Consensus guidelines for delineation of clinical target volume for intensity-modulated pelvic radiotherapy in postoperative treatment of endometrial and cervical cancer.
OBJECTIVE
To develop an atlas of the clinical target volume (CTV) definitions for postoperative radiotherapy of endometrial and cervical cancer to be used for planning pelvic intensity-modulated radiotherapy.


METHODS
The Radiation Therapy Oncology Group led an international collaboration of cooperative groups in the development of the atlas. The groups included the Radiation Therapy Oncology Group, Gynecologic Oncology Group, National Cancer Institute of Canada, European Society of Therapeutic Radiology and Oncology, and American College of Radiology Imaging Network. The members of the group were asked by questionnaire to define the areas that were to be included in the CTV and to outline theses areas on individual computed tomography images. The initial formulation of the group began in late 2004 and culminated with a formal consensus conference in June 2005.


RESULTS
The committee achieved a consensus CTV definition for postoperative therapy for endometrial and cervical cancer. The CTV should include the common, external, and internal iliac lymph node regions. The upper 3.0 cm of the vagina and paravaginal soft tissue lateral to the vagina should also be included. For patients with cervical cancer, or endometrial cancer with cervical stromal invasion, it is also recommended that the CTV include the presacral lymph node region.


CONCLUSIONS
This report serves as an international template for the definition of the CTV for postoperative intensity-modulated radiotherapy for endometrial and cervical cancer.
Small
William
W
Department of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL 60611, USA. wsmall@nmff.org.
Mell
Loren K
LK
Anderson
Penny
P
Creutzberg
Carien
C
De Los Santos
Jennifer
J
Gaffney
David
D
Jhingran
Anuja
A
Portelance
Lorraine
L
Schefter
Tracey
T
Iyer
Revathy
R
Varia
Mahesh
M
Winter
Kathryn
K
Mundt
Arno J
AJ
D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D006801:Humans; D007391:International Cooperation; D008488:Medical Illustration; D018787:Radiation Oncology / Q000592:standards; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods / Q000592:standards*; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy / Q000601:surgery