Cancer Therapy Centre, Liverpool Hospital, Australia; South Western Sydney Clinical School, University of New South Wales, Australia; Western Sydney University, Australia.
Cancer Therapy Centre, Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research, Liverpool Hospital, Australia; Centre for Medical Radiation Physics, University of Wollongong, Australia.
Radiother Oncol. 2016 Nov;121(2):169-179. doi: 10.1016/j.radonc.2016.09.009. Epub 2016 Oct 8.
Volume delineation is a well-recognised potential source of error in radiotherapy. Whilst it is important to quantify the degree of interobserver variability (IOV) in volume delineation, the resulting impact on dosimetry and clinical outcomes is a more relevant endpoint. We performed a literature review of studies evaluating IOV in target volume and organ-at-risk (OAR) delineation in order to analyse these with respect to the metrics used, reporting of dosimetric consequences, and use of statistical tests.
Medline and Pubmed databases were queried for relevant articles using keywords. We included studies published in English between 2000 and 2014 with more than two observers.
119 studies were identified covering all major tumour sites. CTV (n=47) and GTV (n=38) were most commonly contoured. Median number of participants and data sets were 7 (3-50) and 9 (1-132) respectively. There was considerable heterogeneity in the use of metrics and methods of analysis. Statistical analysis of results was reported in 68% (n=81) and dosimetric consequences in 21% (n=25) of studies.
There is a lack of consistency in conducting and reporting analyses from IOV studies. We suggest a framework to use for future studies evaluating IOV.
体积勾画是放射治疗中一个公认的潜在误差源。虽然量化勾画体积中的观察者间变异性（IOV）程度很重要，但对剂量学和临床结果的影响是一个更相关的终点。我们对评估靶区和危及器官（OAR）勾画中的 IOV 的研究进行了文献回顾，以便根据使用的指标、剂量学后果的报告以及统计检验的使用来分析这些研究。
使用关键词在 Medline 和 Pubmed 数据库中检索相关文章。我们纳入了 2000 年至 2014 年期间发表的、有超过两名观察者参与的英文文章。
共确定了 119 项研究，涵盖了所有主要的肿瘤部位。CTV（n=47）和 GTV（n=38）是最常勾画的。参与者中位数和数据集中位数分别为 7（3-50）和 9（1-132）。在使用指标和分析方法方面存在很大的异质性。有 68%（n=81）的研究报告了统计学分析结果，有 21%（n=25）的研究报告了剂量学后果。
在进行和报告 IOV 研究的分析方面缺乏一致性。我们建议使用一个框架来评估未来的 IOV 研究。
