Department of Radiation Oncology, Gustave Roussy, Institut d'Oncologie Thoracique (IOT), Villejuif, France.
Division of Cancer Sciences, University of Manchester and The Christie NHS Foundation Trust, Manchester, UK.
Radiother Oncol. 2020 Nov;152:89-95. doi: 10.1016/j.radonc.2020.07.012. Epub 2020 Jul 13.
Radiotherapy (RT) plays a major role in the treatment of small cell lung cancer (SCLC). Therefore, the ACROP committee was asked by ESTRO to provide recommendations on target volume delineation for standard clinical scenarios in definitive (chemo)-radiotherapy (CRT), adjuvant RT for stages I-III SCLC and consolidation thoracic RT for stage IV disease. The aim of these guidelines is to standardise and optimise the process of RT treatment planning for clinical practice and prospective studies. The process for the development of the guidelines included the evaluation of a structured questionnaire followed by a consensus discussion, voting and writing process within the committee. Firstly, we provide recommendations for both the imaging to be performed as part of the diagnostic work-up and for the RT planning process. Secondly, recommendations are made for target volume delineation including delineation of the primary gross tumour volume (GTV) and lymph node GTV and clinical tumour volume (CTV) expansion in the context of definitive and adjuvant RT. With regard to internal target volume (ITV) and planning target volume (PTV) definitions, we make recommendations about the management of geometric uncertainties and target motion. Finally, we provide our opinions on organ at risk (OAR) delineation and organisational issues to be considered.
放射治疗（RT）在小细胞肺癌（SCLC）的治疗中起着重要作用。因此，ESTRO 请 ACROP 委员会就明确（化疗）放射治疗（CRT）、I-III 期 SCLC 的辅助放射治疗和 IV 期疾病的巩固性胸部放射治疗的标准临床情况下的靶区勾画提供建议。本指南的目的是为临床实践和前瞻性研究标准化和优化 RT 治疗计划的制定过程。指南制定过程包括评估结构化问卷，然后在委员会内进行共识讨论、投票和撰写。首先，我们为诊断工作中要进行的影像学检查以及 RT 计划过程提供建议。其次，针对明确和辅助 RT 中的原发肿瘤大体体积（GTV）和淋巴结 GTV 以及临床肿瘤体积（CTV）勾画，我们提出了靶区勾画的建议。关于内靶区（ITV）和计划靶区（PTV）的定义，我们就几何不确定性和靶区运动的管理提出了建议。最后，我们就危及器官（OAR）勾画和需要考虑的组织问题提出了我们的意见。
