Consequences of anorectal cancer atlas implementation in the cooperative group setting

Radiobiologic analysis of a prospective randomized in silico target delineation study

Panayiotis Mavroidis, Drosoula Giantsoudis, Musaddiq J. Awan, Jasper Nijkamp, Coen R N Rasch, Joop C. Duppen, Charles Thomas, Paul Okunieff, William E. Jones, Lisa A. Kachnic, Niko Papanikolaou, Clifton D. Fuller

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose The aim of this study is to ascertain the subsequent radiobiological impact of using a consensus guideline target volume delineation atlas. Materials and methods Using a representative case and target volume delineation instructions derived from a proposed IMRT rectal cancer clinical trial, gross tumor volume (GTV) and clinical/planning target volumes (CTV/PTV) were contoured by 13 physician observers (Phase 1). The observers were then randomly assigned to follow (atlas) or not-follow (control) a consensus guideline/atlas for anorectal cancers, and instructed to re-contour the same case (Phase 2). Results The atlas group was found to have increased tumor control probability (TCP) after the atlas intervention for both the CTV (p <0.0001) and PTV1 (p = 0.0011) with decreasing normal tissue complication probability (NTCP) for small intestine, while the control group did not. Additionally, the atlas group had reduced variance in TCP for all target volumes and reduced variance in NTCP for the bowel. In Phase 2, the atlas group had increased TCP relative to the control for CTV (p = 0.03). Conclusions Visual atlas and consensus treatment guideline usage in the development of rectal cancer IMRT treatment plans reduced the inter-observer radiobiological variation, with clinically relevant TCP alteration for CTV and PTV volumes.

Original languageEnglish (US)
Pages (from-to)418-424
Number of pages7
JournalRadiotherapy and Oncology
Volume112
Issue number3
DOIs
StatePublished - Sep 1 2014

Fingerprint

Atlases
Computer Simulation
Neoplasms
Guidelines
Rectal Neoplasms
Observer Variation
Tumor Burden
Small Intestine
Clinical Trials
Physicians
Control Groups
Therapeutics

Keywords

  • Anorectal cancer
  • Atlas implementation
  • Inter-observer variation
  • Radiobiological analysis
  • Target delineation

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

Cite this

Consequences of anorectal cancer atlas implementation in the cooperative group setting : Radiobiologic analysis of a prospective randomized in silico target delineation study. / Mavroidis, Panayiotis; Giantsoudis, Drosoula; Awan, Musaddiq J.; Nijkamp, Jasper; Rasch, Coen R N; Duppen, Joop C.; Thomas, Charles; Okunieff, Paul; Jones, William E.; Kachnic, Lisa A.; Papanikolaou, Niko; Fuller, Clifton D.

In: Radiotherapy and Oncology, Vol. 112, No. 3, 01.09.2014, p. 418-424.

Research output: Contribution to journalArticle

Mavroidis, P, Giantsoudis, D, Awan, MJ, Nijkamp, J, Rasch, CRN, Duppen, JC, Thomas, C, Okunieff, P, Jones, WE, Kachnic, LA, Papanikolaou, N & Fuller, CD 2014, 'Consequences of anorectal cancer atlas implementation in the cooperative group setting: Radiobiologic analysis of a prospective randomized in silico target delineation study', Radiotherapy and Oncology, vol. 112, no. 3, pp. 418-424. https://doi.org/10.1016/j.radonc.2014.05.011
Mavroidis, Panayiotis ; Giantsoudis, Drosoula ; Awan, Musaddiq J. ; Nijkamp, Jasper ; Rasch, Coen R N ; Duppen, Joop C. ; Thomas, Charles ; Okunieff, Paul ; Jones, William E. ; Kachnic, Lisa A. ; Papanikolaou, Niko ; Fuller, Clifton D. / Consequences of anorectal cancer atlas implementation in the cooperative group setting : Radiobiologic analysis of a prospective randomized in silico target delineation study. In: Radiotherapy and Oncology. 2014 ; Vol. 112, No. 3. pp. 418-424.
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AU - Duppen, Joop C.

AU - Thomas, Charles

AU - Okunieff, Paul

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