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    Proposal for the delineation of neoadjuvant target volumes in oesophageal cancer

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    Authors
    Thomas, M.
    Mortensen, H. R.
    Hoffmann, L.
    Møller, D. S.
    Troost, E. G. C.
    Muijs, C. T.
    Berbee, M.
    Bütof, R.
    Nicholas, O.
    Radhakrishna, Ganesh
    Defraene, G.
    Nafteux, P.
    Nordsmark, M.
    Haustermans, K.
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    Affiliation
    KU Leuven - University of Leuven, Department of Oncology - Laboratory of Experimental Radiotherapy, Leuven, Belgium; University Hospitals Leuven, Department of Radiation Oncology, Leuven, Belgium.
    Issue Date
    2020
    
    Metadata
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    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=0.2-0.4cm). 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.
    Citation
    Thomas M, Mortensen HR, Hoffmann L, Moller DS, Troost EGC, Muijs CT, et al. Proposal for the delineation of neoadjuvant target volumes in oesophageal cancer. Radiother Oncol. 2020;156:102-12.
    Journal
    Radiotherapy and Oncology
    URI
    http://hdl.handle.net/10541/623650
    DOI
    10.1016/j.radonc.2020.11.032
    PubMed ID
    33285194
    Additional Links
    https://dx.doi.org/10.1016/j.radonc.2020.11.032
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.radonc.2020.11.032
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