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1 PublicationESTRO consensus guideline on target volume delineation for elective radiation therapy of early stage breast cancer.
Offersen, B. V.; Boersma, L. J.; Kirkove, C.; Hol, S.; Aznar, M. C.; Biete Sola, A.; Kirova, Y. M.; Pignol, J. P.; Remouchamps, V.; Verhoeven, K.; Weltens, C.; Arenas, M.; Gabrys, D.; Kopek, N.; Krause, M.; Lundstedt, D.; Marinko, T.; Montero, A.; Yarnold, J.; Poortmans, P.
Abstract
BACKGROUND AND PURPOSE:
Delineation of clinical target volumes (CTVs) is a weak link in radiation therapy (RT), and large inter-observer variation is seen in breast cancer patients. Several guidelines have been proposed, but most result in larger CTVs than based on conventional simulator-based RT. The aim was to develop a delineation guideline obtained by consensus between a broad European group of radiation oncologists.
MATERIAL AND METHODS:
During ESTRO teaching courses on breast cancer, teachers sought consensus on delineation of CTV through dialogue based on cases. One teacher delineated CTV on CT scans of 2 patients, followed by discussion and adaptation of the delineation. The consensus established between teachers was sent to other teams working in the same field, both locally and on a national level, for their input. This was followed by developing a broad consensus based on discussions.
RESULTS:
Borders of the CTV encompassing a 5mm margin around the large veins, running through the regional lymph node levels were agreed, and for the breast/thoracic wall other vessels were pointed out to guide delineation, with comments on margins for patients with advanced breast cancer.
CONCLUSION:
The ESTRO consensus on CTV for elective RT of breast cancer, endorsed by a broad base of the radiation oncology community, is presented to improve consistency.
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Radiotherapy and Oncology 114(2015)1, 3-10
DOI: 10.1016/j.radonc.2014.11.030
Cited 448 times in Scopus
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