Enhanced head and neck radiotherapy target definition through multidisciplinary delineation and peer review: A prospective single-center study.
Détails
ID Serval
serval:BIB_E1D4FFDB6729
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Enhanced head and neck radiotherapy target definition through multidisciplinary delineation and peer review: A prospective single-center study.
Périodique
Clinical and translational radiation oncology
ISSN
2405-6308 (Electronic)
ISSN-L
2405-6308
Statut éditorial
Publié
Date de publication
09/2024
Peer-reviewed
Oui
Volume
48
Pages
100837
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Résumé
This study evaluates the benefit of weekly delineation and peer review by a multidisciplinary team (MDT) of radiation oncologists (ROs), radiologists (RXs), and nuclear medicine (NM) physicians in defining primary and lymph node tumor volumes (GTVp and GTVn) for head and neck cancer (HNC) radiotherapy. This study includes 30 consecutive HNC patients referred for definitive curative (chemo)-radiotherapy. Imaging data including head and neck MRI, [18F]-FDG-PET and CT scan were evaluated by the MDT. The RO identified the 'undeniable' tumor as GTVp_core and determined GTVp_max, representing the maximum tumoral volume. The MDT delineation (MDT-D) by RX and NM physicians outlined their respective primary GTVs (GTVp_RX and GTVp_NM). During the MDT meeting (MDT-M), these contours were discussed to reach a consensus on the final primary GTV (GTVp_final). In the comparative analysis of various GTVp delineations, we performed descriptive statistics and assessed two MDT-M factors: 1) the added value of MDT-M, which includes the section of GTVp_final outside GTVp_core but within GTVp_RX or GTVp_NM, and 2) the part of GTVp_final that deviates from GTVp_max, representing the area missed by the RO. For GTVn, discussions evaluated lymph node extent and malignancy, documenting findings and the frequency of disagreements. The average GTVp core and max volumes were 19.5 cc (range: 0.4-90.1) and 22.1 cc (range: 0.8-106.2), respectively. Compared to GTVp_core, MDT-D to GTVp_final added an average of 3.3 cc (range: 0-25.6) and spared an average of 1.3 cc (0-15.6). Compared to GTVp_max, MDT-D and -M added an average of 2.7 cc (range: 0-20.3) and removed 2.3 cc (0-21.3). The most frequent GTVn discussions included morphologically suspicious nodes not fixing on [18F]-FDG-PET and small [18F]-FDG-PET negative retropharyngeal lymph nodes. Multidisciplinary review of target contours in HNC is essential for accurate treatment planning, ensuring precise tumor and lymph node delineation, potentially improving local control and reducing toxicity.
Mots-clé
Head and neck cancer, Multidisciplinary peer review, Radiotherapy, Target volume delineation
Pubmed
Web of science
Open Access
Oui
Création de la notice
09/09/2024 13:50
Dernière modification de la notice
10/09/2024 6:17