Pelvic Normal Tissue Contouring Guidelines for Radiation Therapy: A Radiation Therapy Oncology Group Consensus Panel Atlas

Journal Article · Sun Jul 01 04:00:00 EDT 2012 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2012.01.023· OSTI ID:22058908

Barthold, H Joseph ^[1]; O'Meara, Elizabeth ^[2]; Bosch, Walter R ^[3]; El Naqa, Issam ^[4]; Al-Lozi, Rawan ^[3]; Rosenthal, Seth A ^[5]; Lawton, Colleen ^[6]; Lee, W Robert ^[7]; Sandler, Howard ^[8]; Zietman, Anthony ^[9]; Myerson, Robert ^[3]; Dawson, Laura A ^[10]; Willett, Christopher ^[7]; Kachnic, Lisa A ^[11]; Jhingran, Anuja ^[12]; Portelance, Lorraine ^[13]; Ryu, Janice ^[5]; others, and

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1. Commonwealth Hematology and Oncology, Weymouth, MA (United States)
2. Radiation Therapy Oncology Group, Philadelphia, PA (United States)
3. Washington University School of Medicine, St Louis, MO (United States)
4. Department of Radiation Oncology, McGill University Health Center, Montreal, Quebec (Canada)
5. Radiation Oncology Centers, Radiological Associates of Sacramento, Sacramento, CA (United States)
6. Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States)
7. Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States)
8. Cedars-Sinai Medical Center, Los Angeles, CA (United States)
9. Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)
10. Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada)
11. Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA (United States)
12. Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States)
13. University of Miami, Miami, FL (United States)

Purpose: To define a male and female pelvic normal tissue contouring atlas for Radiation Therapy Oncology Group (RTOG) trials. Methods and Materials: One male pelvis computed tomography (CT) data set and one female pelvis CT data set were shared via the Image-Guided Therapy QA Center. A total of 16 radiation oncologists participated. The following organs at risk were contoured in both CT sets: anus, anorectum, rectum (gastrointestinal and genitourinary definitions), bowel NOS (not otherwise specified), small bowel, large bowel, and proximal femurs. The following were contoured in the male set only: bladder, prostate, seminal vesicles, and penile bulb. The following were contoured in the female set only: uterus, cervix, and ovaries. A computer program used the binomial distribution to generate 95% group consensus contours. These contours and definitions were then reviewed by the group and modified. Results: The panel achieved consensus definitions for pelvic normal tissue contouring in RTOG trials with these standardized names: Rectum, AnoRectum, SmallBowel, Colon, BowelBag, Bladder, UteroCervix, Adnexa{sub R}, Adnexa{sub L}, Prostate, SeminalVesc, PenileBulb, Femur{sub R}, and Femur{sub L}. Two additional normal structures whose purpose is to serve as targets in anal and rectal cancer were defined: AnoRectumSig and Mesorectum. Detailed target volume contouring guidelines and images are discussed. Conclusions: Consensus guidelines for pelvic normal tissue contouring were reached and are available as a CT image atlas on the RTOG Web site. This will allow uniformity in defining normal tissues for clinical trials delivering pelvic radiation and will facilitate future normal tissue complication research.

• OSTI ID: 22058908
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 83; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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