Australasian Gastrointestinal Trials Group (AGITG) Contouring Atlas and Planning Guidelines for Intensity-Modulated Radiotherapy in Anal Cancer

被引：155
作者：
Ng, Michael [1 ]
Leong, Trevor [2 ,6 ]
Chander, Sarat [2 ]
Chu, Julie [2 ]
Kneebone, Andrew [3 ,7 ]
Carroll, Susan [4 ,7 ]
Wiltshire, Kirsty [2 ]
Ngan, Samuel [2 ,6 ]
Kachnic, Lisa [5 ,6 ]
机构：
[1] Radiat Oncol Victoria, Epping, Vic 3076, Australia
[2] Peter MacCallum Canc Ctr, Dept Radiat Oncol, Melbourne, Vic, Australia
[3] Royal N Shore Hosp, No Sydney Canc Ctr, Dept Radiat Oncol, Sydney, NSW, Australia
[4] Royal Prince Alfred Hosp, Sydney Canc Ctr, Dept Radiat Oncol, Camperdown, NSW, Australia
[5] Boston Univ, Sch Med, Boston Med Ctr, Dept Radiat Oncol, Boston, MA 02118 USA
[6] Univ Melbourne, Melbourne, Vic 3010, Australia
[7] Univ Sydney, Sydney, NSW 2006, Australia
来源：
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2012年 / 83卷 / 05期
关键词：
Anal cancer; IMRT; Chemoradiation; Atlas; Guidelines; CLINICAL TARGET VOLUME; RECTAL-CANCER; DELINEATION; CARCINOMA; MITOMYCIN; NODES; IMRT;
D O I：
10.1016/j.ijrobp.2011.12.058
中图分类号：
R73 [肿瘤学];
学科分类号：
100214 ;
摘要：
Purpose: To develop a high-resolution target volume atlas with intensity-modulated radiotherapy (IMRT) planning guidelines for the conformal treatment of anal cancer. Methods and Materials: A draft contouring atlas and planning guidelines for anal cancer IMRT were prepared at the Australasian Gastrointestinal Trials Group (AGITG) annual meeting in September 2010. An expert panel of radiation oncologists contoured an anal cancer case to generate discussion on recommendations regarding target definition for gross disease, elective nodal volumes, and organs at risk (OARs). Clinical target volume (CTV) and planning target volume (PTV) margins, dose fractionation, and other IMRT-specific issues were also addressed. A steering committee produced the final consensus guidelines. Results: Detailed contouring and planning guidelines and a high-resolution atlas are provided. Gross tumor and elective target volumes are described and pictorially depicted. All elective regions should be routinely contoured for all disease stages, with the possible exception of the inguinal and high pelvic nodes for select, early-stage T1N0. A 20-mm CTV margin for the primary, 10- to 20-mm CTV margin for involved nodes and a 7-mm CTV margin for the elective pelvic nodal groups are recommended, while respecting anatomical boundaries. A 5- to 10-mm PTV margin is suggested. When using a simultaneous integrated boost technique, a dose of 54 Gy in 30 fractions to gross disease and 45 Gy to elective nodes with chemotherapy is appropriate. Guidelines are provided for OAR delineation. Conclusion: These consensus planning guidelines and high-resolution atlas complement the existing Radiation Therapy Oncology Group (RTOG) elective nodal ano-rectal atlas and provide additional anatomic, clinical, and technical instructions to guide radiation oncologists in the planning and delivery of IMRT for anal cancer. (C) 2012 Elsevier Inc.
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收藏
页码：1455 / 1462
页数：8
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