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Fokas, E; Eccles, C; Patel, N; Chu, KY; Warren, S; Gillies, McKenna, W; Brunner, TB.
Comparison of four target volume definitions for pancreatic cancer. Guidelines for treatment of the lymphatics and the primary tumor.
Strahlenther Onkol. 2013; 189(5):407-16 Doi: 10.1007/s00066-013-0332-3
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Leading authors Med Uni Graz
Brunner Thomas Baptist
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Abstract:
BACKGROUND AND PURPOSE: Target volume definitions for radiotherapy in pancreatic ductal adenocarcinoma (PDAC) vary substantially. Some groups aim to treat the primary tumor only, whereas others include elective lymph nodes (eLNs). eLNs close to the primary tumor are often included unintentionally within the treatment volume, depending on the respective treatment philosophies. We aimed to measure the percentages of anatomical coverage of eLNs by comparing four different contouring guidelines. PATIENTS AND METHODS: Planning target volumes (PTVs) were contoured using planning computed tomography (CT) scans of 11 patients with PDAC based on the Oxford, RTOG (Radiation Therapy Oncology Group), Michigan, and SCALOP (Selective Chemoradiation in Advanced Localised Pancreatic Cancer trial) guidelines. Clinical target volumes (CTVs) included the peripancreatic, para-aortic, paracaval, celiac trunk, superior mesenteric, and portal vein lymph node areas. Volumetric comparisons of the coverage of all eLN regions were conducted to illustrate the differences between the four contouring strategies. RESULTS: The PTV sizes of the RTOG and Oxford guidelines were comparable. The SCALOP and Michigan PTV sizes were similar to each other and significantly smaller than the RTOG and Oxford PTVs. A large variability of eLN coverage was found for the various subregions according to the respective contouring strategies. CONCLUSION: This is the first study to directly compare the percentage of anatomical coverage of eLNs according to four PTVs in the same patient cohort. Potential practical consequences are discussed in detail.
Find related publications in this database (using NLM MeSH Indexing)
Carcinoma, Pancreatic Ductal - diagnosis, radiotherapy, secondary
Germany - administration & dosage
Humans - administration & dosage
Imaging, Three-Dimensional - standards
Lymphatic Metastasis - administration & dosage
Pancreatic Neoplasms - diagnostic imaging, radiotherapy
Practice Guidelines as Topic - administration & dosage
Reproducibility of Results - administration & dosage
Sensitivity and Specificity - administration & dosage
Tomography, X-Ray Computed - standards
Tumor Burden - administration & dosage

Find related publications in this database (Keywords)
Pancreatic cancer
Planning target volume
Lymph nodes
Primary tumor
Guidelines
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