An atlas for clinical target volume definition, including elective nodal irradiation in definitive radiotherapy of biliary cancer

Francesco Deodato, Gian Carlo Mattiucci, Francesco Cellini, Giuseppina Sallustio, Gabriella Macchia, Silvia Bisello, Matteo Renzulli, Milly Buwenge, Lucia Calculli, Silvia Cammelli, Alessandra Arcelli, Lucia Giaccherini, Giovanni Brandi, Sara Guerri, Rita Golfieri, Lorenzo Fuccio, Alessio G. Morganti, Alessandra Guido

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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.
Original languageEnglish
Pages (from-to)1784-1790
Number of pages7
JournalOncology Letters
Volume17
DOIs
Publication statusPublished - 2019

Keywords

  • Biliary neoplasms
  • Clinical target volume
  • Elective nodal irradiation
  • Radiotherapy

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