Development of RTOG Consensus Guidelines for the Definition of the Clinical Target Volume for Postoperative Conformal Radiation Therapy for Prostate Cancer

Journal Article · Mon Feb 01 00:00:00 EST 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.02.006· OSTI ID:21372047

Lawton, Colleen ^[1]; El Naqa, Issam ^[2]; Ritter, Mark ^[3]; O'Meara, Elizabeth C ^[4]; Seider, Michael J ^[5]; Lee, W Robert ^[6]; Rosenthal, Seth A ^[7]; Pisansky, Thomas ^[8]; Catton, Charles ^[9]; Valicenti, Richard K ^[10]; Zietman, Anthony L ^[11]; Bosch, Walter R ^[2]; Sandler, Howard ^[12]; Buyyounouski, Mark K ^[13]; Menard, Cynthia ^[9]

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1. Medical College of Wisconsin, Milwaukee, WI (United States)
2. Washington University School of Medicine, St. Louis, MO (United States)
3. University of Wisconsin Comprehensive Cancer Center, Madison, WI (United States)
4. Radiation Therapy Oncology Group, Philadelphia, PA (United States)
5. Akron City Hospital, Akron, OH (United States)
6. Duke University Medical Center, Durham, NC (United States)
7. Radiation Oncology Centers, Radiological Associates of Sacramento, Sacramento, CA (United States)
8. Mayo Clinic, Rochester, MN (United States)
9. Princess Margaret Hospital, Toronto, Ontario (Canada)
10. Bodine Center for Cancer Treatment, Philadelphia, PA (United States)
11. Massachusetts General Hospital, Boston, MA (United States)
12. University of Michigan, Ann Arbor, MI (United States)
13. Fox Chase Cancer Center, Philadelphia, PA (United States)

Purpose: To define a prostate fossa clinical target volume (PF-CTV) for Radiation Therapy Oncology Group (RTOG) trials using postoperative radiotherapy for prostate cancer. Methods and Materials: An RTOG-sponsored meeting was held to define an appropriate PF-CTV after radical prostatectomy. Data were presented describing radiographic failure patterns after surgery. Target volumes used in previous trials were reviewed. Using contours independently submitted by 13 radiation oncologists, a statistical imputation method derived a preliminary 'consensus' PF-CTV. Results: Starting from the model-derived CTV, consensus was reached for a CT image-based PF-CTV. The PF-CTV should extend superiorly from the level of the caudal vas deferens remnant to >8-12 mm inferior to vesicourethral anastomosis (VUA). Below the superior border of the pubic symphysis, the anterior border extends to the posterior aspect of the pubis and posteriorly to the rectum, where it may be concave at the level of the VUA. At this level, the lateral border extends to the levator ani. Above the pubic symphysis, the anterior border should encompass the posterior 1-2 cm of the bladder wall; posteriorly, it is bounded by the mesorectal fascia. At this level, the lateral border is the sacrorectogenitopubic fascia. Seminal vesicle remnants, if present, should be included in the CTV if there is pathologic evidence of their involvement. Conclusions: Consensus on postoperative PF-CTV for RT after prostatectomy was reached and is available as a CT image atlas on the RTOG website. This will allow uniformity in defining PF-CTV for clinical trials that include postprostatectomy RT.

• OSTI ID: 21372047
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 76, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2009.02.006; PII: S0360-3016(09)00224-7; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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