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Variation in the definition of clinical target volumes for pelvic nodal conformal radiation therapy for prostate cancer.

Publication ,  Journal Article
Lawton, CAF; Michalski, J; El-Naqa, I; Kuban, D; Lee, WR; Rosenthal, SA; Zietman, A; Sandler, H; Shipley, W; Ritter, M; Valicenti, R; Roach, M ...
Published in: Int J Radiat Oncol Biol Phys
June 1, 2009

PURPOSE: We conducted a comparative study of clinical target volume (CTV) definition of pelvic lymph nodes by multiple genitourinary (GU) radiation oncologists looking at the levels of discrepancies amongst this group. METHODS AND MATERIALS: Pelvic computed tomography (CT) scans from 2 men were distributed to 14 Radiation Therapy Oncology Group GU radiation oncologists with instructions to define CTVs for the iliac and presacral lymph nodes. The CT data with contours were then returned for analysis. In addition, a questionnaire was completed that described the physicians' method for target volume definition. RESULTS: Significant variation in the definition of the iliac and presacral CTVs was seen among the physicians. The minimum, maximum, mean (SD) iliac volumes (mL) were 81.8, 876.6, 337.6 +/- 203 for case 1 and 60.3, 627.7, 251.8 +/- 159.3 for case 2. The volume of 100% agreement was 30.6 and 17.4 for case 1 and 2 and the volume of the union of all contours was 1,012.0 and 807.4 for case 1 and 2, respectively. The overall agreement was judged to be moderate in both cases (kappa = 0.53 (p < 0.0001) and kappa = 0.48 (p < 0.0001). There was no volume of 100% agreement for either of the two presacral volumes. These variations were confirmed in the responses to the associated questionnaire. CONCLUSIONS: Significant disagreement exists in the definition of the CTV for pelvic nodal radiation therapy among GU radiation oncology specialists. A consensus needs to be developed so as to accurately assess the merit and safety of such treatment.

Duke Scholars

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

June 1, 2009

Volume

74

Issue

2

Start / End Page

377 / 382

Location

United States

Related Subject Headings

  • Urology
  • Urinary Bladder
  • Tumor Burden
  • Rectum
  • Radiotherapy, Conformal
  • Radiotherapy Dosage
  • Radiography
  • Radiation Oncology
  • Prostatic Neoplasms
  • Pelvis
 

Citation

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Lawton, C. A. F., Michalski, J., El-Naqa, I., Kuban, D., Lee, W. R., Rosenthal, S. A., … Seider, M. (2009). Variation in the definition of clinical target volumes for pelvic nodal conformal radiation therapy for prostate cancer. Int J Radiat Oncol Biol Phys, 74(2), 377–382. https://doi.org/10.1016/j.ijrobp.2008.08.003
Lawton, Colleen A. F., Jeff Michalski, Issam El-Naqa, Deborah Kuban, W Robert Lee, Seth A. Rosenthal, Anthony Zietman, et al. “Variation in the definition of clinical target volumes for pelvic nodal conformal radiation therapy for prostate cancer.Int J Radiat Oncol Biol Phys 74, no. 2 (June 1, 2009): 377–82. https://doi.org/10.1016/j.ijrobp.2008.08.003.
Lawton CAF, Michalski J, El-Naqa I, Kuban D, Lee WR, Rosenthal SA, et al. Variation in the definition of clinical target volumes for pelvic nodal conformal radiation therapy for prostate cancer. Int J Radiat Oncol Biol Phys. 2009 Jun 1;74(2):377–82.
Lawton, Colleen A. F., et al. “Variation in the definition of clinical target volumes for pelvic nodal conformal radiation therapy for prostate cancer.Int J Radiat Oncol Biol Phys, vol. 74, no. 2, June 2009, pp. 377–82. Pubmed, doi:10.1016/j.ijrobp.2008.08.003.
Lawton CAF, Michalski J, El-Naqa I, Kuban D, Lee WR, Rosenthal SA, Zietman A, Sandler H, Shipley W, Ritter M, Valicenti R, Catton C, Roach M, Pisansky TM, Seider M. Variation in the definition of clinical target volumes for pelvic nodal conformal radiation therapy for prostate cancer. Int J Radiat Oncol Biol Phys. 2009 Jun 1;74(2):377–382.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

June 1, 2009

Volume

74

Issue

2

Start / End Page

377 / 382

Location

United States

Related Subject Headings

  • Urology
  • Urinary Bladder
  • Tumor Burden
  • Rectum
  • Radiotherapy, Conformal
  • Radiotherapy Dosage
  • Radiography
  • Radiation Oncology
  • Prostatic Neoplasms
  • Pelvis