PDF(Pubmed)
Abstract：
UNASSIGNED: Radiotherapy to the prostate bed is a potentially curative salvage option after radical prostatectomy. Although prostate bed contouring guidelines are available in the literature, important variabilities exist. The objective of this work is to provide a contemporary consensus guideline for prostate bed delineation for postoperative radiotherapy.
UNASSIGNED: An ESTRO-ACROP contouring consensus panel consisting of 11 radiation oncologists and one radiologist, all with known subspecialty expertise in prostate cancer, was established. Participants were asked to delineate the prostate bed clinical target volumes (CTVs) in 3 separate clinically relevant scenarios: adjuvant radiation, salvage radiation with PSA progression, and salvage radiation with persistently elevated PSA. These cases focused on the presence of positive surgical margin, extracapsular extension, and seminal vesicles involvement. None of the cases had radiographic evidence of local recurrence on imaging. A single computed tomography (CT) dataset was shared via FALCON platform and contours were performed using EduCaseTM software. Contours were analyzed qualitatively using heatmaps which provided a visual assessment of controversial regions and quantitatively analyzed using Sorensen-Dice similarity coefficients. Participants also answered case-specific questionnaires addressing detailed recommendations on target delineation. Discussions via electronic mails and videoconferences for final editing and consensus were performed.
UNASSIGNED: The mean CTV for the adjuvant case was 76 cc (SD = 26.6), salvage radiation with PSA progression was 51.80 cc (SD = 22.7), and salvage radiation with persistently elevated PSA 57.63 cc (SD = 25.2). Compared to the median, the mean Sorensen-Dice similarity coefficient for the adjuvant case was 0.60 (SD 0.10), salvage radiation with PSA progression was 0.58 (SD = 0.12), and salvage radiation with persistently elevated PSA 0.60 (SD = 0.11). A heatmap for each clinical scenario was generated. The group agreed to proceed with a uniform recommendation for all cases, independent of the radiotherapy timing. Several controversial areas of the prostate bed CTV were identified based on both heatmaps and questionnaires. This formed the basis for discussions via videoconferences where the panel achieved consensus on the prostate bed CTV to be used as a novel guideline for postoperative prostate cancer radiotherapy.
UNASSIGNED: Variability was observed in a group formed by experienced genitourinary radiation oncologists and a radiologist. A single contemporary ESTRO-ACROP consensus guideline was developed to address areas of dissonance and improve consistency in prostate bed delineation, independent of the indication.There is important variability in existing contouring guidelines for postoperative prostate bed (PB) radiotherapy (RT) after radical prostatectomy. This work aimed at providing a contemporary consensus guideline for PB delineation. An ESTRO ACROP consensus panel including radiation oncologists and a radiologist, all with known subspecialty expertise in prostate cancer, delineated the PB CTV in 3 scenarios: adjuvant RT, salvage RT with PSA progression, and salvage RT with persistently elevated PSA. None of the cases had evidence of local recurrence. Contours were analysed qualitatively using heatmaps for visual assessment of controversial regions and quantitatively using Sorensen-Dice coefficient. Case-specific questionnaires were also discussed via e-mails and videoconferences for consensus. Several controversial areas of the PB CTV were identified based on both heatmaps and questionnaires. This formed the basis for discussions via videoconferences. Finally, a contemporary ESTRO-ACROP consensus guideline was developed to address areas of dissonance and improve consistency in PB delineation, independent of the indication.
UNASSIGNED: An ESTRO-ACROP contouring consensus panel consisting of 11 radiation oncologists and one radiologist, all with known subspecialty expertise in prostate cancer, was established. Participants were asked to delineate the prostate bed clinical target volumes (CTVs) in 3 separate clinically relevant scenarios: adjuvant radiation, salvage radiation with PSA progression, and salvage radiation with persistently elevated PSA. These cases focused on the presence of positive surgical margin, extracapsular extension, and seminal vesicles involvement. None of the cases had radiographic evidence of local recurrence on imaging. A single computed tomography (CT) dataset was shared via FALCON platform and contours were performed using EduCaseTM software. Contours were analyzed qualitatively using heatmaps which provided a visual assessment of controversial regions and quantitatively analyzed using Sorensen-Dice similarity coefficients. Participants also answered case-specific questionnaires addressing detailed recommendations on target delineation. Discussions via electronic mails and videoconferences for final editing and consensus were performed.
UNASSIGNED: The mean CTV for the adjuvant case was 76 cc (SD = 26.6), salvage radiation with PSA progression was 51.80 cc (SD = 22.7), and salvage radiation with persistently elevated PSA 57.63 cc (SD = 25.2). Compared to the median, the mean Sorensen-Dice similarity coefficient for the adjuvant case was 0.60 (SD 0.10), salvage radiation with PSA progression was 0.58 (SD = 0.12), and salvage radiation with persistently elevated PSA 0.60 (SD = 0.11). A heatmap for each clinical scenario was generated. The group agreed to proceed with a uniform recommendation for all cases, independent of the radiotherapy timing. Several controversial areas of the prostate bed CTV were identified based on both heatmaps and questionnaires. This formed the basis for discussions via videoconferences where the panel achieved consensus on the prostate bed CTV to be used as a novel guideline for postoperative prostate cancer radiotherapy.
UNASSIGNED: Variability was observed in a group formed by experienced genitourinary radiation oncologists and a radiologist. A single contemporary ESTRO-ACROP consensus guideline was developed to address areas of dissonance and improve consistency in prostate bed delineation, independent of the indication.There is important variability in existing contouring guidelines for postoperative prostate bed (PB) radiotherapy (RT) after radical prostatectomy. This work aimed at providing a contemporary consensus guideline for PB delineation. An ESTRO ACROP consensus panel including radiation oncologists and a radiologist, all with known subspecialty expertise in prostate cancer, delineated the PB CTV in 3 scenarios: adjuvant RT, salvage RT with PSA progression, and salvage RT with persistently elevated PSA. None of the cases had evidence of local recurrence. Contours were analysed qualitatively using heatmaps for visual assessment of controversial regions and quantitatively using Sorensen-Dice coefficient. Case-specific questionnaires were also discussed via e-mails and videoconferences for consensus. Several controversial areas of the PB CTV were identified based on both heatmaps and questionnaires. This formed the basis for discussions via videoconferences. Finally, a contemporary ESTRO-ACROP consensus guideline was developed to address areas of dissonance and improve consistency in PB delineation, independent of the indication.
摘要：
■根治性前列腺切除术后，对前列腺床进行放射治疗是一种潜在的治愈性挽救选择。尽管文献中提供了前列腺床轮廓指南，存在重要的可变性。这项工作的目的是为术后放疗的前列腺床勾画提供当代共识指南。
■由11名放射肿瘤学家和一名放射科医师组成的ESTRO-ACROP轮廓共识小组，都有已知的前列腺癌亚专科专业知识，已建立。要求参与者在3种独立的临床相关场景中描绘前列腺床临床目标体积（CTV）：辅助放射，具有PSA进展的抢救放射，和PSA持续升高的抢救辐射。这些病例集中在手术切缘阳性的情况下，囊外延伸，和精囊受累。所有病例均无影像学检查显示局部复发。通过FALCON平台共享单个计算机断层扫描（CT）数据集，并使用EduCaseTM软件进行轮廓。使用热图对轮廓进行定性分析，该热图提供了对有争议区域的视觉评估，并使用Sorensen-Dice相似性系数进行了定量分析。与会者还回答了针对具体案例的问卷，这些问卷涉及关于目标划定的详细建议。通过电子邮件和视频会议进行了讨论，以进行最终编辑和达成共识。
■佐剂病例的平均CTV为76cc（SD=26.6），PSA进展的抢救放疗为51.80cc（SD=22.7），和抢救辐射，PSA持续升高57.63cc（SD=25.2）。与中位数相比，佐剂病例的平均Sorensen-Dice相似系数为0.60（SD0.10），PSA进展的抢救放疗为0.58（SD=0.12），和抢救辐射，PSA持续升高0.60（SD=0.11）。生成每个临床场景的热图。该小组同意对所有案件提出统一建议，独立于放疗时机。根据热图和问卷调查确定了前列腺床CTV的几个有争议的区域。这构成了通过视频会议进行讨论的基础，该小组就前列腺床CTV达成了共识，将其用作术后前列腺癌放疗的新指南。
■在由经验丰富的泌尿生殖系统放射肿瘤学家和放射科医师组成的组中观察到了变异性。制定了一个单一的当代ESTRO-ACROP共识指南，以解决不和谐的领域，并提高前列腺床勾画的一致性。独立于指示。前列腺癌根治术后术后前列腺床（PB）放疗（RT）的现有轮廓指南存在重要差异。这项工作旨在为PB划定提供当代共识指南。ESTROACROP共识小组包括放射肿瘤学家和放射科医生，都有已知的前列腺癌亚专科专业知识，将PBCTV划分为3种方案：辅助RT，抢救RT与PSA进展，和抢救RT与持续升高的PSA。所有病例都没有局部复发的证据。使用热图对轮廓进行定性分析，以对有争议的区域进行视觉评估，并使用Sorensen-Dice系数进行定量分析。还通过电子邮件和视频会议讨论了针对具体情况的问卷，以达成共识。根据热图和问卷调查确定了PBCTV的几个有争议的领域。这构成了通过电视会议进行讨论的基础。最后,制定了当代ESTRO-ACROP共识指南，以解决不和谐的领域并提高PB划定的一致性，独立于指示。
■由11名放射肿瘤学家和一名放射科医师组成的ESTRO-ACROP轮廓共识小组，都有已知的前列腺癌亚专科专业知识，已建立。要求参与者在3种独立的临床相关场景中描绘前列腺床临床目标体积（CTV）：辅助放射，具有PSA进展的抢救放射，和PSA持续升高的抢救辐射。这些病例集中在手术切缘阳性的情况下，囊外延伸，和精囊受累。所有病例均无影像学检查显示局部复发。通过FALCON平台共享单个计算机断层扫描（CT）数据集，并使用EduCaseTM软件进行轮廓。使用热图对轮廓进行定性分析，该热图提供了对有争议区域的视觉评估，并使用Sorensen-Dice相似性系数进行了定量分析。与会者还回答了针对具体案例的问卷，这些问卷涉及关于目标划定的详细建议。通过电子邮件和视频会议进行了讨论，以进行最终编辑和达成共识。
■佐剂病例的平均CTV为76cc（SD=26.6），PSA进展的抢救放疗为51.80cc（SD=22.7），和抢救辐射，PSA持续升高57.63cc（SD=25.2）。与中位数相比，佐剂病例的平均Sorensen-Dice相似系数为0.60（SD0.10），PSA进展的抢救放疗为0.58（SD=0.12），和抢救辐射，PSA持续升高0.60（SD=0.11）。生成每个临床场景的热图。该小组同意对所有案件提出统一建议，独立于放疗时机。根据热图和问卷调查确定了前列腺床CTV的几个有争议的区域。这构成了通过视频会议进行讨论的基础，该小组就前列腺床CTV达成了共识，将其用作术后前列腺癌放疗的新指南。
■在由经验丰富的泌尿生殖系统放射肿瘤学家和放射科医师组成的组中观察到了变异性。制定了一个单一的当代ESTRO-ACROP共识指南，以解决不和谐的领域，并提高前列腺床勾画的一致性。独立于指示。前列腺癌根治术后术后前列腺床（PB）放疗（RT）的现有轮廓指南存在重要差异。这项工作旨在为PB划定提供当代共识指南。ESTROACROP共识小组包括放射肿瘤学家和放射科医生，都有已知的前列腺癌亚专科专业知识，将PBCTV划分为3种方案：辅助RT，抢救RT与PSA进展，和抢救RT与持续升高的PSA。所有病例都没有局部复发的证据。使用热图对轮廓进行定性分析，以对有争议的区域进行视觉评估，并使用Sorensen-Dice系数进行定量分析。还通过电子邮件和视频会议讨论了针对具体情况的问卷，以达成共识。根据热图和问卷调查确定了PBCTV的几个有争议的领域。这构成了通过电视会议进行讨论的基础。最后,制定了当代ESTRO-ACROP共识指南，以解决不和谐的领域并提高PB划定的一致性，独立于指示。
