Radiation therapy oncology group consensus panel guidelines for the delineation of the clinical target volume in the postoperative treatment of pancreatic head cancer

Karyn A. Goodman, William F. Regine, Laura A. Dawson, Edgar Ben-Josef, Karin Haustermans, Walter R. Bosch, Julius Turian, Ross A. Abrams

Research output: Contribution to journalArticle

65 Scopus citations

Abstract

Purpose: To develop contouring guidelines to be used in the Radiation Therapy Oncology Group protocol 0848, a Phase III randomized trial evaluating the benefit of adjuvant chemoradiation in patients with resected head of pancreas cancer. Methods and Materials: A consensus committee of six radiation oncologists with expertise in gastrointestinal radiotherapy developed stepwise contouring guidelines and an atlas for the delineation of the clinical target volume (CTV) in the postoperative treatment of pancreas cancer, based on identifiable regions of interest and margin expansions. Areas at risk for subclinical disease to be included in the CTV were defined, including nodal regions, anastomoses, and the preoperative primary tumor location. Regions of interest that could be reproducibly contoured on postoperative imaging after a pancreaticoduodenectomy were identified. Standardized expansion margins to encompass areas at risk were developed after multiple iterations to determine the optimal margin expansions. Results: New contouring recommendations based on CT anatomy were established. Written guidelines for the delineation of the postoperative CTV and normal tissues, as well as a Web-based atlas, were developed. Conclusions: The postoperative abdomen has been a difficult area for effective radiotherapy. These new guidelines will help physicians create fields that better encompass areas at risk and minimize dose to normal tissues.

Original languageEnglish
Pages (from-to)901-908
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume83
Issue number3
DOIs
StatePublished - Jul 1 2012

Keywords

  • Abdominal anatomy
  • Adjuvant radiotherapy
  • Consensus statement
  • Intensity-modulated radiotherapy
  • Pancreatic cancer

Fingerprint Dive into the research topics of 'Radiation therapy oncology group consensus panel guidelines for the delineation of the clinical target volume in the postoperative treatment of pancreatic head cancer'. Together they form a unique fingerprint.

  • Cite this