Radiation therapy oncology group consensus panel guidelines for the delineation of the clinical target volume in the postoperative treatment of pancreatic head cancer Journal Article
| Authors: | Goodman, K. A.; Regine, W. F.; Dawson, L. A.; Ben-Josef, E.; Haustermans, K.; Bosch, W. R.; Turian, J.; Abrams, R. A. |
| Article Title: | Radiation therapy oncology group consensus panel guidelines for the delineation of the clinical target volume in the postoperative treatment of pancreatic head cancer |
| Abstract: | Purpose: To develop contouring guidelines to be used in the Radiation Therapy Oncology Group protocol 0848, a Phase III randomized trial evaluating the benefit of adjuvant chemoradiation in patients with resected head of pancreas cancer. Methods and Materials: A consensus committee of six radiation oncologists with expertise in gastrointestinal radiotherapy developed stepwise contouring guidelines and an atlas for the delineation of the clinical target volume (CTV) in the postoperative treatment of pancreas cancer, based on identifiable regions of interest and margin expansions. Areas at risk for subclinical disease to be included in the CTV were defined, including nodal regions, anastomoses, and the preoperative primary tumor location. Regions of interest that could be reproducibly contoured on postoperative imaging after a pancreaticoduodenectomy were identified. Standardized expansion margins to encompass areas at risk were developed after multiple iterations to determine the optimal margin expansions. Results: New contouring recommendations based on CT anatomy were established. Written guidelines for the delineation of the postoperative CTV and normal tissues, as well as a Web-based atlas, were developed. Conclusions: The postoperative abdomen has been a difficult area for effective radiotherapy. These new guidelines will help physicians create fields that better encompass areas at risk and minimize dose to normal tissues. © 2012 Elsevier Inc. All rights reserved. |
| Keywords: | controlled study; treatment outcome; cancer localization; postoperative period; cancer adjuvant therapy; cancer patient; cancer radiotherapy; pancreas cancer; pancreas resection; radiation dose; lymph node metastasis; antineoplastic agent; preoperative evaluation; pancreaticoduodenectomy; computer assisted tomography; randomized controlled trial; radiotherapy; clinical protocol; practice guideline; diagnostic imaging; oncology; risk factor; histology; radiologist; intensity-modulated radiotherapy; consensus development; phase 3 clinical trial; pancreatic cancer; adjuvant radiotherapy; diseases; tissue; medical expert; clinical target volume; pancreatic cancers; web browser; consensus statement; abdominal anatomy; pancreas head cancer |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 83 |
| Issue: | 3 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2012-07-01 |
| Start Page: | 901 |
| End Page: | 908 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2012.01.022 |
| PROVIDER: | scopus |
| PUBMED: | 22483737 |
| PMCID: | PMC6211792 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 2 July 2012" - "CODEN: IOBPD" - "Source: Scopus" |
