Elective Clinical Target Volumes for Conformal Therapy in Anorectal Cancer: A Radiation Therapy Oncology Group Consensus Panel Contouring Atlas

Journal Article · Wed Jul 01 00:00:00 EDT 2009 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.08.070· OSTI ID:21276870

Garofalo, Michael C ^[1]; El Naqa, Issam ^[2]; Abrams, Ross A ^[3]; Apte, Aditya; Bosch, Walter R ^[2]; Das, Prajnan ^[4]; Gunderson, Leonard L ^[5]; Hong, Theodore S ^[6]; Kim, J.J. John ^[7]; Willett, Christopher G ^[8]; Kachnic, Lisa A ^[9]

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1. Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, MD (United States)
2. Department of Radiation Oncology, Washington University, St. Louis, MO (United States)
3. Department of Radiation Oncology, Rush University Medical Center, Chicago, IL (United States)
4. Department of Radiation Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX (United States)
5. Department of Radiation Oncology, Mayo Clinic, Scottsdale AZ (United States)
6. Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States)
7. Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON (Canada)
8. Department of Radiation Oncology, Duke University, Durham, NC (United States)
9. Department of Radiation Oncology, Boston University Medical Center, Boston, MA (United States)

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.

• OSTI ID: 21276870
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 74, Issue 3; Other Information: DOI: 10.1016/j.ijrobp.2008.08.070; PII: S0360-3016(08)03600-6; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
IMAGES
NEOPLASMS
PLANNING
RADIOTHERAPY
RECTUM