Consequences of anorectal cancer atlas implementation in the cooperative group setting: Radiobiologic analysis of a prospective randomized in silico target delineation study
Consequences of anorectal cancer atlas implementation in the cooperative group setting: Radiobiologic analysis of a prospective randomized in silico target delineation study
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DOI：
10.1016/j.radonc.2014.05.011
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发表时间：
2014-09-01
影响因子：
5.7
通讯作者：
Commit, Southwest Oncology Group Radiation Oncology
中科院分区：
文献类型：
--
作者：
Mavroidis, Panayiotis;Giantsoudis, Drosoula;Commit, Southwest Oncology Group Radiation Oncology
目的：本研究的目的是确定随后的放射生物学的影响，使用一个共识的指导方针的目标体积划定atlas.Materials和方法：使用一个代表性的情况下，目标体积划定指令来自一个建议的IMRT直肠癌临床试验，肿瘤体积（GTV）和临床/规划目标体积（CTV/PTV）轮廓由13名医生观察员（第1阶段）。然后将观察者随机分配到遵循（图谱）或不遵循（对照）肛门直肠癌的共识指南/图谱，并指导他们重新勾画同一病例的轮廓（第2阶段）。寰椎组在寰椎介入后CTV和CTV的肿瘤控制概率（TCP）均增加。PTV 1组（p = 0.0011）和PTV 2组（p <0.0001）均降低了小肠正常组织并发症概率（NTCP），而对照组则没有。此外，寰椎组所有靶体积的TCP方差均降低，肠道的NTCP方差也降低。在第2阶段，图集组增加了TCP相对于控制CTV（p = 0.03）。结论：视觉图集和共识治疗指南的使用在直肠癌调强放射治疗计划的发展减少了观察者间的放射生物学变化，与临床相关的TCP改变CTV和PTV体积。(C)2014爱思唯尔爱尔兰有限公司版权所有。
Purpose: The aim of this study is to ascertain the subsequent radiobiological impact of using a consensus guideline target volume delineation atlas.Materials and methods: Using a representative case and target volume delineation instructions derived from a proposed IMRT rectal cancer clinical trial, gross tumor volume (GTV) and clinical/planning target volumes (CTV/PTV) were contoured by 13 physician observers (Phase 1). The observers were then randomly assigned to follow (atlas) or not-follow (control) a consensus guideline/atlas for anorectal cancers, and instructed to re-contour the same case (Phase 2).Results: The atlas group was found to have increased tumor control probability (TCP) after the atlas intervention for both the CTV (p < 0.0001) and PTV1 (p = 0.0011) with decreasing normal tissue complication probability (NTCP) for small intestine, while the control group did not. Additionally, the atlas group had reduced variance in TCP for all target volumes and reduced variance in NTCP for the bowel. In Phase 2, the atlas group had increased TCP relative to the control for CTV (p = 0.03).Conclusions: Visual atlas and consensus treatment guideline usage in the development of rectal cancer IMRT treatment plans reduced the inter-observer radiobiological variation, with clinically relevant TCP alteration for CTV and PTV volumes. (C) 2014 Elsevier Ireland Ltd. All rights reserved.