PMID- 29909882 OWN - NLM STAT- MEDLINE DCOM- 20191213 LR - 20191217 IS - 1879-0593 (Electronic) IS - 1368-8375 (Linking) VI - 82 DP - 2018 Jul TI - Interobserver variations in the delineation of target volumes and organs at risk and their impact on dose distribution in intensity-modulated radiation therapy for nasopharyngeal carcinoma. PG - 1-7 LID - S1368-8375(18)30167-2 [pii] LID - 10.1016/j.oraloncology.2018.04.025 [doi] AB - OBJECTIVE: This study aimed to (a) assess the differences in the delineation of target volumes and organs-at-risk (OARs) by different physicians designing an intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC) and (b) analyze the impact of these differences on the treatment plan optimization. MATERIALS AND METHODS: The planning target volumes (PTVs) and OARs for radiotherapy were manually delineated from computed tomography images of a patient with NPC, and a standard delineation was determined using the STAPLE algorithm of ABAS software. IMRT was designed using one standard plan and 10 individual plans based on the same constraints and field conditions. The maximum/minimum ratio (MMR) of the PTV and OAR volumes and the coefficient of variation (CV) for the different groups were evaluated and compared to the volume of the standard contour. RESULTS: Significant differences were seen in the PTVs of the nasopharynx (PTV(nx)), neck lymph node (PTV(nd)) and the OARs manually delineated by different physicians. Compared to the standard plan, the mean dose-related parameters of various OARs in different individual plans were not significantly different, while that of most organs in different individual plans were reduced. However, a significant difference in the dose at each organ was noted in different individual plans. CONCLUSION: Significant differences were noted in the PTV and OAR delineations by different physicians in radiotherapy of NPC, and their dosimetric parameters were significantly different from the standard planned parameters. Therefore, multicenter trials should pay attention to the impact of these differences on the clinical evaluation. CI - Copyright (c) 2018 Elsevier Ltd. All rights reserved. FAU - Peng, Ying-Lin AU - Peng YL AD - Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China. FAU - Chen, Li AU - Chen L AD - Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China. FAU - Shen, Guan-Zhu AU - Shen GZ AD - Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, PR China. FAU - Li, Ya-Ning AU - Li YN AD - Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China. FAU - Yao, Ji-Jin AU - Yao JJ AD - Department of Radiation Oncology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, PR China. FAU - Xiao, Wei-Wei AU - Xiao WW AD - Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China. FAU - Yang, Lin AU - Yang L AD - Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China. FAU - Zhou, Shu AU - Zhou S AD - Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China. FAU - Li, Jia-Xin AU - Li JX AD - Department of Radiation Oncology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China. FAU - Cheng, Wan-Qin AU - Cheng WQ AD - Department of Oncology, The Shunde Hospital of Southern Medical University, Shunde, PR China. FAU - Guan, Ying AU - Guan Y AD - Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, PR China. FAU - Xia, Hai-Qun AU - Xia HQ AD - Department of Radiation Oncology, Tungwah Hospital of Sun Yat-sen University, Dongguan, PR China. FAU - Liu, Shuai AU - Liu S AD - Department of Radiation Oncology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China. FAU - Zhao, Chong AU - Zhao C AD - Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China. Electronic address: zhaochong@sysucc.org.cn. FAU - Deng, Xiao-Wu AU - Deng XW AD - Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China. Electronic address: dengxw@sysucc.org.cn. LA - eng PT - Case Reports PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20180503 PL - England TA - Oral Oncol JT - Oral oncology JID - 9709118 SB - IM MH - Aged MH - Humans MH - Male MH - Nasopharyngeal Carcinoma/diagnostic imaging/*radiotherapy MH - Nasopharyngeal Neoplasms/diagnostic imaging/*radiotherapy MH - *Observer Variation MH - *Radiotherapy Dosage MH - Radiotherapy, Intensity-Modulated/adverse effects/*methods MH - Tomography, X-Ray Computed OTO - NOTNLM OT - Intensity-modulated radiation therapy OT - Interobserver variations in delineation OT - Nasopharyngeal carcinoma OT - Organs at risk OT - Planning target volume EDAT- 2018/06/19 06:00 MHDA- 2019/12/18 06:00 CRDT- 2018/06/19 06:00 PHST- 2018/01/16 00:00 [received] PHST- 2018/04/10 00:00 [revised] PHST- 2018/04/30 00:00 [accepted] PHST- 2018/06/19 06:00 [entrez] PHST- 2018/06/19 06:00 [pubmed] PHST- 2019/12/18 06:00 [medline] AID - S1368-8375(18)30167-2 [pii] AID - 10.1016/j.oraloncology.2018.04.025 [doi] PST - ppublish SO - Oral Oncol. 2018 Jul;82:1-7. doi: 10.1016/j.oraloncology.2018.04.025. Epub 2018 May 3.