Retroperitoneal Sarcoma (RPS) High Risk Gross Tumor Volume Boost (HR GTV Boost) Contour Delineation Agreement Among NRG Sarcoma Radiation and Surgical Oncologists
Retroperitoneal Sarcoma (RPS) High Risk Gross Tumor Volume Boost (HR GTV Boost) Contour Delineation Agreement Among NRG Sarcoma Radiation and Surgical Oncologists
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DOI：
10.1245/s10434-015-4633-x
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发表时间：
2015-09-01
影响因子：
3.7
通讯作者：
Wang, Dian
中科院分区：
文献类型：
--
作者：
Baldini, Elizabeth H.;Bosch, Walter;Wang, Dian
腹膜后肉瘤（RPS）的根治性治疗需要大体全切除。术前放疗（RT）通常用作手术的辅助治疗，但复发率仍然很高。为了在可接受的耐受性下增强RT疗效，有兴趣将RT的“加强剂量”递送到被判断为具有阳性切除边缘风险的总肿瘤体积（HR GTV）的高风险区域。我们试图评估合作肉瘤放射和外科肿瘤学家团队之间HR GTV增强靶区勾画的变异性，将3例RPS的放射计划CT扫描分发给6个机构的7个配对放射和外科肿瘤学家团队。团队概述了每种情况下的HR GTV提升量。使用同步真值和性能水平估计（STAPLE）算法和kappa统计进行轮廓一致性分析。7个团队之间的HRGTV升压容积轮廓一致性在所有情况下均为“实质性”或“中等”。一致性最好的是躯干壁后方（邻接胸腹壁后方）和内侧（邻接同侧椎旁间隙和大血管）。轮廓变化更显着毗邻内脏器官，由于不同的手术意见，计划的部分器官切除。协议的RPS HRGTV之间的肉瘤放射和外科肿瘤学家团队的推量是实质性的中度。在毗邻内脏器官的区域差异最显著，突出了放射和外科肿瘤学家之间合作的重要性，以根据被认为有风险的区域和计划切除进行“个性化”靶勾画。
Curative intent management of retroperitoneal sarcoma (RPS) requires gross total resection. Preoperative radiotherapy (RT) often is used as an adjuvant to surgery, but recurrence rates remain high. To enhance RT efficacy with acceptable tolerance, there is interest in delivering "boost doses" of RT to high-risk areas of gross tumor volume (HR GTV) judged to be at risk for positive resection margins. We sought to evaluate variability in HR GTV boost target volume delineation among collaborating sarcoma radiation and surgical oncologist teams.Radiation planning CT scans for three cases of RPS were distributed to seven paired radiation and surgical oncologist teams at six institutions. Teams contoured HR GTV boost volumes for each case. Analysis of contour agreement was performed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics.HRGTV boost volume contour agreement between the seven teams was "substantial" or "moderate" for all cases. Agreement was best on the torso wall posteriorly (abutting posterior chest abdominal wall) and medially (abutting ipsilateral para-vertebral space and great vessels). Contours varied more significantly abutting visceral organs due to differing surgical opinions regarding planned partial organ resection.Agreement of RPS HRGTV boost volumes between sarcoma radiation and surgical oncologist teams was substantial to moderate. Differences were most striking in regions abutting visceral organs, highlighting the importance of collaboration between the radiation and surgical oncologist for "individualized" target delineation on the basis of areas deemed at risk and planned resection.