A Consensus-based Guideline Defining the Clinical Target Volume for Pelvic Lymph Nodes in External Beam Radiotherapy for Uterine Cervical Cancer
A Consensus-based Guideline Defining the Clinical Target Volume for Pelvic Lymph Nodes in External Beam Radiotherapy for Uterine Cervical Cancer
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DOI：
10.1093/jjco/hyp191
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发表时间：
2010-05-01
影响因子：
2.4
通讯作者：
Hiraoka, Masahiro
中科院分区：
文献类型：
--
作者：
Toita, Takafumi;Ohno, Tatsuya;Hiraoka, Masahiro
为了制定一个基于共识的指南以及一个定义宫颈癌外照射放射治疗中盆腔淋巴结临床靶体积的图谱，日本临床肿瘤学组放射治疗研究小组于2008年7月制定了一个工作小组，以建立基于共识的宫颈癌临床靶体积指南。工作小组由7名放射肿瘤学家组成。该过程导致的共识包括比较轮廓的CT图像之间的成员，审查出版的教科书和相关文献和分布分析的转移性淋巴结的计算机断层扫描/磁共振成像的实际patients.The工作小组定义的盆腔淋巴结的宫颈癌的临床靶体积，并制定了相关的图集。作为一项基本标准，淋巴结临床靶体积定义为适用盆腔血管周围7 mm边缘所涵盖的区域。在每个淋巴结区域进行修改，以覆盖存在显微镜下淋巴结转移风险的相邻脂肪组织。虽然骨骼和肌肉被排除在外，但肠道在定义中并没有被常规排除。定义了以下盆腔淋巴结区域：髂总动脉、髂外动脉、髂内动脉、闭孔肌和骶前动脉。每个淋巴结区域边界的解剖结构定义为六个方向：前、后、外侧、内侧、颅侧和尾侧。JCOG妇科癌症研究组（GCSG）的成员审查了定义和图谱的草案。我们制定了一个基于共识的指南，定义了盆腔淋巴结临床靶体积，包括图谱。该指南将不断更新，以反映该领域正在发生的变化。
To develop a consensus-based guideline as well as an atlas defining pelvic nodal clinical target volumes in external beam radiotherapy for uterine cervical cancer.A working subgroup to establish the consensus-based guideline on clinical target volumes for uterine cervical cancer was formulated by the Radiation Therapy Study Group of the Japan Clinical Oncology Group in July 2008. The working subgroup consisted of seven radiation oncologists. The process resulting in the consensus included a comparison of contouring on CT images among the members, reviewing of published textbooks and the relevant literature and a distribution analysis of metastatic nodes on computed tomography/magnetic resonance imaging of actual patients.The working subgroup defined the pelvic nodal clinical target volumes for cervical cancer and developed an associated atlas. As a basic criterion, the lymph node clinical target volume was defined as the area encompassed by a 7 mm margin around the applicable pelvic vessels. Modifications were made in each nodal area to cover adjacent adipose tissues at risk of microscopic nodal metastases. Although the bones and muscles were excluded, the bowel was not routinely excluded in the definition. Each of the following pelvic node regions was defined: common iliac, external iliac, internal iliac, obturator and presacral. Anatomical structures bordering each lymph node region were defined for six directions; anterior, posterior, lateral, medial, cranial and caudal. Drafts of the definition and the atlas were reviewed by members of the JCOG Gynecologic Cancer Study Group (GCSG).We developed a consensus-based guideline defining the pelvic node clinical target volumes that included an atlas. The guideline will be continuously updated to reflect the ongoing changes in the field.