Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group* (I):: concepts and terms in 3D image based 3D treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment of GTV and CTV
Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group* (I):: concepts and terms in 3D image based 3D treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment of GTV and CTV
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DOI：
10.1016/j.radonc.2004.12.015
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发表时间：
2005-03-01
影响因子：
5.7
通讯作者：
Wachter-Gerstner, N
中科院分区：
文献类型：
--
作者：
Haie-Meder, C;Pötter, R;Wachter-Gerstner, N
背景和目的：近距离放射治疗（BT）在I期至IV期浸润性宫颈癌的治疗中起着至关重要的作用。腔内技术基于后装装置，具有不同类型的施用器。与传统方法相比，CT和/或MRI兼容的施用器允许基于断层图像的方法，能够更好地评估大体肿瘤体积（GTV）以及靶体积（CTV）的定义和描绘。GTV、CTV和PTV以及关键器官的准确和可再现的描绘对BT治疗计划有直接影响，特别是如果可以通过使用DVH分析进行优化来调整梨形等剂量。当引入一个3D图像为基础的方法GTV和CTV评估，有必要为一个共同的语言来描述的概念，并定义的术语，其中被used.Methods：在2000年，GEC-ESTRO决定支持3D成像为基础的3D治疗计划的方法在宫颈癌BT与创建一个工作组。任务是描述基本概念和术语，并制定一个术语，使在这一先进领域工作的各个小组能够使用一种共同的语言。本报告所述的建议是根据不同机构的临床经验和剂量学概念提出的（IGR，Leuven，维也纳），并在不同临床经验的背景下逐步验证。结论：由于BT的GTV和CTV在治疗期间发生显著变化，本报告规定了评估BT的GTV和CTV的时间范围：诊断时GTV（D）、CTVD和BT时GTV（B）、CTVB。此外，BT的CTV被定义为与复发风险相关：高风险CTV和中等风险CTV。除了文字描述之外，部分以示意图的形式给出了详细的示例。(c)2005爱思唯尔爱尔兰有限公司保留所有权利。
Background and purpose: Brachytherapy (BT) plays a crucial role in the management of invasive cervix cancer from stage I to IV. Intracavitary techniques are based on afterloading devices, with different types of applicators. CT and/or MRI compatible applicators allow a sectional image based approach with a better assessment of gross tumour volume (GTV) and definition and delineation of target volume (CTV) compared to traditional approaches. Accurate and reproducible delineation of GTV, CTV and PTV, as well as of critical organs has a direct impact on BT treatment planning, especially if it is possible to adapt the pear-shape isodose by optimisation using DVH analysis. When introducing a 3D image based approach for GTV and CTV assessment, there is a need for a common language to describe the concepts and to define the terms which are to be used.Methods: In 2000, GEC-ESTRO decided to support 3D imaging based 3D treatment planning approach in cervix cancer BT with the creation of a Working Group. The task was to describe basic concepts and terms and to work out a terminology enabling various groups working in this advanced field to use a common language. The recommendations described in this report were proposed based on clinical experience and dosimetric concepts of different institutions (IGR, Leuven, Vienna) and were stepwise validated against the background of different clinical experience.Conclusions: As GTV and CTV for BT change significantly during treatment, time frame for assessment of GTV and CTV for BT is specified in this report: at time of diagnosis GTV(D), CTVD and at time of BT GTV(B), CTVB. Furthermore, CTV for BT is defined related to risk for recurrence: high risk CTV and intermediate risk CTV. Beside verbal descriptions detailed examples are given, partly in form of schematic drawings. (c) 2005 Elsevier Ireland Ltd. All rights reserved.