TY - JOUR
T1 - Elective Clinical Target Volumes for Conformal Therapy in Anorectal Cancer
T2 - A Radiation Therapy Oncology Group Consensus Panel Contouring Atlas
AU - Myerson, Robert J.
AU - Garofalo, Michael C.
AU - El Naqa, Issam
AU - Abrams, Ross A.
AU - Apte, Aditya
AU - Bosch, Walter R.
AU - Das, Prajnan
AU - Gunderson, Leonard L.
AU - Hong, Theodore S.
AU - Kim, J. J.John
AU - Willett, Christopher G.
AU - Kachnic, Lisa A.
N1 - Funding Information:
L. A. K. and R. J. M. co-wrote the manuscript. This work was supported by RTOG U10 CA21661, CCOP U10 CA37422, Stat U10 CA32115 NCI grants. The contents are the sole responsibility of the authors and do not necessarily represent official views of the National Cancer Institute. Advanced Technology QA Consortium supported by National Institutes of Health/National Cancer Institute U24 Grant CA81647.
PY - 2009/7/1
Y1 - 2009/7/1
N2 - Purpose: To develop a Radiation Therapy Oncology Group (RTOG) atlas of the elective clinical target volume (CTV) definitions to be used for planning pelvic intensity-modulated radiotherapy (IMRT) for anal and rectal cancers. Methods and Materials: The Gastrointestinal Committee of the RTOG established a task group (the nine physician co-authors) to develop this atlas. They responded to a questionnaire concerning three elective CTVs (CTVA: internal iliac, presacral, and perirectal nodal regions for both anal and rectal case planning; CTVB: external iliac nodal region for anal case planning and for selected rectal cases; CTVC: inguinal nodal region for anal case planning and for select rectal cases), and to outline these areas on individual computed tomographic images. The imaging files were shared via the Advanced Technology Consortium. A program developed by one of the co-authors (I.E.N.) used binomial maximum-likelihood estimates to generate a 95% group consensus contour. The computer-estimated consensus contours were then reviewed by the group and modified to provide a final contouring consensus atlas. Results: The panel achieved consensus CTV definitions to be used as guidelines for the adjuvant therapy of rectal cancer and definitive therapy for anal cancer. The most important difference from similar atlases for gynecologic or genitourinary cancer is mesorectal coverage. Detailed target volume contouring guidelines and images are discussed. Conclusion: This report serves as a template for the definition of the elective CTVs to be used in IMRT planning for anal and rectal cancers, as part of prospective RTOG trials.
AB - Purpose: To develop a Radiation Therapy Oncology Group (RTOG) atlas of the elective clinical target volume (CTV) definitions to be used for planning pelvic intensity-modulated radiotherapy (IMRT) for anal and rectal cancers. Methods and Materials: The Gastrointestinal Committee of the RTOG established a task group (the nine physician co-authors) to develop this atlas. They responded to a questionnaire concerning three elective CTVs (CTVA: internal iliac, presacral, and perirectal nodal regions for both anal and rectal case planning; CTVB: external iliac nodal region for anal case planning and for selected rectal cases; CTVC: inguinal nodal region for anal case planning and for select rectal cases), and to outline these areas on individual computed tomographic images. The imaging files were shared via the Advanced Technology Consortium. A program developed by one of the co-authors (I.E.N.) used binomial maximum-likelihood estimates to generate a 95% group consensus contour. The computer-estimated consensus contours were then reviewed by the group and modified to provide a final contouring consensus atlas. Results: The panel achieved consensus CTV definitions to be used as guidelines for the adjuvant therapy of rectal cancer and definitive therapy for anal cancer. The most important difference from similar atlases for gynecologic or genitourinary cancer is mesorectal coverage. Detailed target volume contouring guidelines and images are discussed. Conclusion: This report serves as a template for the definition of the elective CTVs to be used in IMRT planning for anal and rectal cancers, as part of prospective RTOG trials.
KW - Anal cancer
KW - Conformal pelvic radiation
KW - Contouring guidelines
KW - Intensity-modulated radiotherapy
KW - Rectal cancer
UR - http://www.scopus.com/inward/record.url?scp=67349203305&partnerID=8YFLogxK
U2 - 10.1016/j.ijrobp.2008.08.070
DO - 10.1016/j.ijrobp.2008.08.070
M3 - Article
C2 - 19117696
AN - SCOPUS:67349203305
SN - 0360-3016
VL - 74
SP - 824
EP - 830
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 3
ER -