PMID- 28105886
OWN - NLM
STAT- MEDLINE
DCOM- 20170425
LR  - 20220129
IS  - 1651-226X (Electronic)
IS  - 0284-186X (Linking)
VI  - 56
IP  - 4
DP  - 2017 Apr
TI  - Interobserver delineation uncertainty in involved-node radiation therapy (INRT) 
      for early-stage Hodgkin lymphoma: on behalf of the Radiotherapy Committee of the 
      EORTC lymphoma group.
PG  - 608-613
LID - 10.1080/0284186X.2017.1279750 [doi]
AB  - BACKGROUND AND PURPOSE: In early-stage classical Hodgkin lymphoma (HL) the target 
      volume nowadays consists of the volume of the originally involved nodes. 
      Delineation of this volume on a post-chemotherapy CT-scan is challenging. We 
      report on the interobserver variability in target volume definition and its 
      impact on resulting treatment plans. MATERIALS AND METHODS: Two representative 
      cases were selected (1: male, stage IB, localization: left axilla; 2: female, 
      stage IIB, localizations: mediastinum and bilateral neck). Eight experienced 
      observers individually defined the clinical target volume (CTV) using 
      involved-node radiotherapy (INRT) as defined by the EORTC-GELA guidelines for the 
      H10 trial. A consensus contour was generated and the standard deviation computed. 
      We investigated the overlap between observer and consensus contour [Sorensen-Dice 
      coefficient (DSC)] and the magnitude of gross deviations between the surfaces of 
      the observer and consensus contour (Hausdorff distance). 3D-conformal (3D-CRT) 
      and intensity-modulated radiotherapy (IMRT) plans were calculated for each 
      contour in order to investigate the impact of interobserver variability on each 
      treatment modality. Similar target coverage was enforced for all plans. RESULTS: 
      The median CTV was 120 cm(3) (IQR: 95-173 cm(3)) for Case 1, and 255 cm(3) (IQR: 
      183-293 cm(3)) for Case 2. DSC values were generally high (>0.7), and Hausdorff 
      distances were about 30 mm. The SDs between all observer contours, providing an 
      estimate of the systematic error associated with delineation uncertainty, ranged 
      from 1.9 to 3.8 mm (median: 3.2 mm). Variations in mean dose resulting from 
      different observer contours were small and were not higher in IMRT plans than in 
      3D-CRT plans. CONCLUSIONS: We observed considerable differences in target volume 
      delineation, but the systematic delineation uncertainty of around 3 mm is 
      comparable to that reported in other tumour sites. This report is a first step 
      towards calculating an evidence-based planning target volume margin for INRT in 
      HL.
FAU - Aznar, Marianne C
AU  - Aznar MC
AD  - a Department of Oncology, Section of Radiotherapy, Rigshospitalet , University of 
      Copenhagen , Copenhagen, Denmark.
FAU - Girinsky, Theodore
AU  - Girinsky T
AD  - b Service de Radiotherapie Oncologique , Institut Gustave Roussy , Villejuif , 
      France.
FAU - Berthelsen, Anne Kiil
AU  - Berthelsen AK
AD  - a Department of Oncology, Section of Radiotherapy, Rigshospitalet , University of 
      Copenhagen , Copenhagen, Denmark.
FAU - Aleman, Berthe
AU  - Aleman B
AD  - c Department of Radiotherapy , The Netherlands Cancer Institute , Amsterdam , The 
      Netherlands.
FAU - Beijert, Max
AU  - Beijert M
AD  - d Department of Radiation Oncology , University of Groningen, University Medical 
      Center Groningen , Groningen , The Netherlands.
FAU - Hutchings, Martin
AU  - Hutchings M
AD  - e Department of Haematology, Rigshospitalet , University of Copenhagen , 
      Copenhagen, Denmark.
FAU - Lievens, Yolande
AU  - Lievens Y
AD  - f Department of Radiation Oncology , Ghent University Hospital , Ghent , Belgium.
FAU - Meijnders, Paul
AU  - Meijnders P
AD  - g Department of Radiation Oncology GZA, Iridium Cancer Network , University of 
      Antwerp , Antwerp , Belgium.
FAU - Meidahl Petersen, Peter
AU  - Meidahl Petersen P
AD  - a Department of Oncology, Section of Radiotherapy, Rigshospitalet , University of 
      Copenhagen , Copenhagen, Denmark.
AD  - e Department of Haematology, Rigshospitalet , University of Copenhagen , 
      Copenhagen, Denmark.
FAU - Schut, Deborah
AU  - Schut D
AD  - a Department of Oncology, Section of Radiotherapy, Rigshospitalet , University of 
      Copenhagen , Copenhagen, Denmark.
FAU - Maraldo, Maja V
AU  - Maraldo MV
AD  - a Department of Oncology, Section of Radiotherapy, Rigshospitalet , University of 
      Copenhagen , Copenhagen, Denmark.
FAU - van der Maazen, Richard
AU  - van der Maazen R
AD  - h Department of Radiotherapy , Radboud University Medical Center , Nijmegen , The 
      Netherlands.
FAU - Specht, Lena
AU  - Specht L
AD  - a Department of Oncology, Section of Radiotherapy, Rigshospitalet , University of 
      Copenhagen , Copenhagen, Denmark.
AD  - e Department of Haematology, Rigshospitalet , University of Copenhagen , 
      Copenhagen, Denmark.
LA  - eng
GR  - MC_U137686858/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
DEP - 20170120
PL  - Sweden
TA  - Acta Oncol
JT  - Acta oncologica (Stockholm, Sweden)
JID - 8709065
SB  - IM
MH  - Female
MH  - Hodgkin Disease/*pathology/*radiotherapy
MH  - Humans
MH  - Lymphatic Irradiation/*methods
MH  - Male
MH  - Observer Variation
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/*methods
MH  - Radiotherapy, Conformal/methods
MH  - Radiotherapy, Intensity-Modulated/methods
MH  - Uncertainty
EDAT- 2017/01/21 06:00
MHDA- 2017/04/26 06:00
CRDT- 2017/01/21 06:00
PHST- 2017/01/21 06:00 [pubmed]
PHST- 2017/04/26 06:00 [medline]
PHST- 2017/01/21 06:00 [entrez]
AID - 10.1080/0284186X.2017.1279750 [doi]
PST - ppublish
SO  - Acta Oncol. 2017 Apr;56(4):608-613. doi: 10.1080/0284186X.2017.1279750. Epub 2017 
      Jan 20.