DEVELOPMENT OF RTOG CONSENSUS GUIDELINES FOR THE DEFINITION OF THE CLINICAL TARGET VOLUME FOR POSTOPERATIVE CONFORMAL RADIATION THERAPY FOR PROSTATE CANCER

被引:293
|
作者
Michalski, Jeff M. [1 ]
Lawton, Colleen [2 ]
El Naqa, Issam
Ritter, Mark [3 ]
O'Meara, Elizabeth [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.
Sandler, Howard [12 ]
Buyyounouski, Mark K. [13 ]
Menard, Cynthia [9 ]
机构
[1] Washington Univ, Sch Med, Dept Radiat Oncol, St Louis, MO 63110 USA
[2] Med Coll Wisconsin, Milwaukee, WI 53226 USA
[3] Univ Wisconsin, Ctr Comprehens Canc, Madison, WI USA
[4] Radiat Therapy Oncol Grp, Philadelphia, PA USA
[5] Akron City Hosp, Akron, OH USA
[6] Duke Univ, Med Ctr, Durham, NC USA
[7] Radiol Associates Sacramento, Radiat Oncol Ctr, Sacramento, CA USA
[8] Mayo Clin, Rochester, MN USA
[9] Princess Margaret Hosp, Toronto, ON M4X 1K9, Canada
[10] Bodine Ctr Canc Treatment, Philadelphia, PA USA
[11] Massachusetts Gen Hosp, Boston, MA 02114 USA
[12] Univ Michigan, Ann Arbor, MI 48109 USA
[13] Fox Chase Canc Ctr, Philadelphia, PA 19111 USA
关键词
Prostate cancer; Conformal radiation therapy; Target volumes; Postoperative; RADICAL PROSTATECTOMY; LOCAL RECURRENCE; ADJUVANT RADIOTHERAPY; ALGORITHM; TRIAL; COIL; MEN;
D O I
10.1016/j.ijrobp.2009.02.006
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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 nun interior 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. (C) 2010 Elsevier Inc.
引用
收藏
页码:361 / 368
页数:8
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