Challenges with Target Volume Delineation for Pelvic Rhabdomyosarcoma in the FaR-RMS Trial: A QUARTET Report

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics Pub Date : 2025-02-03 DOI:10.1016/j.ijrobp.2024.11.019

M. Lo Greco , S. Kelly , R. Dávila Fajardo , H. Magelssen , A. Cameron , C. Corning , J. Chisholm , M. Jenney , V. Bernier-Chastagner , G. Scarzello , M. Gaze , A. Safwat , H. Mandeville

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引用次数: 0

Abstract

Objectives

Radiotherapy Quality Assurance has been implemented for the FaR-RMS trial (EudraCT number 2018-000515-24) through the SIOPE QUARTET Project, including prospective Individual Case Review (ICR) for all randomized patients. A high rejection rate of target volume contours has been observed for pelvic RMS. We have undertaken to identify areas of uncertainty and variation in primary tumour and nodal target volumes.

Methods

All pelvic RMS patients (n=37) in the FaR-RMS trial submitted to QUARTET, up to 19/02/2024, where reviewers assessed primary tumour or nodal contours as unacceptable variations were identified. The ICR forms, submitted contours and plans were then assessed to identify the most common problem areas.

Results

Unacceptable variations were identified in 16/37 (43%) of Pelvic RMS cases, 69% of which were related to target delineation. Unacceptable variations were related to primary clinical target volume (CTVp) in 36% of these cases, whereas 73% had errors in nodal clinical target volume delineation (CTVn). Delineation errors for CTVn concerned geographical miss (70%), inclusion of excess normal tissue within the CTV (10%) or other reasons (20%). Following reviewer feedback and reassessment, 89% of plans, were considered acceptable.

Conclusion

The delineation of clinical target volume in patients with pelvic RMS represents a challenge for radiation oncologists. Prospective review allows early identification of contouring errors and provides feedback to correct these and refine treatment plans. Given the high proportion of nodal target volume delineation errors, QUARTET is developing a nodal target delineation atlas in collaboration with the EpSSG Radiotherapy Committee.

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来源期刊

International Journal of Radiation Oncology Biology Physics 医学-核医学

CiteScore

11.00

自引率

7.10%

发文量

2538

审稿时长

6.6 weeks

期刊介绍： International Journal of Radiation Oncology • Biology • Physics (IJROBP), known in the field as the Red Journal, publishes original laboratory and clinical investigations related to radiation oncology, radiation biology, medical physics, and both education and health policy as it relates to the field. This journal has a particular interest in original contributions of the following types: prospective clinical trials, outcomes research, and large database interrogation. In addition, it seeks reports of high-impact innovations in single or combined modality treatment, tumor sensitization, normal tissue protection (including both precision avoidance and pharmacologic means), brachytherapy, particle irradiation, and cancer imaging. Technical advances related to dosimetry and conformal radiation treatment planning are of interest, as are basic science studies investigating tumor physiology and the molecular biology underlying cancer and normal tissue radiation response.