International consensus guidelines on Clinical Target Volume delineation in rectal cancer

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• 作者：Vincenzo Valentini^a ; ^{vincenzo.valentini@unicatt.it" class="auth_mail" title="E-mail the corresponding author} ; Maria Antonietta Gambacorta^a ; ^{magambacorta@rm.unicatt.it" class="auth_mail" title="E-mail the corresponding author} ; Brunella Barbaro^b ; ^{bbarbaro@rm.unicatt.it" class="auth_mail" title="E-mail the corresponding author} ; Giuditta Chiloiro^a ; ^{vchiloiro@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Claudio Coco^c ; ^{coco_claudio@rm.unicatt.it" class="auth_mail" title="E-mail the corresponding author} ; Prajnan Das^d ; ^{PrajDas@mdanderson.org" class="auth_mail" title="E-mail the corresponding author} ; Francesco Fanfani^e ; ^{francesco.fanfani@unich.it" class="auth_mail" title="E-mail the corresponding author} ; Ines Joye^f ; ^{ines.joye@uzleuven.be" class="auth_mail" title="E-mail the corresponding author} ; Lisa Kachnic^g ; ^{lisa.kachnic@bmc.org" class="auth_mail" title="E-mail the corresponding author} ; Philippe Maingon^h ; ^{PMaingon@cgfl.fr" class="auth_mail" title="E-mail the corresponding author} ; Corrie Marijnenⁱ ; ^{c.a.m.marijnen@lumc.nl" class="auth_mail" title="E-mail the corresponding author} ; Samuel Ngan^j ; ^{Sam.Ngan@petermac.org" class="auth_mail" title="E-mail the corresponding author} ; Karin Haustermans^f ; ^{karin.haustermans@uz.kuleuven.ac.be" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Consensus guidelines ; Rectal cancer ; Clinical Target Volume delineation
• 刊名：Radiotherapy and Oncology
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：120
• 期：2
• 页码：195-201
• 全文大小：619 K

文摘

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.