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1、CONSENSUSPANELCONTOURINGCONSENSUSPANELCONTOURINGATLASFORTHEDELINEATIONOFTHECLINICALTARGETVOLUMEINTHECLINICALTARGETVOLUMEINTHEPOSTOPERATIVETREATMENTOFPANCREATICCANCERCollaborators•RossAAbramsMDRossA.Abrams,M.D.1,WilliamFRegineMDWilliamF.Regine,M.D.2,KarynA.Goodman,M.D.3,Lau
2、raA.Dawson,MDM.D.4,EdgarBenEdgarBen-JosefMDJosef,M.D.5,KarinHaustermans,M.D.6,WalterR.Bosch,D.Sc.7,JuliusTurian,PhDPh.D11RushUniversityMedicalCollege,Chicago,IL;2UniversityofMarylandSchoolofMedicine,Baltimore,MD;MarylandSchoolofMedicine,Baltimore,MD;3MemorialSloanMemorialS
3、loan-KetteringCancerCenter,NewYork,NY;4PrincessMargaretHospital,UniversityofToronto,Toronto,ON;5UniversityofMichiganMedicalSchool,AnnArbor,MI;6UniversityHospitalLLBLeuven,Leuven,Bellgiium;7Image-GiddThGuidedTherapyQACtQACenter(ITC),WashingtonUniversity,St.Louis,MOBackgroun
4、d•Radiotherapy(RT)qualityassuranceisessentialtovalidttlidatetreatmentffitefficacy•RTfieldswereprospectivelyreviewedintheRTOG97-04studydemonstratingthat48%oftreatmentplansdidnotstudydemonstratingthat48%oftreatmentplansdidnotmeetprotocolrequirements.•Basedon“ppperprotocol”ve
5、rsus“notppperprotocol”radiationdelivery,thefrequencyofgrade3/4toxicitydidnotvarysignificantlyonthe5-FUarmbutdidshowatdftrendofltiilesstoxicittftyforpatiittentsonthhegemciittbabiinearm.•Survivalwassignificantlyincreasedforpatientstreatedperprotocol(p=0019)perprotocol(p=0.01
6、9).Background•InRTOG0848,,pprosppectiveradiationqqualityycontrolisrequired•Centralreviewwillbeperformedpriortotreatmentdelivery•CT-basedplanningisrequired•Either3Dconformal(3DCRT)orintensityEither3Dconformal(3DCRT)orintensity-modulatedradiotherapy(IMRT)planning•Thenormalti
7、ssuesmustbedelineatedandaclinicaltargetvolume(CTV)illbdfi(CTV)willbedefinedBackground•Tooesueensuretheeadequacyoadequacyoftheposepost-opeopearativeCTVaadondtodevelopstandardizedcontouringguidelinesforRTOG0848,aconsensuscommitteeofsixradiationoncologists,wihithexpertiiisein
8、gastroiintestilRTdinalRT,devellopeddastepwisecontouringapproachbasedonidentifiableregions
