International guideline for the delineation of the clinical target volumes (CTV) for nasopharyngeal carcinoma

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Tarih
2018-01-01
Yazarlar
Lee, Anne W.
Ng, Wai Tong
Pan, Jian Ji
Poh, Sharon S.
Ahn, Yong Chan
AlHussain, Hussain
Corry, June
Grau, Cai
Gregoire, Vincent
Harrington, Kevin J.
Süreli Yayın başlığı
Süreli Yayın ISSN
Cilt Başlığı
Yayınevi
ELSEVIER IRELAND LTD
Dergi Adı
RADIOTHERAPY AND ONCOLOGY
Özet
Purpose: Target delineation in nasopharyngeal carcinoma (NPC) often proves challenging because of the notoriously narrow therapeutic margin. High doses are needed to achieve optimal levels of tumour control, and dosimetric inadequacy remains one of the most important independent factors affecting treatment outcome. Method: A review of the available literature addressing the natural behaviour of NPC and correlation between clinical and pathological aspects of the disease was conducted. Existing international guidelines as well as published protocols specified by clinical trials on contouring of clinical target volumes (CTV) were compared. This information was then summarized into a preliminary draft guideline which was then circulated to international experts in the field for exchange of opinions and subsequent voting on areas with the greatest controversies. Results: Common areas of uncertainty and variation in practices among experts experienced in radiation therapy for NPC were elucidated. Iterative revisions were made based on extensive discussion and final voting on controversial areas by the expert panel, to formulate the recommendations on contouring of CTV based on optimal geometric expansion and anatomical editing for those structures with substantial risk of microscopic infiltration. Conclusion: Through this comprehensive review of available evidence and best practices at major institutions, as well as interactive exchange of vast experience by international experts, this set of consensus guidelines has been developed to provide a practical reference for appropriate contouring to ensure optimal target coverage. However, the final decision on the treatment volumes should be based on full consideration of individual patients' factors and facilities of an individual centre (including the quality of imaging methods and the precision of treatment delivery). (C) 2017 Elsevier B.V. All rights reserved.
Açıklama
Anahtar kelimeler
Nasopharyngeal carcinoma, Clinical target volume (CTV), Gross target volume (GTV), Guideline, Delineation
Alıntı
Koleksiyonlar