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RTOG Sarcoma Radiation Oncologists Reach Consensus on Gross Tumor Volume (GTV) and Clinical Target Volume (CTV) on Computed Tomographic Images for Preoperative Radiotherapy of Primary Soft Tissue Sarcoma of Extremity in RTOG Studies

Identifieur interne : 002A04 ( Pmc/Curation ); précédent : 002A03; suivant : 002A05

RTOG Sarcoma Radiation Oncologists Reach Consensus on Gross Tumor Volume (GTV) and Clinical Target Volume (CTV) on Computed Tomographic Images for Preoperative Radiotherapy of Primary Soft Tissue Sarcoma of Extremity in RTOG Studies

Auteurs : Dian Wang [États-Unis] ; Walter Bosch [États-Unis] ; David Roberge [Canada] ; Steven E. Finkelstein [États-Unis] ; Ivy Petersen [États-Unis] ; Michael Haddock [États-Unis] ; Yen-Lin E. Chen [États-Unis] ; Naoyuki G. Saito [États-Unis] ; David G. Kirsch [États-Unis] ; Ying J. Hitchcock [États-Unis] ; Aaron H. Wolfson ; Thomas F. Delaney [États-Unis]

Source :

RBID : PMC:3205346

Abstract

Objective

To develop an Radiation Therapy Oncology Group (RTOG) atlas delineating gross tumor volume (GTV), and clinical target volume (CTV) to be used for preoperative radiotherapy of primary extremity soft tissue sarcoma (STS).

Methods

A consensus meeting was held during the RTOG meeting in January 2010 to reach agreement about GTV and CTV delineation on CT images for preoperative radiotherapy of high-grade large extremity STS. Data were presented to address the local extension of STS. Extensive discussion ensued to develop optimal criteria for GTV and CTV delineation on CT images.

Results

A consensus was reached on appropriate CT-based GTV and CTV. GTV is gross tumor defined by T1 contrast-enhanced MRI images. Fusion of MRI and CT is recommended to delineate the GTV. CTV for high-grade large STS typically includes GTV plus 3 cm margins in the longitudinal directions. If this causes the field to extend beyond the compartment, the field can be shortened to include the end of a compartment. The radial margin from the lesion should be 1.5 cm including any portion of the tumor not confined by an intact fascial barrier, bone or skin surface.

Conclusion

The consensus on GTV and CTV for preoperative radiotherapy of high-grade large extremity STS is available as web-based images as well as descriptive format through the RTOG. This is expected to improve target volume consistency and allow for rigorous evaluation of the benefits and risks of such treatment.


Url:
DOI: 10.1016/j.ijrobp.2011.04.038
PubMed: 21676552
PubMed Central: 3205346

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Aaron H. Wolfson
<affiliation>
<nlm:aff id="A10">University of Miami Miller School of Medicine, Miami, FL.</nlm:aff>
<wicri:noCountry code="subfield">FL.</wicri:noCountry>
</affiliation>

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<sec id="S1">
<title>Objective</title>
<p id="P1">To develop an Radiation Therapy Oncology Group (RTOG) atlas delineating gross tumor volume (GTV), and clinical target volume (CTV) to be used for preoperative radiotherapy of primary extremity soft tissue sarcoma (STS).</p>
</sec>
<sec sec-type="methods" id="S2">
<title>Methods</title>
<p id="P2">A consensus meeting was held during the RTOG meeting in January 2010 to reach agreement about GTV and CTV delineation on CT images for preoperative radiotherapy of high-grade large extremity STS. Data were presented to address the local extension of STS. Extensive discussion ensued to develop optimal criteria for GTV and CTV delineation on CT images.</p>
</sec>
<sec id="S3">
<title>Results</title>
<p id="P3">A consensus was reached on appropriate CT-based GTV and CTV. GTV is gross tumor defined by T1 contrast-enhanced MRI images. Fusion of MRI and CT is recommended to delineate the GTV. CTV for high-grade large STS typically includes GTV plus 3 cm margins in the longitudinal directions. If this causes the field to extend beyond the compartment, the field can be shortened to include the end of a compartment. The radial margin from the lesion should be 1.5 cm including any portion of the tumor not confined by an intact fascial barrier, bone or skin surface.</p>
</sec>
<sec id="S4">
<title>Conclusion</title>
<p id="P4">The consensus on GTV and CTV for preoperative radiotherapy of high-grade large extremity STS is available as web-based images as well as descriptive format through the RTOG. This is expected to improve target volume consistency and allow for rigorous evaluation of the benefits and risks of such treatment.</p>
</sec>
</div>
</front>
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<contrib contrib-type="author">
<name>
<surname>Wang</surname>
<given-names>Dian</given-names>
</name>
<xref ref-type="aff" rid="A1">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bosch</surname>
<given-names>Walter</given-names>
</name>
<xref ref-type="aff" rid="A2"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Roberge</surname>
<given-names>David</given-names>
</name>
<xref ref-type="aff" rid="A3">§</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Finkelstein</surname>
<given-names>Steven E.</given-names>
</name>
<xref ref-type="aff" rid="A5"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Petersen</surname>
<given-names>Ivy</given-names>
</name>
<xref ref-type="aff" rid="A4">§§</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Haddock</surname>
<given-names>Michael</given-names>
</name>
<xref ref-type="aff" rid="A4">§§</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Chen</surname>
<given-names>Yen-Lin E.</given-names>
</name>
<xref ref-type="aff" rid="A6">**</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Saito</surname>
<given-names>Naoyuki G.</given-names>
</name>
<xref ref-type="aff" rid="A7">††</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kirsch</surname>
<given-names>David G.</given-names>
</name>
<xref ref-type="aff" rid="A8"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Hitchcock</surname>
<given-names>Ying J.</given-names>
</name>
<xref ref-type="aff" rid="A9">‡‡</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wolfson</surname>
<given-names>Aaron H.</given-names>
</name>
<xref ref-type="aff" rid="A10">¶¶</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>DeLaney</surname>
<given-names>Thomas F.</given-names>
</name>
<xref ref-type="aff" rid="A6">**</xref>
</contrib>
</contrib-group>
<aff id="A1">
<label>*</label>
Medical College of Wisconsin, Milwaukee, WI</aff>
<aff id="A2">
<label></label>
Washington University , St Louis, MO</aff>
<aff id="A3">
<label>§</label>
McGill University, Montreal, QC, Canada</aff>
<aff id="A4">
<label>§§</label>
Mayo Clinic, Rochester, MN</aff>
<aff id="A5">
<label></label>
Moffitt Cancer Center, Tampa, FL</aff>
<aff id="A6">
<label>**</label>
Massachusetts General Hospital, Boston, MA</aff>
<aff id="A7">
<label>††</label>
Roswell Park Cancer Institute, Buffalo, NY</aff>
<aff id="A8">
<label></label>
Duke University, Durham, NC</aff>
<aff id="A9">
<label>‡‡</label>
University of Utah, Salt Lake City, UT</aff>
<aff id="A10">
<label>¶¶</label>
University of Miami Miller School of Medicine, Miami, FL.</aff>
<author-notes>
<corresp id="CR1">Reprint requests to: Dian Wang, MD., Ph.D., Department of Radiation Oncology, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53045; Tel: (414) 805-4496; Fax: (414) 805-4369;
<email>dwang@mcw.edu</email>
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</author-notes>
<pub-date pub-type="nihms-submitted">
<day>9</day>
<month>8</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="epub">
<day>15</day>
<month>6</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="ppub">
<day>15</day>
<month>11</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>15</day>
<month>11</month>
<year>2012</year>
</pub-date>
<volume>81</volume>
<issue>4</issue>
<fpage>e525</fpage>
<lpage>e528</lpage>
<permissions>
<copyright-statement>© 2011 Elsevier Inc. All rights reserved.</copyright-statement>
<copyright-year>2011</copyright-year>
</permissions>
<abstract>
<sec id="S1">
<title>Objective</title>
<p id="P1">To develop an Radiation Therapy Oncology Group (RTOG) atlas delineating gross tumor volume (GTV), and clinical target volume (CTV) to be used for preoperative radiotherapy of primary extremity soft tissue sarcoma (STS).</p>
</sec>
<sec sec-type="methods" id="S2">
<title>Methods</title>
<p id="P2">A consensus meeting was held during the RTOG meeting in January 2010 to reach agreement about GTV and CTV delineation on CT images for preoperative radiotherapy of high-grade large extremity STS. Data were presented to address the local extension of STS. Extensive discussion ensued to develop optimal criteria for GTV and CTV delineation on CT images.</p>
</sec>
<sec id="S3">
<title>Results</title>
<p id="P3">A consensus was reached on appropriate CT-based GTV and CTV. GTV is gross tumor defined by T1 contrast-enhanced MRI images. Fusion of MRI and CT is recommended to delineate the GTV. CTV for high-grade large STS typically includes GTV plus 3 cm margins in the longitudinal directions. If this causes the field to extend beyond the compartment, the field can be shortened to include the end of a compartment. The radial margin from the lesion should be 1.5 cm including any portion of the tumor not confined by an intact fascial barrier, bone or skin surface.</p>
</sec>
<sec id="S4">
<title>Conclusion</title>
<p id="P4">The consensus on GTV and CTV for preoperative radiotherapy of high-grade large extremity STS is available as web-based images as well as descriptive format through the RTOG. This is expected to improve target volume consistency and allow for rigorous evaluation of the benefits and risks of such treatment.</p>
</sec>
</abstract>
<kwd-group>
<kwd>Sarcoma</kwd>
<kwd>target definition</kwd>
<kwd>radiotherapy</kwd>
</kwd-group>
<funding-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-34 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-33 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-32S4 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-32S3 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-32S2 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-32S1 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-32 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-31S1 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-31 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-30 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-29 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-28S1 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-28 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-27S2 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-27S1 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-27 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-26 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-25 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-24S1 || CA</award-id>
</award-group>
<award-group>
<funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>U10 CA021661-24 || CA</award-id>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
</record>

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