NRG Oncology International Consensus Contouring Atlas on Target Volumes and Dosing Strategies for Dose-Escalated Pancreatic Cancer Radiation Therapy

被引：1

作者：

Sanford, Nina N. ^{[1
]}

Narang, Amol K. ^{[2
]}

Aguilera, Todd A. ^{[1
]}

Bassetti, Michael F. ^{[3
]}

Chuong, Michael D. ^{[4
]}

Erickson, Beth A. ^{[5
]}

Goodman, Karyn A. ^{[6
]}

Herman, Joseph M. ^{[7
,8
]}

Intven, Martijn ^{[9
]}

Kilcoyne, Aoife ^{[10
]}

Kim, Hyun ^{[11
]}

Paulson, Eric ^{[5
]}

Reyngold, Marsha ^{[12
]}

Tsai, Susan ^{[13
]}

Tchelebi, Leila T. ^{[7
]}

Tuli, Richard ^{[14
]}

Versteijne, Eva ^{[15
]}

Wei, Alice C. ^{[16
]}

Wo, Jennifer Y. ^{[17
]}

Zhang, Ying ^{[1
]}

Hong, Theodore S. ^{[17
]}

Hall, William A. ^{[5
]}

机构：

[1] Univ Texas Southwestern Med Ctr, Dept Radiat Oncol, Dallas, TX 75390 USA

[2] Johns Hopkins Univ, Sch Med, Dept Radiat Oncol, Baltimore, MD USA

[3] Univ Wisconsin Hosp & Clin, Dept Human Oncol, Madison, WI USA

[4] Miami Canc Inst, Dept Radiat Oncol, Miami, FL USA

[5] Med Coll Wisconsin, Dept Radiat Oncol, Milwaukee, WI USA

[6] Icahn Sch Med Mt Sinai, Dept Radiat Oncol, New York, NY USA

[7] Zucker Sch Med Hofstra Northwell, Northwell Hlth Canc Inst, Dept Radiat Med, New Hyde Pk, NY USA

[8] Histosonics, Plymouth, MN USA

[9] Univ Med Ctr Utrecht, Dept Radiat Oncol, Utrecht, Netherlands

[10] Massachusetts Gen Hosp, Dept Radiol, Boston, MA USA

[11] Washington Univ, Sch Med, Dept Radiat Oncol, St Louis, MO USA

[12] Mem Sloan Kettering Canc Ctr, Dept Radiat Oncol, New York, NY USA

[13] Ohio State Univ, Dept Surg Oncol, Columbus, OH USA

[14] Univ S Florida, Morsani Coll Med, Dept Radiat Oncol, Tampa, FL USA

[15] Univ Amsterdam, Med Ctr, Dept Radiat Oncol, Amsterdam, Netherlands

[16] Mem Sloan Kettering Canc Ctr, Dept Surg Oncol, New York, NY USA

[17] Massachusetts Gen Hosp, Dept Radiat Oncol, Boston, MA USA

来源：

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2025年 / 121卷 / 04期

关键词：

EXTRAPANCREATIC NERVE PLEXUS; DUCTAL ADENOCARCINOMA; PERINEURAL INVASION; PATTERNS; RADIOTHERAPY; RECURRENCE; CARCINOMA; CHEMORADIATION; GEMCITABINE; DELINEATION;

D O I：

10.1016/j.ijrobp.2024.10.026

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: Dose-escalated radiation therapy is increasingly used in the treatment of pancreatic cancer; however, approaches to target delineation vary widely. We present the first North American cooperative group consensus contouring atlas for dose-escalated pancreatic cancer radiation therapy. Methods and Materials: An expert international panel comprising 15 radiation oncologists, 2 surgeons, and 1 radiologist was recruited. Participants used MimCloud software to contour high- and low-risk clinical target volumes (CTVs) on 3 pancreatic cancer cases: a borderline resectable head tumor, a locally advanced head tumor, and a medically inoperable tail tumor. Simultaneous Truth and Performance Level Estimation volumes were created, and contours were analyzed using Dice similarity coefficients. Results: The contoured gross tumor volume for the borderline head, locally advanced head, and unresectable tail tumor cases were 156.7, 58.2, and 9.0 cc, respectively, and the Dice similarity coefficients (SD) for the high- and low-risk CTV ranged from 0.45 to 0.82. Consensus volumes were agreed upon by authors. High-risk CTVs comprised the tumor plus abutting vessels. Low-risk CTVs started superiorly at (tail and distal body tumors) or 1 cm above (head, neck and proximal body tumors) the celiac takeoff and extended inferiorly to the superior mesenteric artery at the level of the first jejunal takeoff. For head, neck, and proximal body tumors, the lateral volume encompassed the entire pancreas head and 5 to 10 mm around the celiac, superior mesenteric artery, superior mesenteric vein, including the common hepatic artery and medial portal vein, consistent with a “Triangle” volume-based approach. For distal body and tail tumors, the entire tail was included, along with the splenic vessels and the takeoffs of celiac artery. Conclusions: Through multidisciplinary collaboration, we created consensus contouring guidelines for dose-escalated pancreatic cancer radiation therapy. These volumes include not only gross disease, but also routine elective coverage, and can be used to standardize practice for future trials seeking to define the role of dose-escalated radiation therapy in pancreatic cancer. © 2024 Elsevier Inc.

引用

页码：918 / 929

页数：12

共 46 条

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