluated. RESULTS: Sixteen of 17 radiation oncologists recommended three CTVs dose levels. (CTV HD, CTV ID and CTV LD); CTV ID was not delineated by one of the participants and by the reference center. The distance between the reference centroid and the mean centroid of CTVs HD was 1.09 cm (0.36-3.99 cm); for CTV LD, a mean centroids distance of 2.45 (0.27-4.83 cm) was found, and for CTV HD, mean DSI is 0.48 and mean Jaccard index is 0.32 and MDA was 8.89 mm. CTV LD showed a mean DSI of 0.46, mean Jaccard index of 0.31 and MDA of 14.87 when compared to the reference. CONCLUSION: Many aspects concerning treatment optimization of cervical nodes metastases from occult primary remain unclear, and we found a notable heterogeneity of global radiotherapy management reporting discordances both in target volume delineation and volume prescription.
Entities:
Keywords:
Head and neck cancer; Inter-observer variability; Neck lymph node metastases; Radiotherapy; Target volume delineation; Unknown primary
Authors: Min Yao; Thanh Nguyen; John M Buatti; Kenneth J Dornfeld; Huaming Tan; Judith Wacha; John E Bayouth; Gerald H Clamon; Gerry F Funk; Russell B Smith; Kristi Chang; Henry T Hoffman Journal: Am J Clin Oncol Date: 2006-12 Impact factor: 2.339
Authors: Patricia Tai; Jake Van Dyk; Jerry Battista; Edward Yu; Larry Stitt; Jon Tonita; Olusegun Agboola; James Brierley; Rashid Dar; Christopher Leighton; Shawn Malone; Barbara Strang; Pauline Truong; Gregory Videtic; C Shun Wong; Rebecca Wong; Youssef Youssef Journal: Int J Radiat Oncol Biol Phys Date: 2002-07-01 Impact factor: 7.038