TY - JOUR
T1 - ESTRO consensus guideline on target volume delineation for elective radiation therapy of early stage breast cancer
AU - Offersen, BV
AU - Boersma, LJ
AU - Kirkove, C
AU - Hol, S
AU - Aznar, MC
AU - Sola, AB
AU - Kirova, YM
AU - Pignol, Jean-Philippe
AU - Remouchamps, V
AU - Verhoeven, K
AU - Weltens, C
AU - Arenas, M
AU - Gabrys, D
AU - Kopek, N
AU - Krause, M
AU - Lundstedt, D
AU - Marinko, T
AU - Montero, A
AU - Yarnold, J
AU - Poortmans, P
PY - 2015
Y1 - 2015
N2 - 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 5 mm 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. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
AB - 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 5 mm 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. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
U2 - 10.1016/j.radonc.2014.11.030
DO - 10.1016/j.radonc.2014.11.030
M3 - Article
C2 - 25630428
SN - 0167-8140
VL - 114
SP - 3
EP - 10
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 1
ER -
