International Consensus Guidelines on the Delineation of Radiation Therapy Target Volumes for Nasopharyngeal Carcinoma After Induction Chemotherapy Using a 2-Round Modified Delphi Survey.

IF 3.4 3区 医学 Q2 ONCOLOGY
Nejla Fourati, Warren Bacorro, Omar Nouri, Ryan Anthony Agas, Audrey Larnaudie, Lester Bryan Co, Hela Hammami, Clevelinda Calma, Melvin L K Chua, Chong Zhao, Jamel Daoud, Michael Benedict Mejia
{"title":"International Consensus Guidelines on the Delineation of Radiation Therapy Target Volumes for Nasopharyngeal Carcinoma After Induction Chemotherapy Using a 2-Round Modified Delphi Survey.","authors":"Nejla Fourati, Warren Bacorro, Omar Nouri, Ryan Anthony Agas, Audrey Larnaudie, Lester Bryan Co, Hela Hammami, Clevelinda Calma, Melvin L K Chua, Chong Zhao, Jamel Daoud, Michael Benedict Mejia","doi":"10.1016/j.prro.2025.01.015","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Induction chemotherapy (ICT), a new standard in the management of locally advanced nasopharyngeal carcinoma (NPC), is increasingly used in endemic regions. Radiation therapy (RT) target volume delineation protocols and dose level prescriptions vary significantly in the literature. High-level evidence to support a particular approach is currently lacking. We developed an international consensus guideline toward harmonizing practices based on a literature review and expert opinion.</p><p><strong>Methods and materials: </strong>The study entailed the following: consensus scope definition by focus group discussion (FGD); evidence gap identification by a scoping review of guidelines and literature reviews; evidence review and synthesis by a systematic review of experimental and observational studies and drafting of consensus statements by FGD; and consensus voting by modified Delphi process and FGD. The task force consisted of radiation oncologists from intermediate- and high-endemicity regions with expertise in treating NPC, evidence review, and consensus guideline development. The consensus panel consisted of relevant specialists from intermediate- and high-endemicity regions or with expertise in treating NPC. A modified e-Delphi method was used.</p><p><strong>Results: </strong>Four clinical situations after ICT for patients with NPC were selected for the consensus questions: optimal timing of chemoradiation; optimal imaging modalities for simulation and target volume delineation; optimal dose and fractionation; and RT target volume delineation. The consensus panel consisted of radiation oncologists (12), clinical oncologists (4), radiologists (3), a nuclear medicine specialist, medical physicists (2), and dosimetrists (2). The consensus guidelines were formulated after 2 rounds of Delphi voting and FGD; iterative revisions were made based on 2 rounds of internal review. The guidelines were subjected to external review and open commentary; further revisions were made if the consensus vote was not invalidated.</p><p><strong>Conclusions: </strong>An international consensus guideline on delineating RT target volumes and corresponding dose levels in post-ICT NPC, as well as timing and modalities for imaging, was developed to help harmonize practices and enhance the comparability of interpretations of reported outcomes.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Practical Radiation Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.prro.2025.01.015","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: Induction chemotherapy (ICT), a new standard in the management of locally advanced nasopharyngeal carcinoma (NPC), is increasingly used in endemic regions. Radiation therapy (RT) target volume delineation protocols and dose level prescriptions vary significantly in the literature. High-level evidence to support a particular approach is currently lacking. We developed an international consensus guideline toward harmonizing practices based on a literature review and expert opinion.

Methods and materials: The study entailed the following: consensus scope definition by focus group discussion (FGD); evidence gap identification by a scoping review of guidelines and literature reviews; evidence review and synthesis by a systematic review of experimental and observational studies and drafting of consensus statements by FGD; and consensus voting by modified Delphi process and FGD. The task force consisted of radiation oncologists from intermediate- and high-endemicity regions with expertise in treating NPC, evidence review, and consensus guideline development. The consensus panel consisted of relevant specialists from intermediate- and high-endemicity regions or with expertise in treating NPC. A modified e-Delphi method was used.

Results: Four clinical situations after ICT for patients with NPC were selected for the consensus questions: optimal timing of chemoradiation; optimal imaging modalities for simulation and target volume delineation; optimal dose and fractionation; and RT target volume delineation. The consensus panel consisted of radiation oncologists (12), clinical oncologists (4), radiologists (3), a nuclear medicine specialist, medical physicists (2), and dosimetrists (2). The consensus guidelines were formulated after 2 rounds of Delphi voting and FGD; iterative revisions were made based on 2 rounds of internal review. The guidelines were subjected to external review and open commentary; further revisions were made if the consensus vote was not invalidated.

Conclusions: An international consensus guideline on delineating RT target volumes and corresponding dose levels in post-ICT NPC, as well as timing and modalities for imaging, was developed to help harmonize practices and enhance the comparability of interpretations of reported outcomes.

求助全文
约1分钟内获得全文 求助全文
来源期刊
Practical Radiation Oncology
Practical Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
5.20
自引率
6.10%
发文量
177
审稿时长
34 days
期刊介绍: The overarching mission of Practical Radiation Oncology is to improve the quality of radiation oncology practice. PRO''s purpose is to document the state of current practice, providing background for those in training and continuing education for practitioners, through discussion and illustration of new techniques, evaluation of current practices, and publication of case reports. PRO strives to provide its readers content that emphasizes knowledge "with a purpose." The content of PRO includes: Original articles focusing on patient safety, quality measurement, or quality improvement initiatives Original articles focusing on imaging, contouring, target delineation, simulation, treatment planning, immobilization, organ motion, and other practical issues ASTRO guidelines, position papers, and consensus statements Essays that highlight enriching personal experiences in caring for cancer patients and their families.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信