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• W2271359554 abstract "Several organizations are considering studying the role of adjuvant radiation for bladder cancer patients at elevated risk of locoregional failure (LF). However, the clinical target volumes (CTVs) and organs at risk (OARs) for this treatment have not been defined in detail. The purpose of this project was to define multi-institutional consensus CTVs and OARs for male and female bladder cancer patients undergoing adjuvant radiation in clinical trials. We convened a multidisciplinary group of bladder cancer specialists representing 9 institutions in 3 countries. Five radiation oncologists and 7 urologists participated in the development of the proposed contours, and another 5 radiation oncologists participated in their validation. The development group proposed initial language for the CTVs and OARs and contoured according to these on CT scans of a male and female patient who had prior radical cystectomies. We required that initial contours for the CTVs have input from at least 1 urologist at each participating institution. Using the binomial maximum-likelihood estimates method, we generated 95% level initial development group contours. We evaluated the contours for level of agreement using the Landis and Koch interpretation of the K statistic. Based on the initial contouring, the development group updated its descriptions of the CTVs and OARs. To determine whether the updated language produces consistent contours, the cystectomy bed contour was redrawn on the male and female CT sets by an additional 5 radiation oncologists. The development group proposed that patients at elevated risk for LF but negative surgical margins should be treated to pelvic lymph node regions alone, including the internal iliac, external iliac, distal common iliac, and presacral nodes. In contrast, it is proposed that patients with positive surgical margins be treated to both the pelvic lymph nodes and the cystectomy bed. The development group proposed that the following OARs be identified: rectum, bowel space, bone marrow, and urinary diversion. The level of agreement for the initial CTVs and OARs from the development group varied substantially (Table). Consensus language to describe CTV and OAR structures where the initial contours varied was successfully developed. Contours and feedback from the validation group are being analyzed. Initial descriptions of CTVs and OARs have been successfully developed. External validation and feedback are pending. The results of this work will be applicable to clinical trials of adjuvant radiation in bladder cancer.Oral Scientific Abstracts 53; Table 1.K-statisticCyst bedPelvic LNBowel spaceRectumBone marrowUrinary diversionMale0.590.680.640.550.840.43Female0.550.580.670.500.810.50 Open table in a new tab" @default.
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• W2271359554 date "2015-11-01" @default.
• W2271359554 modified "2023-10-02" @default.
• W2271359554 title "Development and Validation of Contouring Guidelines for Postcystectomy Adjuvant Radiation of Bladder Cancer" @default.
• W2271359554 doi "https://doi.org/10.1016/j.ijrobp.2015.07.062" @default.
• W2271359554 hasPublicationYear "2015" @default.
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