title: Proposed definition of the vaginal cuff and paracolpium clinical target volume in postoperative uterine cervical cancer.
abstract: OBJECTIVE
  The aim of this study was to develop an appropriate definition for vaginal cuff and paracolpium clinical target volume (CTV) for postoperative intensity modulated radiation therapy in patients with uterine cervical cancer.
  
  
  METHODS
  A working subgroup was organized within the Radiation Therapy Study Group of the Japan Clinical Oncology Group to develop a definition for the postoperative vaginal cuff and paracolpium CTV in December 2013. The group consisted of 5 radiation oncologists who specialized in gynecologic oncology and a gynecologic oncologist. A comprehensive literature review that included anatomy, surgery, and imaging fields was performed and was followed by multiple discreet face-to-face discussions and e-mail messages before a final consensus was reached.
  
  
  RESULTS
  Definitions for the landmark structures in all directions that demarcate the vaginal cuff and paracolpium CTV were decided by consensus agreement of the working group. A table was created that showed boundary structures of the vaginal cuff and paracolpium CTV in each direction.
  
  
  CONCLUSIONS
  A definition of the postoperative cervical cancer vaginal cuff and paracolpium CTV was developed. It is expected that this definition guideline will serve as a template for future radiation therapy clinical trial protocols, especially protocols involving intensity modulated radiation therapy.
authors.affiliation: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan. Electronic address: namuraka@ncc.go.jp.
authors.forename: Naoya
authors.initials: N
authors.lastname: Murakami
authors.affiliation: Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Radiation Therapy, Bell Land General Hospital, Osaka, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Norihisa
authors.affiliation: Department of Radiation Oncology, Osaka University Hospital, Osaka, Japan.
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Isohashi
authors.affiliation: Department of Radiation Oncology, University of Tsukuba, Ibaraki, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Murofushi
authors.affiliation: Department of Radiology, Graduate School of Medicine, University of Ryukyus, Okinawa, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Ariga
authors.affiliation: Department of Gynecological Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Inaba
authors.affiliation: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okamoto
authors.affiliation: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Department of Radiology, Graduate School of Medicine, University of Ryukyus, Okinawa, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Toita
authors.affiliation: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Itami
mesh_terms: D005260:Female; D006801:Humans; D011184:Postoperative Period; D017410:Practice Guidelines as Topic; D011379:Prognosis; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D050397:Radiotherapy, Intensity-Modulated; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000532:radiotherapy; D014621:Vagina / Q000601:surgery*; D014625:Vaginal Neoplasms / Q000473:pathology* / Q000532:radiotherapy