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Multidisciplinary collaborative gross tumour volume definition for lung cancer radiotherapy: a prospective study

机译：肺癌放疗的多学科协作总体肿瘤体积定义：前瞻性研究

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Variability in gross tumour volume (GTV) definition is a major source of systematic error in conformal radiotherapy. This prospective study assesses the role of multidisciplinary collaboration between oncologists and radiologists in defining lung cancer volumes. Twenty patients with non–small cell lung cancer due to receive three-dimensional conformal radiotherapy formed the study population. GTVs were defined by a radiologist (GTVrad) and an oncologist (GTVonc) using available clinical information and imaging. A collaborative meeting was then held to agree on a final, common GTV (GTVfin) to be used for treatment planning, and differences analysed. The collaboration changed the GTV in 19/20 patients with a total of 50 regions being edited. Changes made were categorized as (a) differentiation of tumour from atelectasis or ground glass shadowing, (b) separation of tumour from vasculature, and (c) defining mediastinal extent of tumour. Oncologists were more confident in the GTVfin than the GTVonc. The radiologist took longer to define the GTV than the oncologist. Real-time collaborative GTV definition by a radiologist and oncologist is practical and feasible. This approach allows specific areas of uncertainty to be categorized and focussed on, reducing systematic error in GTV definition. The physician's approach to risk and decision making for each patient may also play a role.
机译：总肿瘤体积（GTV）定义的变异性是保形放射治疗中系统错误的主要来源。这项前瞻性研究评估了肿瘤学家和放射学家之间多学科合作在定义肺癌量中的作用。 20例因接受三维共形放疗而导致的非小细胞肺癌患者组成了研究人群。放射科医生（GTVrad）和肿瘤科医生（GTVonc）使用可用的临床信息和影像来定义GTV。然后举行了一次合作会议，以商定用于治疗计划的最终通用GTV（GTVfin），并分析差异。这项合作改变了19/20位患者的GTV，总共编辑了50个区域。所做的改变归类为（a）肺不张或磨玻璃影的区别;（b）血管与血管的分离;（c）纵隔肿瘤的范围。肿瘤学家对GTVfin的信心比对GTVonc的信心更大。放射科医生定义GTV的时间比肿瘤医师花费的时间更长。放射科医生和肿瘤科医生的实时协作GTV定义是切实可行的。这种方法允许对不确定性的特定领域进行分类和关注，从而减少GTV定义中的系统误差。医师对每个患者进行风险和决策的方法也可能起作用。

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