Optimal delineation of the clinical target volume for thymomas in the post-resection setting: A multi-center study.


Journal

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
ISSN: 1879-0887
Titre abrégé: Radiother Oncol
Pays: Ireland
ID NLM: 8407192

Informations de publication

Date de publication:
12 2021
Historique:
received: 29 07 2021
revised: 29 09 2021
accepted: 08 10 2021
pubmed: 22 10 2021
medline: 31 12 2021
entrez: 21 10 2021
Statut: ppublish

Résumé

The definition of the clinical target volume (CTV) for post-operative radiotherapy (PORT) for thymoma is largely unexplored. The aim of this study was to analyze the difference in CTV delineation between radiation oncologists (RTO) and surgeons. This retrospective multi-center study enrolled 31 patients who underwent PORT for a thymoma from five hospitals. Three CTVs were delineated per patient: one CTV by the RTO, one CTV by the surgeon (blinded to the results of the RTO) and a joint CTV after collaboration. Volumes (cm RTO delineated significantly bigger CTVs than surgeons (mean: 93.9 ± 63.1, versus 57.9 ± 61.3 cm To the best of our knowledge, this is the first study investigating CTV definition in thymoma. We demonstrated a significant variability between RTO and surgeons. Joint delineation prompted revisions in smaller CTV as well as favoring the surgeons' judgement, suggesting that surgeons provided relevant insight into other risk areas than RTO. We recommend a multidisciplinary approach to PORT for thymomas in clinical practice.

Sections du résumé

BACKGROUND
The definition of the clinical target volume (CTV) for post-operative radiotherapy (PORT) for thymoma is largely unexplored. The aim of this study was to analyze the difference in CTV delineation between radiation oncologists (RTO) and surgeons.
METHODS
This retrospective multi-center study enrolled 31 patients who underwent PORT for a thymoma from five hospitals. Three CTVs were delineated per patient: one CTV by the RTO, one CTV by the surgeon (blinded to the results of the RTO) and a joint CTV after collaboration. Volumes (cm
RESULTS
RTO delineated significantly bigger CTVs than surgeons (mean: 93.9 ± 63.1, versus 57.9 ± 61.3 cm
CONCLUSIONS
To the best of our knowledge, this is the first study investigating CTV definition in thymoma. We demonstrated a significant variability between RTO and surgeons. Joint delineation prompted revisions in smaller CTV as well as favoring the surgeons' judgement, suggesting that surgeons provided relevant insight into other risk areas than RTO. We recommend a multidisciplinary approach to PORT for thymomas in clinical practice.

Identifiants

pubmed: 34673091
pii: S0167-8140(21)08763-6
doi: 10.1016/j.radonc.2021.10.007
pii:
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

8-13

Informations de copyright

Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Florit Marcuse (F)

Department of Pulmonology, Maastricht University Medical Center+, the Netherlands. Electronic address: florit.marcuse@mumc.nl.

Stephanie Peeters (S)

Department of Radiation Oncology (Maastro Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, the Netherlands.

Kato Herman (K)

Department of Pulmonology, Maastricht University Medical Center+, the Netherlands.

Femke Vaassen (F)

Department of Radiation Oncology (Maastro Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, the Netherlands.

Wouter van Elmpt (W)

Department of Radiation Oncology (Maastro Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, the Netherlands.

Alexander P W M Maat (APWM)

Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.

John Praag (J)

Department of Radiation Oncology, Erasmus Medical Center, Rotterdam, the Netherlands.

Charlotte Billiet (C)

Department of Radiation Oncology, Iridium Netwerk, Wilrijk, University of Antwerp, Belgium.

Paul Van Schil (P)

Department of Thoracic and Vascular Surgery, Antwerp University Hospital and Antwerp University, Belgium.

Maarten Lambrecht (M)

Department of Radiation Oncology, University Hospitals Leuven/KU Leuven, Belgium.

Dirk Van Raemdonck (D)

Department of Thoracic Surgery, University Hospitals Leuven/KU Leuven, Belgium.

Kim Cao (K)

Department of Radiation Oncology, L'Institut du Thorax Curie-Montsouris, Paris, France.

Madalina Grigoroiu (M)

Department of Thoracic Surgery, L'Institut du Thorax Curie-Montsouris, Paris, France.

Nicolas Girard (N)

Institut du Thorax Curie-Montsouris, Institut Curie, Paris, France; UVSQ, Paris Saclay, Versailles, France.

Monique Hochstenbag (M)

Department of Pulmonology, Maastricht University Medical Center+, the Netherlands.

Jos Maessen (J)

Department of Cardiothoracic Surgery, Maastricht University Medical Center+, the Netherlands.

Dirk De Ruysscher (D)

Department of Radiation Oncology (Maastro Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, the Netherlands.

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