Evaluation of a target contouring protocol for 3D conformal radiotherapy in non-small cell lung cancer
Evaluation of a target contouring protocol for 3D conformal radiotherapy in non-small cell lung cancer
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DOI：
10.1016/s0167-8140(99)00143-7
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发表时间：
1999-12-01
影响因子：
5.7
通讯作者：
Lagerwaard, FJ
中科院分区：
文献类型：
--
作者：
Senan, S;de Koste, JV;Lagerwaard, FJ
背景：实施了肺癌靶体积轮廓的方案。随后，进行了一项研究，以确定临床内和临床间轮廓体积的变化。材料和方法：6名放射肿瘤学家（RO）分别在两个不同的时间对3例非小细胞肺癌（NSCLC）患者进行了肿瘤总体积（GTV）和/或临床靶体积（CTV）和计划靶体积（PTV）的测量。分别为界限分明的T1N0M0病变、形状不规则的T2N0M0病变和T2N2M0肿瘤。提供详细的放射诊断报告，并将轮廓输入三维规划系统。计算目标体积，并生成光束眼视图（BEV）图，以可视化轮廓的差异。利用软件工具对自动导出的PTV进行了GTV和CTV的三维扩展。结果：所有患者的轮廓靶体积均观察到ro间的显著差异，且这些差异大于ro内的差异。T1N0病变的GTV最大与最小轮廓体积之比为1.6，T2N2病变的PTV最大与最小轮廓体积之比为2.0。BEV图显示纵隔CTV的分布有显著的ro间差异。使用3D边缘程序获得的PTV比手动绘制的PTV更大。这些变化与活性氧的经历无关。结论：尽管采用了机构轮廓方案，但在非小细胞肺癌的靶体积轮廓上，临床医生之间仍然存在显著差异。应将减少此类变异的其他措施纳入临床试验。1999爱思唯尔科学爱尔兰有限公司版权所有。
Background: A protocol for the contouring of target volumes in lung cancer was implemented. Subsequently, a study was performed in order to determine the intra and inter-clinician variations in contoured volumes.Materials and methods: Six radiation oncologists (RO) contoured the gross tumour volume (GTV) and/or clinical target volume (CTV), and planning target volume (PTV) for three patients with non-small cell lung cancer (NSCLC), on two separate occasions. These were, respectively, a well-circumscribed T1N0M0 lesion, an irregularly shaped T2N0M0 lesion, and a T2N2M0 tumour. Detailed diagnostic radiology reports were provided and contours were entered into a 3D planning system. The target volumes were calculated and beams-eye view (BEV) plots were generated to visualise differences in contouring. A software tool was used to expand the GTV and CTV in three dimensions for an automatically derived PTV.Results: Significant inter-RO variations in contoured target volumes were observed for all patients, and these were greater than intra-RO differences. The ratio of the largest to smallest contoured volume ranged from 1.6 for the GTV in the T1N0 lesion, to 2.0 for the PTV in the T2N2 lesion. The BEV plots revealed significant inter-RO variations in contouring the mediastinal CTV. The PTV's derived using a 3D margin programme were larger than manually contoured PTV's. These variations did not correlate with the experience of ROs.Conclusions: Despite the use of an institutional contouring protocol, significant interclinician variations persist in contouring target volumes in NSCLC. Additional measures to decrease such variations should be incorporated into clinical trials. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.