A treatment planning comparison of four target volume contouring guidelines for locally advanced pancreatic cancer radiotherapy
Background and purpose Contouring of target volumes varies significantly in radiotherapy of pancreatic ductal adenocarcinoma (PDAC). There is a lack of consensus as to whether elective lymph nodes (eLN's) should be included or not in the planning target volume (PTV). In the present study we ana...
| Main Authors: | , , , , , , |
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| Format: | Journal article |
| Language: | English |
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2013
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| _version_ | 1826257589279653888 |
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| author | Fokas, E Eccles, C Patel, N Chu, K Warren, S Mckenna, W Brunner, T |
| author_facet | Fokas, E Eccles, C Patel, N Chu, K Warren, S Mckenna, W Brunner, T |
| author_sort | Fokas, E |
| collection | OXFORD |
| description | Background and purpose Contouring of target volumes varies significantly in radiotherapy of pancreatic ductal adenocarcinoma (PDAC). There is a lack of consensus as to whether elective lymph nodes (eLN's) should be included or not in the planning target volume (PTV). In the present study we analyzed the dosimetric coverage of the eLN's and organs at risk (OAR) by comparing four different contouring guidelines. Methods and materials PTVs were delineated with (Oxford and RTOG guidelines) or without (Michigan and SCALOP guidelines) including the eLNs in eleven patients with PDAC. eLNs included the peripancreatic, paraaortic, paracaval, celiac trunk, superior mesenteric and portal vein clinical target volumes (CTVs). A 3D-CRT plan (50.40 Gy in 28 fractions) was performed to analyze and compare the dosimetric coverage of all eLNs and OAR between the 4 contouring guidelines. Results The size of Oxford and RTOG PTVs was comparable and significantly larger than the SCALOP and Michigan PTVs. Interestingly the eLNs received a significant amount of incidental dose irradiation by PTV-based plans that only aimed to treat the tumor without the eLNs. The dosimetric coverage of eLN presented a large variability according to the respective contouring methods. The difference in the size of the 4 PTVs was reflected to the dose distribution at the OAR. Conclusions Our study provides important information regarding the impact of different contouring guidelines on the dose distribution to the eLNs and the OAR in patients with locally advanced PDAC treated with radiotherapy. © 2013 Elsevier Ireland Ltd. All rights reserved. |
| first_indexed | 2024-03-06T18:20:35Z |
| format | Journal article |
| id | oxford-uuid:06232530-4cae-49d3-9bc8-c1ed69c0a8e8 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T18:20:35Z |
| publishDate | 2013 |
| record_format | dspace |
| spelling | oxford-uuid:06232530-4cae-49d3-9bc8-c1ed69c0a8e82022-03-26T09:01:04ZA treatment planning comparison of four target volume contouring guidelines for locally advanced pancreatic cancer radiotherapyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:06232530-4cae-49d3-9bc8-c1ed69c0a8e8EnglishSymplectic Elements at Oxford2013Fokas, EEccles, CPatel, NChu, KWarren, SMckenna, WBrunner, TBackground and purpose Contouring of target volumes varies significantly in radiotherapy of pancreatic ductal adenocarcinoma (PDAC). There is a lack of consensus as to whether elective lymph nodes (eLN's) should be included or not in the planning target volume (PTV). In the present study we analyzed the dosimetric coverage of the eLN's and organs at risk (OAR) by comparing four different contouring guidelines. Methods and materials PTVs were delineated with (Oxford and RTOG guidelines) or without (Michigan and SCALOP guidelines) including the eLNs in eleven patients with PDAC. eLNs included the peripancreatic, paraaortic, paracaval, celiac trunk, superior mesenteric and portal vein clinical target volumes (CTVs). A 3D-CRT plan (50.40 Gy in 28 fractions) was performed to analyze and compare the dosimetric coverage of all eLNs and OAR between the 4 contouring guidelines. Results The size of Oxford and RTOG PTVs was comparable and significantly larger than the SCALOP and Michigan PTVs. Interestingly the eLNs received a significant amount of incidental dose irradiation by PTV-based plans that only aimed to treat the tumor without the eLNs. The dosimetric coverage of eLN presented a large variability according to the respective contouring methods. The difference in the size of the 4 PTVs was reflected to the dose distribution at the OAR. Conclusions Our study provides important information regarding the impact of different contouring guidelines on the dose distribution to the eLNs and the OAR in patients with locally advanced PDAC treated with radiotherapy. © 2013 Elsevier Ireland Ltd. All rights reserved. |
| spellingShingle | Fokas, E Eccles, C Patel, N Chu, K Warren, S Mckenna, W Brunner, T A treatment planning comparison of four target volume contouring guidelines for locally advanced pancreatic cancer radiotherapy |
| title | A treatment planning comparison of four target volume contouring guidelines for locally advanced pancreatic cancer radiotherapy |
| title_full | A treatment planning comparison of four target volume contouring guidelines for locally advanced pancreatic cancer radiotherapy |
| title_fullStr | A treatment planning comparison of four target volume contouring guidelines for locally advanced pancreatic cancer radiotherapy |
| title_full_unstemmed | A treatment planning comparison of four target volume contouring guidelines for locally advanced pancreatic cancer radiotherapy |
| title_short | A treatment planning comparison of four target volume contouring guidelines for locally advanced pancreatic cancer radiotherapy |
| title_sort | treatment planning comparison of four target volume contouring guidelines for locally advanced pancreatic cancer radiotherapy |
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