PMID- 23577745
OWN - NLM
STAT- MEDLINE
DCOM- 20140821
LR  - 20131218
IS  - 1651-226X (Electronic)
IS  - 0284-186X (Linking)
VI  - 53
IP  - 1
DP  - 2014 Jan
TI  - Assessment of volume segmentation in radiotherapy of adolescents; a treatment 
      planning study by the Swedish Workgroup for Paediatric Radiotherapy.
PG  - 126-33
LID - 10.3109/0284186X.2013.782104 [doi]
AB  - BACKGROUND AND PURPOSE: The variability in target delineation for similar cases 
      between centres treating paediatric and adolescent patients, and the apparent 
      differences in interpretation of radiotherapy guidelines in the treatment 
      protocols encouraged us to perform a dummy-run study as a part of our quality 
      assurance work. The aim was to identify and quantify differences in the 
      segmentation of target volumes and organs at risk (OARs) and to analyse the 
      treatment plans and dose distributions. MATERIALS AND METHODS: Four patient cases 
      were selected: Wilm's tumour, Hodgkin's disease, rhabdomyosarcoma of the prostate 
      and chordoma of the skull base. The five participating centres received the same 
      patient-related material. They introduced the cases in their treatment planning 
      system, delineated target volumes and OARs and created treatment plans. 
      Dose-volume histograms were retrieved for relevant structures and volumes and 
      dose metrics were derived and compared, e.g. target volumes and their 
      concordance, dose homogeneity index (HI), treated and irradiated volumes, 
      remaining volume at risk and relevant Vx and Dx values. RESULTS: We found 
      significant differences in target segmentation in the majority of the cases. The 
      planning target volumes (PTVs) varied two- to four-fold and conformity indices 
      were in the range of 0.3-0.6. This resulted in large variations in dose 
      distributions to OARs as well as in treated and irradiated volumes even though 
      the treatment plans showed good conformity to the PTVs. Potential reasons for the 
      differences in target delineation were analysed. CONCLUSION: Considerations of 
      the growing child and difficulties in interpretation of the radiotherapy 
      information in the treatment protocols were identified as reasons for the 
      variation. As a result, clarified translated detailed radiotherapy guidelines for 
      paediatric/adolescent patients have been recognised as a way to reduce this 
      variation.
FAU - Kristensen, Ingrid
AU  - Kristensen I
AD  - Department of Clinical Sciences, Oncology, Lund University , Lund , Sweden.
FAU - Agrup, Mans
AU  - Agrup M
FAU - Bergstrom, Per
AU  - Bergstrom P
FAU - Engellau, Jacob
AU  - Engellau J
FAU - Haugen, Hedda
AU  - Haugen H
FAU - Martinsson, Ulla
AU  - Martinsson U
FAU - Nilsson, Kristina
AU  - Nilsson K
FAU - Taheri-Kadkhoda, Zahra
AU  - Taheri-Kadkhoda Z
FAU - Lindh, Jack
AU  - Lindh J
FAU - Nilsson, Per
AU  - Nilsson P
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20130412
PL  - Sweden
TA  - Acta Oncol
JT  - Acta oncologica (Stockholm, Sweden)
JID - 8709065
SB  - IM
MH  - Adolescent
MH  - Chordoma/pathology/*radiotherapy
MH  - Female
MH  - Hodgkin Disease/pathology/*radiotherapy
MH  - Humans
MH  - Kidney Neoplasms/pathology/radiotherapy
MH  - Male
MH  - Pediatrics
MH  - Prognosis
MH  - Prostatic Neoplasms/pathology/*radiotherapy
MH  - Radiotherapy Dosage
MH  - *Radiotherapy Planning, Computer-Assisted
MH  - Radiotherapy, Conformal
MH  - Rhabdomyosarcoma/pathology/*radiotherapy
MH  - Skull Base Neoplasms/pathology/*radiotherapy
MH  - Sweden
MH  - Wilms Tumor/pathology/*radiotherapy
EDAT- 2013/04/13 06:00
MHDA- 2014/08/22 06:00
CRDT- 2013/04/13 06:00
PHST- 2013/04/13 06:00 [entrez]
PHST- 2013/04/13 06:00 [pubmed]
PHST- 2014/08/22 06:00 [medline]
AID - 10.3109/0284186X.2013.782104 [doi]
PST - ppublish
SO  - Acta Oncol. 2014 Jan;53(1):126-33. doi: 10.3109/0284186X.2013.782104. Epub 2013 
      Apr 12.