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Title: Retroperitoneal Sarcoma Target Volume and Organ at Risk Contour Delineation Agreement Among NRG Sarcoma Radiation Oncologists

Purpose: The purpose of this study was to evaluate the variability in target volume and organ at risk (OAR) contour delineation for retroperitoneal sarcoma (RPS) among 12 sarcoma radiation oncologists. Methods and Materials: Radiation planning computed tomography (CT) scans for 2 cases of RPS were distributed among 12 sarcoma radiation oncologists with instructions for contouring gross tumor volume (GTV), clinical target volume (CTV), high-risk CTV (HR CTV: area judged to be at high risk of resulting in positive margins after resection), and OARs: bowel bag, small bowel, colon, stomach, and duodenum. Analysis of contour agreement was performed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics. Results: Ten radiation oncologists contoured both RPS cases, 1 contoured only RPS1, and 1 contoured only RPS2 such that each case was contoured by 11 radiation oncologists. The first case (RPS 1) was a patient with a de-differentiated (DD) liposarcoma (LPS) with a predominant well-differentiated (WD) component, and the second case (RPS 2) was a patient with DD LPS made up almost entirely of a DD component. Contouring agreement for GTV and CTV contours was high. However, the agreement for HR CTVs was only moderate. For OARs, agreement for stomach,more » bowel bag, small bowel, and colon was high, but agreement for duodenum (distorted by tumor in one of these cases) was fair to moderate. Conclusions: For preoperative treatment of RPS, sarcoma radiation oncologists contoured GTV, CTV, and most OARs with a high level of agreement. HR CTV contours were more variable. Further clarification of this volume with the help of sarcoma surgical oncologists is necessary to reach consensus. More attention to delineation of the duodenum is also needed.« less
Authors:
 [1] ;  [2] ;  [3] ;  [4] ;  [5] ;  [6] ;  [7] ;  [3] ;  [8] ;  [9] ;  [10] ;  [9] ;  [2]
  1. Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, Massachusetts (United States)
  2. Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States)
  3. Department of Radiation Oncology, Washington University, St. Louis, Missouri (United States)
  4. Department of Radiation Oncology, Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec (Canada)
  5. Department of Radiotherapy, Netherlands Cancer Institute, Amsterdam (Netherlands)
  6. Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada)
  7. Department of Radiation Oncology, University of Florida Medical Center, Jacksonville, Florida (United States)
  8. Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)
  9. Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)
  10. Translational Research Consortium, 21st Century Oncology, Scottsdale, Arizona (United States)
Publication Date:
OSTI Identifier:
22462401
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 92; Journal Issue: 5; Other Information: Copyright (c) 2015 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; CAT SCANNING; HAZARDS; LARGE INTESTINE; MEDICAL PERSONNEL; PATIENTS; PLANNING; SARCOMAS; SMALL INTESTINE; STATISTICS; STOMACH; SURGERY