PMID- 34477884
OWN - NLM
STAT- MEDLINE
DCOM- 20220330
LR  - 20220401
IS  - 1439-099X (Electronic)
IS  - 0179-7158 (Print)
IS  - 0179-7158 (Linking)
VI  - 198
IP  - 3
DP  - 2022 Mar
TI  - Breast clinical target volume: HU-based glandular CTVs and ESTRO CTVs in modern 
      and historical radiotherapy treatment planning.
PG  - 229-235
LID - 10.1007/s00066-021-01839-5 [doi]
AB  - PURPOSE: The current study aimed to compare contouring of glandular tissue only 
      (gCTV) with the clinical target volume (CTV) as defined according to European 
      Society for Radiotherapy and Oncology (ESTRO) guidelines (eCTV) and historically 
      treated volumes (marked by wire and determined by palpation and anatomic 
      landmarks) in breast cancer radiotherapy. METHODS: A total of 56 consecutive 
      breast cancer patients underwent treatment planning based solely on anatomic 
      landmarks/wire markings ("wire based"). From these treatment plans, the 50% and 
      95% isodoses were transferred as structures and compared to the following 
      CT-based volumes: eCTV; a Hounsfield unit (HU)-based automatic contouring of the 
      gCTV; and standardized planning target volumes (PTVs) generated with 1‑cm safety 
      margins (resulting in the ePTVs and gPTVs, respectively). RESULTS: The 95% 
      isodose volume of the wire-based plan was larger than the eCTV by 
      352.39 +/- 176.06 cm(3) but smaller than the ePTV by 157.58 +/- 189.32 cm(3). The 95% 
      isodose was larger than the gCTV by 921.20 +/- 419.78 cm(3) and larger than the 
      gPTV by 190.91 +/- 233.49 cm(3). Patients with larger breasts had significantly 
      less glandular tissue than those with small breasts. There was a trend toward 
      a lower percentage of glandular tissue in older patients. CONCLUSION: Historical 
      wire and anatomic landmarks-based treatment planning sufficiently covers the 
      glandular tissue and the theoretical gPTV generated for the glandular tissue. 
      Modern CT-based CTV and PTV definition according to ESTRO results in a larger 
      treated volume than the historical wire-based techniques. HU-standardized 
      glandular tissue contouring results in a significantly smaller CTV and might be 
      an option for reducing the treatment volume and improving reproducibility of 
      contouring between institutions.
CI  - (c) 2021. The Author(s).
FAU - Duma, Marciana Nona
AU  - Duma MN
AD  - Department of Radiotherapy and Radiation Oncology; University Hospital, Friedrich 
      Schiller University Jena, Bachstrasse 18, 07743, Jena, Germany. 
      Marciana-Nona.Duma@med.uni-jena.de.
FAU - Kulms, Theresa
AU  - Kulms T
AD  - Department of Radiotherapy and Radiation Oncology; University Hospital, Friedrich 
      Schiller University Jena, Bachstrasse 18, 07743, Jena, Germany.
FAU - Knippen, Stefan
AU  - Knippen S
AD  - Department of Radiotherapy and Radiation Oncology; University Hospital, Friedrich 
      Schiller University Jena, Bachstrasse 18, 07743, Jena, Germany.
FAU - Teichmann, Tobias
AU  - Teichmann T
AD  - Department of Radiotherapy and Radiation Oncology; University Hospital, Friedrich 
      Schiller University Jena, Bachstrasse 18, 07743, Jena, Germany.
FAU - Wittig, Andrea
AU  - Wittig A
AD  - Department of Radiotherapy and Radiation Oncology; University Hospital, Friedrich 
      Schiller University Jena, Bachstrasse 18, 07743, Jena, Germany.
LA  - eng
PT  - Journal Article
DEP - 20210903
PL  - Germany
TA  - Strahlenther Onkol
JT  - Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et 
      al]
JID - 8603469
SB  - IM
MH  - Aged
MH  - Breast
MH  - *Breast Neoplasms/diagnostic imaging/radiotherapy
MH  - Female
MH  - Humans
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/methods
MH  - *Radiotherapy, Conformal/methods
MH  - Reproducibility of Results
PMC - PMC8863698
OTO - NOTNLM
OT  - Breast cancer
OT  - Breast-conserving surgery
OT  - Radiation coverage
OT  - Radiotherapy planning, computer-assisted
OT  - Radiotherapy, adjuvant
COIS- M.N. Duma, T. Kulms, S. Knippen, T. Teichmann, and A. Wittig declare that they 
      have no competing interests.
EDAT- 2021/09/04 06:00
MHDA- 2022/03/31 06:00
PMCR- 2021/09/03
CRDT- 2021/09/03 12:25
PHST- 2021/01/13 00:00 [received]
PHST- 2021/08/09 00:00 [accepted]
PHST- 2021/09/04 06:00 [pubmed]
PHST- 2022/03/31 06:00 [medline]
PHST- 2021/09/03 12:25 [entrez]
PHST- 2021/09/03 00:00 [pmc-release]
AID - 10.1007/s00066-021-01839-5 [pii]
AID - 1839 [pii]
AID - 10.1007/s00066-021-01839-5 [doi]
PST - ppublish
SO  - Strahlenther Onkol. 2022 Mar;198(3):229-235. doi: 10.1007/s00066-021-01839-5. 
      Epub 2021 Sep 3.