Assessing the effect of a contouring protocol on postprostatectomy radiotherapy clinical target volumes and interphysician variation.
Authors
Mitchell, Darren MPerry, Lesley A
Smith, Steve
Elliott, Tony
Wylie, James P
Cowan, Richard A
Livsey, Jacqueline E
Logue, John P
Affiliation
Department of Clinical Oncology, Christie Hospital, Manchester, United Kingdom. dmmitchell@doctors.org.ukIssue Date
2009-11-15
Metadata
Show full item recordAbstract
PURPOSE: To compare postprostatectomy clinical target volume (CTV) delineation before and after the introduction of a contouring protocol and to investigate its effect on interphysician variability METHODS AND MATERIALS: Six site-specialized radiation oncologists independently delineated a CTV on the computed tomography (CT) scans of 3 patients who had received postprostatectomy radiotherapy. At least 3 weeks later this was repeated, but with the physicians adhering to the contouring protocol from the Medical Research Council's Radiotherapy and Androgen Deprivation In Combination After Local Surgery (RADICALS) trial. The volumes obtained before and after the protocol were compared and the effect of the protocol on interphysician variability assessed. RESULTS: An increase in mean CTV for all patients of 40.7 to 53.9 cm(3) was noted as a result of observing the protocol, with individual increases in the mean CTV of 65%, 15%, and 24% for Patients 1, 2, and 3 respectively. A reduction in interphysician variability was noted when the protocol was used. CONCLUSIONS: Substantial interphysician variation in target volume delineation for postprostatectomy radiotherapy exists, which can be reduced by the use of a contouring protocol. The RADICALS contouring protocol increases the target volumes when compared with those volumes typically applied at our center. The effect of treating larger volumes on the therapeutic ratio and resultant toxicity should be carefully monitored, particularly if the same dose-response as documented in radical prostate radiotherapy applies to the adjuvant and salvage setting. Prostate cancer, Postprostatectomy, Radiotherapy, Target volume.Citation
Assessing the effect of a contouring protocol on postprostatectomy radiotherapy clinical target volumes and interphysician variation. 2009, 75 (4):990-3 Int. J. Radiat. Oncol. Biol. Phys.Journal
International Journal of Radiation Oncology, Biology, PhysicsDOI
10.1016/j.ijrobp.2008.12.042PubMed ID
19345515Type
ArticleLanguage
enISSN
1879-355Xae974a485f413a2113503eed53cd6c53
10.1016/j.ijrobp.2008.12.042
Scopus Count
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