The need for consensus on delineation and dose constraints of dentofacial structures in paediatric radiotherapy: Outcomes of a SIOP Europe survey
Background and purpose: Children receiving radiotherapy for head-and-neck tumours often experience severe dentofacial side effects. Despite this, recommendations for contouring and dose constraints to dentofacial structures are lacking in clinical practice. We report on a survey aiming to understand...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-11-01
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| Series: | Clinical and Translational Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630823001064 |
| _version_ | 1797642489389121536 |
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| author | Angela Davey Shermaine Pan Abigail Bryce-Atkinson Henry Mandeville Geert O. Janssens Sarah M. Kelly Marinka Hol Vivian Tang Lucy Siew Chen Davies SIOP-Europe Radiation Oncology Working Group Marianne Aznar |
| author_facet | Angela Davey Shermaine Pan Abigail Bryce-Atkinson Henry Mandeville Geert O. Janssens Sarah M. Kelly Marinka Hol Vivian Tang Lucy Siew Chen Davies SIOP-Europe Radiation Oncology Working Group Marianne Aznar |
| author_sort | Angela Davey |
| collection | DOAJ |
| description | Background and purpose: Children receiving radiotherapy for head-and-neck tumours often experience severe dentofacial side effects. Despite this, recommendations for contouring and dose constraints to dentofacial structures are lacking in clinical practice. We report on a survey aiming to understand current practice in contouring and dose assessment to dentofacial structures. Methods: A digital survey was distributed to European Society for Paediatric Oncology members of the Radiation Oncology Working Group, and member-affiliated centres in Europe, Australia, and New Zealand. The questions focused on clinical practice and aimed to establish areas for future development. Results: Results from 52 paediatric radiotherapy centres across 27 countries are reported. Only 29/52 centres routinely delineated some dentofacial structures, with the most common being the mandible (25 centres), temporo-mandibular joint (22), dentition (13), orbit (10) and maxillary bone (eight). For most bones contoured, an ‘As Low As Reasonably Achievable’ dose objective was implemented. Only four centres reported age-adapted dose constraints.The largest barrier to clinical implementation of dose constraints was firstly, the lack of contouring guidance (49/52, 94%) and secondly, that delineation is time-consuming (33/52, 63%). Most respondents who routinely contour dentofacial structures (25/27, 90%) agreed a contouring atlas would aid delineation. Conclusion: Routine delineation of dentofacial structures is infrequent in paediatric radiotherapy. Based on survey findings, we aim to 1) define a consensus-contouring atlas for dentofacial structures, 2) develop auto-contouring solutions for dentofacial structures to aid clinical implementation, and 3) carry out treatment planning studies to investigate the importance of delineation of these structures for planning optimisation. |
| first_indexed | 2024-03-11T14:01:54Z |
| format | Article |
| id | doaj.art-1db75b3d7096467fb7d38c501d10fb71 |
| institution | Directory Open Access Journal |
| issn | 2405-6308 |
| language | English |
| last_indexed | 2024-03-11T14:01:54Z |
| publishDate | 2023-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj.art-1db75b3d7096467fb7d38c501d10fb712023-11-02T04:13:39ZengElsevierClinical and Translational Radiation Oncology2405-63082023-11-0143100681The need for consensus on delineation and dose constraints of dentofacial structures in paediatric radiotherapy: Outcomes of a SIOP Europe surveyAngela Davey0Shermaine Pan1Abigail Bryce-Atkinson2Henry Mandeville3Geert O. Janssens4Sarah M. Kelly5Marinka Hol6Vivian Tang7Lucy Siew Chen Davies8 SIOP-Europe Radiation Oncology Working Group9Marianne Aznar10Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK; Corresponding author at: Dept 58, Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, UK.Department of Proton Therapy, The Christie NHS Foundation Trust, Manchester, UKDivision of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UKThe Royal Marsden NHS Foundation Trust, London, UKPrincess Maxima Center for Paediatric Oncology, Utrecht, The Netherlands; Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The NetherlandsEuropean Society for Paediatric Oncology (SIOP Europe), Clos Chapelle-aux-Champs 30, Brussels, Belgium; The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Avenue E. Mounier 83, Brussels, Belgium; Faculty of Medicine and Health Sciences, Ghent University, Ghent, BelgiumPrincess Maxima Center for Paediatric Oncology, Utrecht, The Netherlands; Department of Otorhinolaryngology, University Medical Center Utrecht, Utrecht, The NetherlandsPaediatric Radiology, Royal Manchester Children’s Hospital, Manchester, UKDepartment of Radiotherapy, The Christie NHS Foundation Trust, Manchester, UKEuropean Society for Paediatric Oncology (SIOP Europe), Clos Chapelle-aux-Champs 30, Brussels, BelgiumDivision of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UKBackground and purpose: Children receiving radiotherapy for head-and-neck tumours often experience severe dentofacial side effects. Despite this, recommendations for contouring and dose constraints to dentofacial structures are lacking in clinical practice. We report on a survey aiming to understand current practice in contouring and dose assessment to dentofacial structures. Methods: A digital survey was distributed to European Society for Paediatric Oncology members of the Radiation Oncology Working Group, and member-affiliated centres in Europe, Australia, and New Zealand. The questions focused on clinical practice and aimed to establish areas for future development. Results: Results from 52 paediatric radiotherapy centres across 27 countries are reported. Only 29/52 centres routinely delineated some dentofacial structures, with the most common being the mandible (25 centres), temporo-mandibular joint (22), dentition (13), orbit (10) and maxillary bone (eight). For most bones contoured, an ‘As Low As Reasonably Achievable’ dose objective was implemented. Only four centres reported age-adapted dose constraints.The largest barrier to clinical implementation of dose constraints was firstly, the lack of contouring guidance (49/52, 94%) and secondly, that delineation is time-consuming (33/52, 63%). Most respondents who routinely contour dentofacial structures (25/27, 90%) agreed a contouring atlas would aid delineation. Conclusion: Routine delineation of dentofacial structures is infrequent in paediatric radiotherapy. Based on survey findings, we aim to 1) define a consensus-contouring atlas for dentofacial structures, 2) develop auto-contouring solutions for dentofacial structures to aid clinical implementation, and 3) carry out treatment planning studies to investigate the importance of delineation of these structures for planning optimisation.http://www.sciencedirect.com/science/article/pii/S2405630823001064DentofacialRadiotherapyPaediatricsLate adverse effectsContouringDose-volume constraints |
| spellingShingle | Angela Davey Shermaine Pan Abigail Bryce-Atkinson Henry Mandeville Geert O. Janssens Sarah M. Kelly Marinka Hol Vivian Tang Lucy Siew Chen Davies SIOP-Europe Radiation Oncology Working Group Marianne Aznar The need for consensus on delineation and dose constraints of dentofacial structures in paediatric radiotherapy: Outcomes of a SIOP Europe survey Clinical and Translational Radiation Oncology Dentofacial Radiotherapy Paediatrics Late adverse effects Contouring Dose-volume constraints |
| title | The need for consensus on delineation and dose constraints of dentofacial structures in paediatric radiotherapy: Outcomes of a SIOP Europe survey |
| title_full | The need for consensus on delineation and dose constraints of dentofacial structures in paediatric radiotherapy: Outcomes of a SIOP Europe survey |
| title_fullStr | The need for consensus on delineation and dose constraints of dentofacial structures in paediatric radiotherapy: Outcomes of a SIOP Europe survey |
| title_full_unstemmed | The need for consensus on delineation and dose constraints of dentofacial structures in paediatric radiotherapy: Outcomes of a SIOP Europe survey |
| title_short | The need for consensus on delineation and dose constraints of dentofacial structures in paediatric radiotherapy: Outcomes of a SIOP Europe survey |
| title_sort | need for consensus on delineation and dose constraints of dentofacial structures in paediatric radiotherapy outcomes of a siop europe survey |
| topic | Dentofacial Radiotherapy Paediatrics Late adverse effects Contouring Dose-volume constraints |
| url | http://www.sciencedirect.com/science/article/pii/S2405630823001064 |
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