TY - JOUR
T1 - An atlas for clinical target volume definition, including elective nodal irradiation in definitive radiotherapy of biliary cancer
AU - Bisello, Silvia
AU - Renzulli, Matteo
AU - Buwenge, Milly
AU - Calculli, Lucia
AU - Sallustio, Giuseppina
AU - Macchia, Gabriella
AU - Deodato, Francesco
AU - Mattiucci, Gian Carlo
AU - Cammelli, Silvia
AU - Arcelli, Alessandra
AU - Giaccherini, Lucia
AU - Cellini, Francesco
AU - Brandi, Giovanni
AU - Guerri, Sara
AU - Cilla, Savino
AU - Golfieri, Rita
AU - Fuccio, Lorenzo
AU - Morganti, Alessio G.
AU - Guido, Alessandra
PY - 2019
Y1 - 2019
N2 - Radiotherapy (RT) is a treatment option for advanced biliary tract cancer (BTC), often combined with sequential and/or concurrent chemotherapy. The use of modern RT techniques requires accurate clinical target volume (CTV) definition and delineation. However, guidelines for CTV delineation in BTC are lacking. Therefore, the aim of this study was to propose a computer tomography (CT) atlas for CTV definition of BTC. We previously proposed guidelines to define the nodal CTV (CTV-N) in BTC. In this study, based on a literature analysis, we defined the margins to be added to the gross tumor volume (GTV; subclinical and microscopic disease) to define the primary tumor CTV (CTV-T). An abdominal contrast enhanced planning CT scan was performed on three different patients with unresectable intrahepatic cholangiocarcinoma (CC), extrahepatic CC and gallbladder cancer. The GTV and anatomical reference structures were outlined on CT images. Then, based on our guidelines, the CTV-T and CTV-N were delineated and merged to define the final CTV in the three patients. An atlas, showing the defined CTV, was generated from the reference CT images to illustrate the CTV for intra-hepatic CC, extra-hepatic CC and gallbladder cancer. This atlas can be used as an aid for CTV definition in patients with BTC treated with modern RT techniques.
AB - Radiotherapy (RT) is a treatment option for advanced biliary tract cancer (BTC), often combined with sequential and/or concurrent chemotherapy. The use of modern RT techniques requires accurate clinical target volume (CTV) definition and delineation. However, guidelines for CTV delineation in BTC are lacking. Therefore, the aim of this study was to propose a computer tomography (CT) atlas for CTV definition of BTC. We previously proposed guidelines to define the nodal CTV (CTV-N) in BTC. In this study, based on a literature analysis, we defined the margins to be added to the gross tumor volume (GTV; subclinical and microscopic disease) to define the primary tumor CTV (CTV-T). An abdominal contrast enhanced planning CT scan was performed on three different patients with unresectable intrahepatic cholangiocarcinoma (CC), extrahepatic CC and gallbladder cancer. The GTV and anatomical reference structures were outlined on CT images. Then, based on our guidelines, the CTV-T and CTV-N were delineated and merged to define the final CTV in the three patients. An atlas, showing the defined CTV, was generated from the reference CT images to illustrate the CTV for intra-hepatic CC, extra-hepatic CC and gallbladder cancer. This atlas can be used as an aid for CTV definition in patients with BTC treated with modern RT techniques.
KW - Biliary neoplasms
KW - Clinical target volume
KW - Elective nodal irradiation
KW - Radiotherapy
KW - Biliary neoplasms
KW - Clinical target volume
KW - Elective nodal irradiation
KW - Radiotherapy
UR - http://hdl.handle.net/10807/149289
UR - http://www.spandidos-publications.com/ol/17/2/1784/download
U2 - 10.3892/ol.2018.9774
DO - 10.3892/ol.2018.9774
M3 - Article
SN - 1792-1074
VL - 17
SP - 1784
EP - 1790
JO - Oncology Letters
JF - Oncology Letters
ER -
