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Thomas M, Mortensen HR, Hoffmann L, Møller DS, Troost EGC, Muijs CT, Berbee M, Bütof R, Nicholas O, Radhakrishna G, Defraene G, Nafteux P, Nordsmark M, Haustermans K. Proposal for the delineation of neoadjuvant target volumes in oesophageal cancer. Radiother Oncol 2020; 156:102-112. [PMID: 33285194 DOI: 10.1016/j.radonc.2020.11.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE To define instructions for delineation of target volumes in the neoadjuvant setting in oesophageal cancer. MATERIALS AND METHODS Radiation oncologists of five European centres participated in the following consensus process: [1] revision of published (MEDLINE) and national/institutional delineation guidelines; [2] first delineation round of five cases (patient 1-5) according to national/institutional guidelines; [3] consensus meeting to discuss the results of step 1 and 2, followed by a target volume delineation proposal; [4] circulation of proposed instructions for target volume delineation and atlas for feedback; [5] second delineation round of five new cases (patient 6-10) to peer review and validate (two additional centres) the agreed delineation guidelines and atlas; [6] final consensus on the delineation guidelines depicted in an atlas. Target volumes of the delineation rounds were compared between centres by Dice similarity coefficient (DSC) and maximum/mean undirected Hausdorff distances (Hmax/Hmean). RESULTS In the first delineation round, the consistency between centres was moderate (CTVtotal: DSC = 0.59-0.88; Hmean = 0.2-0.4 cm). Delineations in the second round were much more consistent. Lowest variability was obtained between centres participating in the consensus meeting (CTVtotal: DSC: p < 0.050 between rounds for patients 6/7/8/10; Hmean: p < 0.050 for patients 7/8/10), compared to validation centres (CTVtotal: DSC: p < 0.050 between validation and consensus meeting centres for patients 6/7/8; Hmean: p < 0.050 for patients 7/10). A proposal for delineation of target volumes and an atlas were generated. CONCLUSION We proposed instructions for target volume delineation and an atlas for the neoadjuvant radiation treatment in oesophageal cancer. These will enable a more uniform delineation of patients in clinical practice and clinical trials.
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Affiliation(s)
- Melissa Thomas
- KU Leuven - University of Leuven, Department of Oncology - Laboratory of Experimental Radiotherapy, Belgium; University Hospitals Leuven, Department of Radiation Oncology, Belgium.
| | - Hanna R Mortensen
- Aarhus University Hospital, Danish Center of Particle Therapy, Denmark
| | - Lone Hoffmann
- Aarhus University Hospital, Department of Oncology, Denmark
| | - Ditte S Møller
- Aarhus University Hospital, Department of Oncology, Denmark
| | - Esther G C Troost
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, and Helmholtz-Zentrum Dresden-Rossendorf, Germany; Institute of Radiooncology - OncoRay, Helmholtz-Zentrum Dresden-Rossendorf, Germany
| | - Christina T Muijs
- University Medical Center Groningen, University of Groningen, Department of Radiation Oncology, The Netherlands
| | - Maaike Berbee
- Maastricht University Medical Centre, Department of Radiation Oncology (Maastro), GROW School for Oncology, the Netherlands
| | - Rebecca Bütof
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, and Helmholtz-Zentrum Dresden-Rossendorf, Germany
| | - Owen Nicholas
- Swansea NHS Trust, Department of Clinical Oncology, Swansea, UK
| | - Ganesh Radhakrishna
- Christie NHS Foundation Trust, Department of Clinical Oncology, Manchester, UK
| | - Gilles Defraene
- KU Leuven - University of Leuven, Department of Oncology - Laboratory of Experimental Radiotherapy, Belgium
| | - Philippe Nafteux
- University Hospitals Leuven, Department of Thoracic Surgery, Belgium
| | | | - Karin Haustermans
- KU Leuven - University of Leuven, Department of Oncology - Laboratory of Experimental Radiotherapy, Belgium; University Hospitals Leuven, Department of Radiation Oncology, Belgium
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Kneuertz PJ, Hofstetter WL, Chiang YJ, Das P, Blum M, Elimova E, Mansfield P, Ajani J, Badgwell B. Long-Term Survival in Patients with Gastroesophageal Junction Cancer Treated with Preoperative Therapy: Do Thoracic and Abdominal Approaches Differ? Ann Surg Oncol 2016; 23:626-632. [DOI: 10.1245/s10434-015-4898-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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