Consensus Guidelines for Delineation of Clinical Target Volume for Intensity-Modulated Pelvic Radiotherapy for the Definitive Treatment of Cervix Cancer

Lim, Karen; Small, William; Portelance, Lorraine; Creutzberg, Carien L.; Jürgenliemk-Schulz, Ina M.; Mundt, Arno J.; Mell, Loren K.; Mayr, Nina A.; Viswanathan, Akila; Jhingran, Anuja; Erickson, Beth; Santos, Jennifer De Los; Gaffney, David K.; Yashar, Catheryn M.; Beriwal, Sushil; Wolfson, Aaron H.; Taylor, Alexandra; Bosch, Walter; Naqa, Issam El; Fyles, Anthony

doi:10.1016/j.ijrobp.2009.10.075

Cited by 387 publications

(237 citation statements)

References 35 publications

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“…The JI [18][19][20], DICE [4], Hausdorff distance [21] and Kappa (κ) statistic [22,23] outlined in Supplementary Table 1, are metrics commonly used to establish inter-observer variation [6]. JI and DICE values from CERR were verified in 3D Slicer [24][25][26] and MILXview and were consistent to within 2 significant figures.…”

Section: Analysis Metricsmentioning

confidence: 78%

A phantom assessment of achievable contouring concordance across multiple treatment planning systems

Pogson

Begg

Jameson

et al. 2015

Radiotherapy and Oncology

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In this paper, the highest level of inter-and intra-observer conformity achievable with different treatment planning systems (TPSs), contouring tools, shapes, and sites have been established for metrics including the Dice similarity coefficient (DICE) 2 AbstractIn this paper, metrics including the Dice similarity coefficient (DICE) and Hausdorff Distance determine the highest level of inter-and intra-observer conformity achievable with different treatment planning systems (TPSs), contouring tools, shapes, and sites. High conformity values, e.g. DICE Breast_Shape =0.99±0.01, are achieved with differing TPSs. Decreasing image resolution decreased contouring conformity.

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Section: Analysis Metricsmentioning

confidence: 78%

A phantom assessment of achievable contouring concordance across multiple treatment planning systems

Pogson

Begg

Jameson

et al. 2015

Radiotherapy and Oncology

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“…Radiotherapy remains an important local treatment of malignant tumors, with about 70% of cancer patients requiring radiotherapy during treatment; about 40% of all cancers can be eradicated with radiotherapy (Taylor et al, 2005;Eifel, 2006;Forrest et al, 2010;Lim et al, 2011;Rose et al, 2011). In the treatment of cervical cancer, radiotherapy can kill residual tumor cells present after surgery, which effectively prevents recurrence and metastasis.…”

Section: Discussionmentioning

confidence: 99%

“…CR (Lim et al, 2011) refers to the disappearance of all lesions and no incidences of relapse beyond 4 weeks after the disappearance of lesions. PR refers to at least a 30% decrease in the sum of the longest diameter of baseline lesions, with no new lesions for 4 consecutive weeks or longer.…”

Section: Observational Parametersmentioning

confidence: 99%

Clinical value of concurrent radiochemotherapy in cervical cancer and comparison of ultrasonography findings before and after radiochemotherapy

Yan

et al. 2015

Genet. Mol. Res.

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ABSTRACT. Herein, we investigated the clinical value of concurrent radiochemotherapy for patients with advanced cervical cancer and its effects on adverse clinical symptoms. Forty patients with cervical cancer were recruited from January 2011 to January 2014 for this study. Participants were randomly allocated into a test or control group, with 20 patients in each group. Patients in the test group were treated with concurrent radiochemotherapy, whereas patients in the control group received only traditional radiotherapy. At the end of the observation period, clinical efficacy in the two groups was compared. Patients were followed up for 2 years, and the rates of recurrence, survival, and complications were compared; ultrasonographic findings before and after radiotherapy were also correlated. Patients in the test group who received concurrent radiochemotherapy showed significantly higher clinical efficacy than the control group at the end of treatment cycles. After 2 years of follow-up, the rates of recurrence, mortality, and complications were all significantly lower in the test group than in the control group (P < 0.05). Comparison of ultrasonographic findings before and after radiochemotherapy showed that the size of the tumor was significantly smaller in patients after concurrent radiochemotherapy. Compared with traditional radiotherapy, concurrent radiochemotherapy significantly improved clinical outcomes in patients with advanced cervical cancer. Concurrent radiochemotherapy also enhanced the rate of survival and decreased the rate of relapse, with enhanced clinical safety and no significant side effects. Thus, concurrent radiochemotherapy can be more broadly applied in the treatment of advanced cervical cancer.

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“…This study predated the publication of the contouring atlas for definitive cervix [2]. We developed a standardized in-house standard protocol for IMRT in intact cervix patients.…”

Section: Imrt Treatment Planning Parametersmentioning

confidence: 99%

Assessment of intact cervix motion using implanted fiducials in patients treated with helical tomotherapy with daily MVCT positioning

et al. 2013

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Objectives This study assesses the relative motion of the cervix during the course of treatment in patients with intact cervical cancers treated with pelvic intensity modulated radiation therapy (IMRT). Methods Nineteen patients with intact cervical cancer were treated definitively with tomotherapy using daily megavoltage (MV) CT positioning to pelvic bony anatomy. Textured gold fiducials were placed in three of four quadrants of the cervix prior to CT simulation. Daily MVCTs were registered to the planning CT based on bony anatomy. The center of mass (COM) of the fiducials was used to assess interfractional cervical motion by comparing the relative positions of the COMs. Tumor regression was indirectly assessed by calculating the contraction in the relative distance between fiducial pairs. Results Fourteen patients were evaluable. Average vector motion of the COM was 7.0 mm (SD=5.7 mm; range of 0 to 34 mm). Ninety-five percent of fiducial excursions were encompassed by 8 mm right-left, 12 mm anterior-posterior, and 11 mm superior-inferior. Ninety-five percent of all measured COM motions were ≤18 mm. Contraction was observed in 9 out of 12 patients that were analyzable. In those nine patients, the average distances between the fiducial pairs were 23 mm (range, 5.8 to 48 mm) and 18 mm (range, 3.8 to 41 mm) in the planning CT and in the last daily MVCT, respectively. On average, fiducials moved 23 % closer together. Conclusion Quantification of the excursions of the intact cervix using daily imaging of implanted fiducials was feasible and useful to define appropriate clinical target volume-planning target volume (CTV-PTV) margins for IMRT. Nonuniform CTV-PTV margins may be appropriate based on differential directional motion.

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Consensus Guidelines for Delineation of Clinical Target Volume for Intensity-Modulated Pelvic Radiotherapy for the Definitive Treatment of Cervix Cancer

Cited by 387 publications

References 35 publications

A phantom assessment of achievable contouring concordance across multiple treatment planning systems

A phantom assessment of achievable contouring concordance across multiple treatment planning systems

Clinical value of concurrent radiochemotherapy in cervical cancer and comparison of ultrasonography findings before and after radiochemotherapy

Assessment of intact cervix motion using implanted fiducials in patients treated with helical tomotherapy with daily MVCT positioning

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