MSOR02 Presentation Time: 8:05 AM

IF 1.7 4区医学 Q4 ONCOLOGY

Brachytherapy Pub Date : 2024-10-25 DOI:10.1016/j.brachy.2024.08.065

Anne Valkenburg MD , Evert van Limbergen MD, PhD , Maaike Berbée MD, PhD , Mark Long MSc , Nikolaos Tselis MD, PhD , Alexandra Stewart MD, PhD

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引用次数: 0

Abstract

Purpose

Earlier it was demonstrated that lack of standardization in dose reporting is hampering progress in the field of rectal brachytherapy (Verrijssen et al 2019). Standardization of dose reporting and thus treatment data would allow for better comparison of results between patient cohorts of different studies and also allow for NTCP or TCP modelling. A prerequisite for standardized dose reporting is standardization of target volume and organ at risk (OAR) delineation. As there is currently a lack of guidelines for target volume definition and organ at risk delineation in image-guided rectal HDR brachytherapy, this project is aimed at solving this issue. The collaboration involves members of GEC ESTRO and the ABS.

Materials and Methods

The target volume consensus process consists of several steps: Step 1: Selection of an expert group and evaluation group (including radiation oncologists and physicists from Europe/Canada/India). Step 2: Survey regarding target volume delineation in each institution. Step 3: Delineation of 3 rectal cancer (RC) cases with different clinical stages using the FALCON platform. Step 4: First expert group meeting to create a draft guideline. Step 5: Redelineation by the expert group using the draft guideline. Step 6: Second expert group meeting to evaluate the redelineations and optimize the draft guideline. Step 7: Redelineation by the evaluation group and finalization of the guideline.

Results

The current project involves radiation oncologists and physicists from 10 countries in Europe/Canada/India and has currently finalized step 2. Ten out of 17 respondents indicated that they don't have their own delineation guidelines. There is clear variation in the CTV definitions used, for example some use margins and some prescribe to the GTV. Eleven respondents don't use PTV margins. There is no consensus on which OAR need to be delineated and how.

Conclusions

Our survey has shown that target volume delineation and OAR definition varies widely between institutions. Here we describe the methodology to come to international standardization in dose reporting for rectal brachytherapy. The next step is to evaluate the consensus and differences in target and OAR delineation between the different centers using test cases, prior to contouring guideline development.

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MSOR02 演讲时间：上午 8:05

目的早些时候的研究表明，剂量报告缺乏标准化阻碍了直肠近距离治疗领域的进展（Verrijssen 等人，2019 年）。剂量报告的标准化以及治疗数据的标准化有助于更好地比较不同研究的患者队列之间的结果，也有助于建立 NTCP 或 TCP 模型。剂量报告标准化的前提是靶体积和危险器官（OAR）划分的标准化。由于目前缺乏图像引导直肠 HDR 近距离放射治疗的靶体积定义和危险器官划定指南，本项目旨在解决这一问题。目标容积共识过程包括几个步骤：第 1 步：选择专家组和评估组（包括来自欧洲/加拿大/印度的放射肿瘤学家和物理学家）。步骤 2：调查各机构的目标容积划分情况。第 3 步：使用 FALCON 平台对 3 例不同临床分期的直肠癌病例进行划定。第 4 步：召开第一次专家组会议，制定指南草案。第 5 步：专家组利用指南草案进行重新划界。第 6 步：第二次专家组会议，评估重新划线结果并优化指南草案。第 7 步：评估小组重新划线并最终确定指南。结果目前该项目涉及欧洲/加拿大/印度 10 个国家的放射肿瘤学家和物理学家，目前已完成第 2 步。17 个受访者中有 10 个表示他们没有自己的划线指南。所使用的 CTV 定义存在明显差异，例如有些使用边缘，有些则规定使用 GTV。有 11 个受访者不使用 PTV 边界。我们的调查显示，不同机构在目标容积的划分和 OAR 的定义方面存在很大差异。在此，我们介绍了实现直肠近距离放射治疗剂量报告国际标准化的方法。下一步是在制定轮廓指南之前，利用测试案例评估不同中心在靶区和 OAR 划分方面的共识和差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brachytherapy 医学-核医学

CiteScore

3.40

自引率

21.10%

发文量

119

审稿时长

9.1 weeks

期刊介绍： Brachytherapy is an international and multidisciplinary journal that publishes original peer-reviewed articles and selected reviews on the techniques and clinical applications of interstitial and intracavitary radiation in the management of cancers. Laboratory and experimental research relevant to clinical practice is also included. Related disciplines include medical physics, medical oncology, and radiation oncology and radiology. Brachytherapy publishes technical advances, original articles, reviews, and point/counterpoint on controversial issues. Original articles that address any aspect of brachytherapy are invited. Letters to the Editor-in-Chief are encouraged.