skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Consensus Recommendations for Radiation Therapy Contouring and Treatment of Vulvar Carcinoma

Abstract

Purpose: The purpose of this study was to develop a radiation therapy (RT) contouring atlas and recommendations for women with postoperative and locally advanced vulvar carcinoma. Methods and Materials: An international committee of 35 expert gynecologic radiation oncologists completed a survey of the treatment of vulvar carcinoma. An initial set of recommendations for contouring was discussed and generated by consensus. Two cases, 1 locally advanced and 1 postoperative, were contoured by 14 physicians. Contours were compared and analyzed using an expectation-maximization algorithm for simultaneous truth and performance level estimation (STAPLE), and a 95% confidence interval contour was developed. The level of agreement among contours was assessed using a kappa statistic. STAPLE contours underwent full committee editing to generate the final atlas consensus contours. Results: Analysis of the 14 contours showed substantial agreement, with kappa statistics of 0.69 and 0.64 for cases 1 and 2, respectively. There was high specificity for both cases (≥99%) and only moderate sensitivity of 71.3% and 64.9% for cases 1 and 2, respectively. Expert review and discussion generated consensus recommendations for contouring target volumes and treatment for postoperative and locally advanced vulvar cancer. Conclusions: These consensus recommendations for contouring and treatment of vulvar cancer identified areasmore » of complexity and controversy. Given the lack of clinical research evidence in vulvar cancer radiation therapy, the committee advocates a conservative and consistent approach using standardized recommendations.« less

Authors:
 [1];  [2];  [3];  [4];  [5];  [6];  [7];  [8];  [9];  [10]; ;  [6];  [11];  [12];  [13];  [14];
  1. Department of Radiation Oncology, Huntsman Cancer Hospital, Salt Lake City, Utah (United States)
  2. Department of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre and Epworth Radiation Oncology, Melbourne, Victoria (Australia)
  3. Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, Massachusetts (United States)
  4. Department of Radiation Oncology, Centre hospitalier de l'universite de Montreal, Montreal, Quebec (Canada)
  5. Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States)
  6. Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States)
  7. Department of Radiation Oncology, Proedtert and Medical College Clinical Cancer Center, Milwaukee, Wisconsin (United States)
  8. Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada)
  9. Department of Radiation Oncology, British Columbia Cancer Agency, Victoria, British Columbia (Canada)
  10. Department of Radiation Oncology, Stritch School of Medicine, Loyola University, Maywood, Illinois (United States)
  11. Department of Radiation Oncology, University of Washington, Seattle, Washington (United States)
  12. Liverpool Cancer Therapy Centre, Radiation Oncology Unit, Sydney, New South Wales (Australia)
  13. Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States)
  14. Radiation Oncology Department, Miller School of Medicine, University of Miami, Miami, Florida (United States)
Publication Date:
OSTI Identifier:
22648735
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 95; Journal Issue: 4; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; RADIOTHERAPY; RECOMMENDATIONS; SURGERY; UTERUS

Citation Formats

Gaffney, David K., E-mail: david.gaffney@hci.utah.edu, King, Bronwyn, Viswanathan, Akila N., Barkati, Maroie, Beriwal, Sushil, Eifel, Patricia, Erickson, Beth, Fyles, Anthony, Goulart, Jennifer, Harkenrider, Matthew, Jhingran, Anuja, Klopp, Ann, Koh, Wui-Jin, Lim, Karen, Petersen, Ivy, Portelance, Lorraine, and and others. Consensus Recommendations for Radiation Therapy Contouring and Treatment of Vulvar Carcinoma. United States: N. p., 2016. Web. doi:10.1016/J.IJROBP.2016.02.043.
Gaffney, David K., E-mail: david.gaffney@hci.utah.edu, King, Bronwyn, Viswanathan, Akila N., Barkati, Maroie, Beriwal, Sushil, Eifel, Patricia, Erickson, Beth, Fyles, Anthony, Goulart, Jennifer, Harkenrider, Matthew, Jhingran, Anuja, Klopp, Ann, Koh, Wui-Jin, Lim, Karen, Petersen, Ivy, Portelance, Lorraine, & and others. Consensus Recommendations for Radiation Therapy Contouring and Treatment of Vulvar Carcinoma. United States. doi:10.1016/J.IJROBP.2016.02.043.
Gaffney, David K., E-mail: david.gaffney@hci.utah.edu, King, Bronwyn, Viswanathan, Akila N., Barkati, Maroie, Beriwal, Sushil, Eifel, Patricia, Erickson, Beth, Fyles, Anthony, Goulart, Jennifer, Harkenrider, Matthew, Jhingran, Anuja, Klopp, Ann, Koh, Wui-Jin, Lim, Karen, Petersen, Ivy, Portelance, Lorraine, and and others. Fri . "Consensus Recommendations for Radiation Therapy Contouring and Treatment of Vulvar Carcinoma". United States. doi:10.1016/J.IJROBP.2016.02.043.
@article{osti_22648735,
title = {Consensus Recommendations for Radiation Therapy Contouring and Treatment of Vulvar Carcinoma},
author = {Gaffney, David K., E-mail: david.gaffney@hci.utah.edu and King, Bronwyn and Viswanathan, Akila N. and Barkati, Maroie and Beriwal, Sushil and Eifel, Patricia and Erickson, Beth and Fyles, Anthony and Goulart, Jennifer and Harkenrider, Matthew and Jhingran, Anuja and Klopp, Ann and Koh, Wui-Jin and Lim, Karen and Petersen, Ivy and Portelance, Lorraine and and others},
abstractNote = {Purpose: The purpose of this study was to develop a radiation therapy (RT) contouring atlas and recommendations for women with postoperative and locally advanced vulvar carcinoma. Methods and Materials: An international committee of 35 expert gynecologic radiation oncologists completed a survey of the treatment of vulvar carcinoma. An initial set of recommendations for contouring was discussed and generated by consensus. Two cases, 1 locally advanced and 1 postoperative, were contoured by 14 physicians. Contours were compared and analyzed using an expectation-maximization algorithm for simultaneous truth and performance level estimation (STAPLE), and a 95% confidence interval contour was developed. The level of agreement among contours was assessed using a kappa statistic. STAPLE contours underwent full committee editing to generate the final atlas consensus contours. Results: Analysis of the 14 contours showed substantial agreement, with kappa statistics of 0.69 and 0.64 for cases 1 and 2, respectively. There was high specificity for both cases (≥99%) and only moderate sensitivity of 71.3% and 64.9% for cases 1 and 2, respectively. Expert review and discussion generated consensus recommendations for contouring target volumes and treatment for postoperative and locally advanced vulvar cancer. Conclusions: These consensus recommendations for contouring and treatment of vulvar cancer identified areas of complexity and controversy. Given the lack of clinical research evidence in vulvar cancer radiation therapy, the committee advocates a conservative and consistent approach using standardized recommendations.},
doi = {10.1016/J.IJROBP.2016.02.043},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 4,
volume = 95,
place = {United States},
year = {Fri Jul 15 00:00:00 EDT 2016},
month = {Fri Jul 15 00:00:00 EDT 2016}
}