Title

Improving the Consistency in Cervical Esophageal Target Volume Definition by Special Training

Authors

Patricia Tai, London Regional Cancer Center, London, ON
Jake Van Dyk, University of Western OntarioFollow
Jerry Battista, University of Western OntarioFollow
Edward Yu, University of Western OntarioFollow
Larry Stitt, University of Western OntarioFollow
Jon Tonita, Allan Blair Cancer Center, Regina, S
Olusegun Agboola, Ottawa Regional Cancer Center, Ottawa, ON
James Brierley, Princess Margaret Hospital, Toronto, ON
Rashid Dar, University of Western OntarioFollow
Christopher Leighton, Windsor Regional Cancer Center, Windsor, ON
Shawn Malone, Ottawa Regional Cancer Center, Ottawa, ON
Barbara Strang, Hamilton Regional Cancer Center, Hamilton, ON
Pauline Truong, London Regional Cancer Center, London, ON
Gregory Videtic, London Regional Cancer Center, London, ON
C. Shun Wong, Princess Margaret Hospital, Toronto, ON
Rebecca Wong, Toronto-Bayview Regional Cancer Center, Toronto, ON
Youssef Youssef, Kingston Regional Cancer Center, Kingston, ON

Document Type

Article

Publication Date

7-1-2002

Journal

International Journal of Radiation Oncology, Biology, Physics

Volume

53

Issue

3

First Page

766

Last Page

774

URL with Digital Object Identifier

10.1016/S0360-3016(02)02752-9

Abstract

PURPOSE: Three-dimensional conformal radiation therapy requires the precise definition of the target volume. Its potential benefits could be offset by the inconsistency in target definition by radiation oncologists. In a previous survey of radiation oncologists, a large degree of variation in target volume definition of cervical esophageal cancer was noted for the boost phase of radiotherapy. The present study evaluated whether special training could improve the consistency in target volume definitions.

METHODS AND MATERIALS: A pre-training survey was performed to establish baseline values. This was followed by a special one-on-one training session on treatment planning based on the RTOG 94-05 protocol to 12 radiation oncologists. Target volumes were redrawn immediately and at 1-2 months later. Post-training vs. pre-training target volumes were compared.

RESULTS: There was less variability in the longitudinal positions of the target volumes post-training compared to pre-training (p < 0.05 in 5 of 6 comparisons). One case had more variability due to the lack of a visible gross tumor on CT scans. Transverse contours of target volumes did not show any significant difference pre- or post-training.

CONCLUSION: For cervical esophageal cancer, this study suggests that special training on protocol guidelines may improve consistency in target volume definition. Explicit protocol directions are required for situations where the gross tumor is not easily visible on CT scans. This may be particularly important for multicenter clinical trials, to reduce the occurrences of protocol violations.