PMID- 21929770
OWN - NLM
STAT- MEDLINE
DCOM- 20120123
LR  - 20211020
IS  - 1748-717X (Electronic)
IS  - 1748-717X (Linking)
VI  - 6
DP  - 2011 Sep 19
TI  - Delineation in thoracic oncology: a prospective study of the effect of training 
      on contour variability and dosimetric consequences.
PG  - 118
LID - 10.1186/1748-717X-6-118 [doi]
AB  - INTRODUCTION: As part of French residents' radiotherapy training, delineation 
      workstations were available at a national teaching course. We report a 
      prospective comparative study of a non small cell lung cancer (NSCLC) case 
      delineated by 120 residents before and after a radioanatomy/radiotherapy lecture. 
      MATERIALS AND METHODS: The case of a patient with right upper lobe non small cell 
      lung cancer (NSCLC) was provided for delineation to 32 groups of residents before 
      and after a radiation therapy lecture about thoracic delineation. GTV, CTV and 
      PTV was asked to each group. In a second step, the GTV, CTV and PTV were compared 
      with those of 9 groups of senior physicians. Finally the consequences for 
      treatment planning between each group before and after the course were explored. 
      RESULTS: The expert's average GTV, CTV and PTV were 89.1 cm3, 242.3 cm3 and 293.9 
      cm3 respectively. For residents, those volumes were 103.4 cm3, 242.3 cm3 and 
      457.9 cm3 before teaching, compared to 99.5 cm3, 224.2 cm3 and 412.5 cm3 after 
      teaching. The overlap (OV) and kappa (KI) indices before and after education were 
      respectively 0.58 and 0.73. Compared to senior physicians, OV and KI indices were 
      lower in the residents group (p = 0.039 and p = 0.043). An increased dose to the 
      lung is noted for the residents' dosimetry compared to the experts' (V20: 23.2% 
      versus 36.5%) due to the larger PTV delineated. No significant difference was 
      observed for other organs at risk. CONCLUSION: There were no significant 
      differences for the delineation of the GTV and CTV before and after the course, 
      although the differences tended to decrease after the course. The good initial 
      quality of the contours could explain the lack of difference. V20 for lung was 
      higher in the residents group compared to the experts group (23.2% vs 36.5%). No 
      other treatment planning consequences were observed for other critical organs.
FAU - Dewas, Sylvain
AU  - Dewas S
AD  - Departement universitaire de Radiotherapie, Centre Oscar Lambret, Universite 
      Lille II, Lille, France. s-dewas@o-lambret.fr
FAU - Bibault, Jean-Emmanuel
AU  - Bibault JE
FAU - Blanchard, Pierre
AU  - Blanchard P
FAU - Vautravers-Dewas, Claire
AU  - Vautravers-Dewas C
FAU - Pointreau, Yoann
AU  - Pointreau Y
FAU - Denis, Fabrice
AU  - Denis F
FAU - Brauner, Michel
AU  - Brauner M
FAU - Giraud, Philippe
AU  - Giraud P
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20110919
PL  - England
TA  - Radiat Oncol
JT  - Radiation oncology (London, England)
JID - 101265111
SB  - IM
MH  - Aged
MH  - Algorithms
MH  - Carcinoma/*radiotherapy
MH  - Carcinoma, Non-Small-Cell Lung/*radiotherapy
MH  - Education, Medical, Graduate
MH  - France
MH  - Humans
MH  - Lung Neoplasms/*radiotherapy
MH  - Male
MH  - Medical Oncology/*methods
MH  - Observer Variation
MH  - Prospective Studies
MH  - Radiography, Thoracic/*methods
MH  - Radiology/*education/*methods
MH  - Radiometry/methods
MH  - Radiotherapy Planning, Computer-Assisted/*methods
PMC - PMC3195101
EDAT- 2011/09/21 06:00
MHDA- 2012/01/24 06:00
PMCR- 2011/09/19
CRDT- 2011/09/21 06:00
PHST- 2011/05/11 00:00 [received]
PHST- 2011/09/19 00:00 [accepted]
PHST- 2011/09/21 06:00 [entrez]
PHST- 2011/09/21 06:00 [pubmed]
PHST- 2012/01/24 06:00 [medline]
PHST- 2011/09/19 00:00 [pmc-release]
AID - 1748-717X-6-118 [pii]
AID - 10.1186/1748-717X-6-118 [doi]
PST - epublish
SO  - Radiat Oncol. 2011 Sep 19;6:118. doi: 10.1186/1748-717X-6-118.