GEC-ESTRO (ACROP) - ABS - CBG Consensus Brachytherapy Target Definition Guidelines for Recurrent Endometrial and Cervical Tumors in the Vagina. Journal Article

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Authors: Kamrava, M; Leung, E; Bachand, F; Beriwal, S; Chargari, C; D'Souza, D; Erickson, B; Fokdal, L; Han, K; Harkenrider, M; Lin, L; Mahantshetty, U; Nesvacil, N; Ravi, A; Schmid, M; Vigneault, E; Westerveld, H; Yashar, C; Nout, R
Article Title: GEC-ESTRO (ACROP) - ABS - CBG Consensus Brachytherapy Target Definition Guidelines for Recurrent Endometrial and Cervical Tumors in the Vagina.
Abstract: BACKGROUND AND PURPOSE: Representatives from Gynecologic Groupe European de Curietherapie - European Society for Radiotherapy and Oncology (GYN GEC-ESTRO), American Brachytherapy Society (ABS), and Canadian Brachytherapy Group (CBG) met to develop international consensus recommendations for target definitions for image guided adaptive brachytherapy for vaginal recurrences of endometrial or cervical cancer. MATERIAL AND METHODS: 17 radiation oncologists and 2 medical physicists participated. Prior to an in-person meeting each participant anonymously contoured 3 recurrent endometrial/cervical cancer cases. Participants contoured the residual gross primary tumor volume (GTV-Tumor(T)), a high-risk clinical target volume (CTV-T ), and an intermediate-risk clinical target volume (CTV-T ), on T2-weighted MRI images. All contours were drawn using Falcon EduCase. Contours were reviewed at an in-person meeting during which a consensus document was created defining agreed upon target definitions (Trial 1). After establishing these definitions, the group was sent one of the cases again (recurrent cervical cancer vaginal recurrence) and asked to contour the targets again (Trial 2). The Computerized Environment for Radiation Research (CERR) software (The Mathworks, Natwick, MA) was used to analyze the contours. Kappa statistics were generated to assess evel of agreement between contours. A conformity index (CI) defined as, the ratio between the intersection and union volume of a given pair of contours was calculated. A Simultaneous Truth and Performance Level Estimation (STAPLE) contour was created for the CTV-T and CTV-T for the post-meeting case. RESULTS: Consensus definitions for GTV-T, CTV-T , and CTV-T were established. Kappa statistics (Trial 1/Trial 2) for GTV-T, CTV-T, and CTV-T were: 0.536/0.583, 0.575/0.743 and 0.522/0.707. Kappa statistics for Trial 2 for the CTV-T and CTV-T showed 'substantial' agreement while the GTV-T remained at moderate agreement. CONCLUSIONS: This consensus provides recommendations, to facilitate future collaborations, for MRI guided adaptive brachytherapy target definitions in endometrial/cervical vaginal recurrences.
Journal Title: International journal of radiation oncology, biology, physics
ISSN: 1879-355X; 0360-3016
Publisher: Elsevier Inc  
Date Published: 2022