Recommendations for high-risk clinical target volume definition with computed tomography for three-dimensional image-guided brachytherapy in cervical cancer patients.
Our purpose was to develop recommendations for contouring the computed tomography (CT)-based high-risk clinical target volume (CTVHR) for 3D image-guided brachytherapy (3D-IGBT) for cervical cancer. A 15-member Japanese Radiation Oncology Study Group (JROSG) committee with expertise in gynecological radiation oncology initiated guideline development for CT-based CTVHR (based on a comprehensive literature review as well as clinical experience) in July 2014. Extensive discussions occurred during four face-to-face meetings and frequent email communication until a consensus was reached. The CT-based CTVHR boundaries were defined by each anatomical plane (cranial-caudal, lateral, or anterior-posterior) with or without tumor progression beyond the uterine cervix at diagnosis. Since the availability of magnetic resonance imaging (MRI) with applicator insertion for 3D planning is currently limited, T2-weighted MRI obtained at diagnosis and just before brachytherapy without applicator insertion was used as a reference for accurately estimating the tumor size and topography. Furthermore, utilizing information from clinical examinations performed both at diagnosis and brachytherapy is strongly recommended. In conclusion, these recommendations will serve as a brachytherapy protocol to be used at institutions with limited availability of MRI for 3D treatment planning.
Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan.
Tatsuya
T
Ohno
Department of Radiology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
Masaru
M
Wakatsuki
Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan.
Takafumi
T
Toita
Department of Radiation Oncology, National Hospital Organization Fukuyama Medical Center, 4-14-17 Okinogami-cho, Fukuyama, Hiroshima 720-8520, Japan.
Yuko
Y
Kaneyasu
Department of Radiology, Osaka Medical College, 2-7, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan.
Ken
K
Yoshida
Department of Radiation Oncology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.
Shingo
S
Kato
Department of Radiation Oncology, Mie University Hospital, 2-174 Edobashi, Tsu-shi, Mie 514-8507, Japan.
Noriko
N
Ii
Department of Radiology, Saga University, 5-1-1, Nabeshima, Saga, Saga 849-8501, Japan.
Sunao
S
Tokumaru
Department of Therapeutic Radiology, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima 770-8503, Japan.
Hitoshi
H
Ikushima
Department of Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chiba 260-8677, Japan.
Takashi
T
Uno
Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan.
Shin-Ei
SE
Noda
Department of Radiation Oncology, Fukaya Red Cross Hospital, 5-8-1 Kamishiba-cho-nishi, Fukaya-shi, Saitama 366-0052, Japan.
Tomoko
T
Kazumoto
Department of Radiology, Kansai Medical University Medical Center, 10-15, Fumizono-cho, Moriguchi, Osaka 570-8507, Japan.
Yoko
Y
Harima
D001918:Brachytherapy; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D009361:Neoplasm Invasiveness; D061089:Radiotherapy, Image-Guided; D014057:Tomography, X-Ray Computed; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*
brachytherapy; cervical cancer; high-risk clinical target volume; recommendations; three-dimensional planning