Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, No. 440, Jiyan Road, Huaiyin distract, Jinan, 250117, Shandong Province, China.
Department of Oncology, Yankuang New Journey General Hospital, Zoucheng, 273500, China.
BMC Cancer. 2024 Sep 2;24(1):1086. doi: 10.1186/s12885-024-12825-2.
This study aimed to establish a consensus on the delineation of target volumes for neoadjuvant radiation therapy (nRT) in esophageal squamous cell carcinoma (ESCC) within China.
From February 2020 to June 2021, nine ESCC patients who received nRT were retrospectively selected from Sun Yat-sen University Cancer Center and Shandong Cancer Hospital. A panel from eight cancer radiotherapy centers performed two rounds of nRT target volume delineation for these patients: the first round for cases 1-6 and the second for cases 7-9. Online meetings were held after each delineation round to discuss findings. The consistency of delineations across centers was compared using mean undirected Hausdorff distances (Hmean), dice similarity coefficients (DSC), and total volumes, analyzed with the Mann-Whitney U test.
The second round of delineations showed improved consistency across centers (total clinical target volume (CTVtotal): mean DSC = 0.76-0.81; mean Hmean = 2.11-3.14 cm) compared to the first round (CTVtotal: mean DSC = 0.63-0.64; mean Hmean = 5.66-7.34 cm; DSC and Hmean: P < 0.050 between rounds), leading to the formation of a consensus and an atlas for ESCC nRT target volume delineation. A proposal was reached through evaluating target volume delineations, analyzing questionnaire survey outcomes, and reviewing pertinent literature.
We have developed guidelines and an atlas for target volume delineation in nRT therapy for ESCC in China. These resources are designed to facilitate more consistent delineation of target volumes in both clinical practice and clinical trials.
本研究旨在建立中国范围内用于新辅助放化疗（nRT）的食管癌（ESCC）靶区勾画共识。
从 2020 年 2 月至 2021 年 6 月，从中山大学肿瘤防治中心和山东省肿瘤医院回顾性选择了 9 例接受 nRT 的 ESCC 患者。来自 8 家癌症放疗中心的一个小组为这些患者进行了两轮 nRT 靶区勾画：第一轮为病例 1-6，第二轮为病例 7-9。每轮勾画后均举行在线会议讨论结果。使用无向 Hausdorff 距离（Hmean）、骰子相似系数（DSC）和总体积的平均值比较各中心勾画的一致性，采用 Mann-Whitney U 检验进行分析。
与第一轮相比（CTVtotal：平均 DSC=0.63-0.64；平均 Hmean=5.66-7.34cm），第二轮各中心的勾画一致性有所提高（CTVtotal：平均 DSC=0.76-0.81；平均 Hmean=2.11-3.14cm），从而形成了 ESCC nRT 靶区勾画的共识和图谱。通过评估靶区勾画、分析问卷调查结果和回顾相关文献，提出了建议。
我们制定了用于中国 ESCC 新辅助放化疗的靶区勾画指南和图谱。这些资源旨在促进在临床实践和临床试验中更一致地勾画靶区。
