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Clinical Impact of Contouring Variability for Prostate Cancer Tumor Boost.
Zhong, Allison Y; Lui, Asona J; Kuznetsova, Svetlana; Kallis, Karoline; Conlin, Christopher; Do, Deondre D; Domingo, Mariluz Rojo; Manger, Ryan; Hua, Patricia; Karunamuni, Roshan; Kuperman, Joshua; Dale, Anders M; Rakow-Penner, Rebecca; Hahn, Michael E; van der Heide, Uulke A; Ray, Xenia; Seibert, Tyler M.
Afiliación
  • Zhong AY; Department of Radiation Medicine and Applied Sciences, UC San Diego School of Medicine, La Jolla, California.
  • Lui AJ; Department of Radiation Medicine and Applied Sciences, UC San Diego School of Medicine, La Jolla, California.
  • Kuznetsova S; Department of Radiation Medicine and Applied Sciences, UC San Diego School of Medicine, La Jolla, California.
  • Kallis K; Department of Radiation Medicine and Applied Sciences, UC San Diego School of Medicine, La Jolla, California.
  • Conlin C; Department of Radiology, UC San Diego School of Medicine, La Jolla, California.
  • Do DD; Department of Bioengineering, UC San Diego Jacobs School of Engineering, La Jolla, California.
  • Domingo MR; Department of Bioengineering, UC San Diego Jacobs School of Engineering, La Jolla, California.
  • Manger R; Department of Radiation Medicine and Applied Sciences, UC San Diego School of Medicine, La Jolla, California.
  • Hua P; Department of Radiation Medicine and Applied Sciences, UC San Diego School of Medicine, La Jolla, California.
  • Karunamuni R; Department of Radiation Medicine and Applied Sciences, UC San Diego School of Medicine, La Jolla, California.
  • Kuperman J; Department of Radiology, UC San Diego School of Medicine, La Jolla, California.
  • Dale AM; Department of Radiology, UC San Diego School of Medicine, La Jolla, California; Department of Neurosciences, UC San Diego School of Medicine, La Jolla, California; Halicioglu Data Science Institute, UC San Diego School of Medicine, La Jolla, California.
  • Rakow-Penner R; Department of Radiology, UC San Diego School of Medicine, La Jolla, California; Department of Bioengineering, UC San Diego Jacobs School of Engineering, La Jolla, California.
  • Hahn ME; Department of Radiology, UC San Diego School of Medicine, La Jolla, California.
  • van der Heide UA; Department of Radiation Oncology, The Netherlands Cancer Institute (NKI-AVL), Amsterdam, The Netherlands.
  • Ray X; Department of Radiation Medicine and Applied Sciences, UC San Diego School of Medicine, La Jolla, California.
  • Seibert TM; Department of Radiation Medicine and Applied Sciences, UC San Diego School of Medicine, La Jolla, California; Department of Radiology, UC San Diego School of Medicine, La Jolla, California; Department of Bioengineering, UC San Diego Jacobs School of Engineering, La Jolla, California. Electronic addr
Int J Radiat Oncol Biol Phys ; 120(4): 1024-1031, 2024 Nov 15.
Article en En | MEDLINE | ID: mdl-38925224
ABSTRACT

PURPOSE:

The focal radiation therapy (RT) boost technique was shown in a phase III randomized controlled trial (RCT) to improve prostate cancer outcomes without increasing toxicity. This technique relies on the accurate delineation of prostate tumors on MRI. A recent prospective study evaluated radiation oncologists' accuracy when asked to delineate prostate tumors on MRI and demonstrated high variability in tumor contours. We sought to evaluate the impact of contour variability and inaccuracy on predicted clinical outcomes. We hypothesized that radiation oncologists' contour inaccuracies would yield meaningfully worse clinical outcomes. METHODS AND MATERIALS Forty-five radiation oncologists and 2 expert radiologists contoured prostate tumors on 30 patient cases. Of these cases, those with CT simulation or diagnostic CT available were selected for analysis. A knowledge-based planning model was developed to generate focal RT boost plans for each contour per the RCT protocol. The probability of biochemical failure (BF) was determined using a model from the RCT. The primary metric evaluated was delta BF (DBF = Participant BF - Expert BF). An absolute increase in BF ≥5% was considered clinically meaningful.

RESULTS:

Eight patient cases and 394 target volumes for focal RT boost planning were included in this analysis. In general, participant plans were associated with worse predicted clinical outcomes compared to the expert plan, with an average absolute increase in BF of 4.3%. Of participant plans, 37% were noted to have an absolute increase in BF of 5% or more.

CONCLUSIONS:

Radiation oncologists' attempts to contour tumor targets for focal RT boost are frequently inaccurate enough to yield meaningfully inferior clinical outcomes for patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Próstata / Planificación de la Radioterapia Asistida por Computador / Imagen por Resonancia Magnética Límite: Aged / Humans / Male Idioma: En Revista: Int J Radiat Oncol Biol Phys Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Próstata / Planificación de la Radioterapia Asistida por Computador / Imagen por Resonancia Magnética Límite: Aged / Humans / Male Idioma: En Revista: Int J Radiat Oncol Biol Phys Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos