Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/660
Title: Consensus recommendations for radiation therapy contouring and treatment of vulvar carcinoma.
Epworth Authors: King, Bronwyn
Other Authors: Gaffney, David
Viswanathan, Akila
Barkati, Maroie
Beriwal, Sushil
Eifel, Patricia
Erickson, Beth
Fyles, Anthony
Goulart, Jennifer
Harkenrider, Matthew
Jhingran, Anuja
Klopp, Ann
Koh, Wui-Jin
Lim, Karen
Petersen, Ivy
Portelance, Lorraine
Small, William
Stewart, Alexandra
Wiebe, Ericka
Wolfson, Aaron
Yashar, Catheryn
Bosch, Walter
Keywords: Vulvar Carcinoma
Vulvar Cancer
Radiation Therapy
Radiation Oncology
Contouring Atlas
Locally Advanced
Postoperative
Simultaneous Truth and Performance Level Estimation
STAPLE
Expectation-Maximization Algorithm
Kappa
Epworth Radiation Oncology Research Centre
Obstetrics and Gynaecology Clinical Institute, Epworth HealthCare, Victoria, Australia
Cancer Services Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Feb-2016
Publisher: Elsevier
Citation: Int J Radiat Oncol Biol Phys. 2016 Jul 15;95(4):1191-200
Abstract: PURPOSE: The purpose of this study was to develop a radiation therapy (RT) contouring atlas and recommendations for women with postoperative and locally advanced vulvar carcinoma. METHODS AND MATERIALS: An international committee of 35 expert gynecologic radiation oncologists completed a survey of the treatment of vulvar carcinoma. An initial set of recommendations for contouring was discussed and generated by consensus. Two cases, 1 locally advanced and 1 postoperative, were contoured by 14 physicians. Contours were compared and analyzed using an expectation-maximization algorithm for simultaneous truth and performance level estimation (STAPLE), and a 95% confidence interval contour was developed. The level of agreement among contours was assessed using a kappa statistic. STAPLE contours underwent full committee editing to generate the final atlas consensus contours. RESULTS: Analysis of the 14 contours showed substantial agreement, with kappa statistics of 0.69 and 0.64 for cases 1 and 2, respectively. There was high specificity for both cases (≥99%) and only moderate sensitivity of 71.3% and 64.9% for cases 1 and 2, respectively. Expert review and discussion generated consensus recommendations for contouring target volumes and treatment for postoperative and locally advanced vulvar cancer. CONCLUSIONS: These consensus recommendations for contouring and treatment of vulvar cancer identified areas of complexity and controversy. Given the lack of clinical research evidence in vulvar cancer radiation therapy, the committee advocates a conservative and consistent approach using standardized recommendations.
URI: http://hdl.handle.net/11434/660
DOI: 10.1016/j.ijrobp.2016.02.043
PubMed URL: http://www.ncbi.nlm.nih.gov/pubmed/27130794
ISSN: 0360-3016
Journal Title: International Journal of Radiation Oncology*Biology*Physics
Type: Journal Article
Affiliated Organisations: Department of Radiation Oncology, Huntsman Cancer Hospital, Salt Lake City, Utah, USA
Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, Massachusetts, USA
Department of Radiation Oncology, Centre hospitalier de l'universite de Montreal, Montreal, Quebec, Canada
Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania, USA
Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
Department of Radiation Oncology, Proedtert and Medical College Clinical Cancer Center, Milwaukee, Wisconsin, USA
Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
Department of Radiation Oncology, British Columbia Cancer Agency, Victoria, British Columbia, Canada
Department of Radiation Oncology, Stritch School of Medicine, Loyola University, Maywood, Illinois, USA
Department of Radiation Oncology, University of Washington, Seattle, Washington, USA
Liverpool Cancer Therapy Centre, Radiation Oncology Unit, Sydney, New South Wales, Australia
Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA
Radiation Oncology Department, Miller School of Medicine, University of Miami, Miami, Florida, USA
St. Luke's Cancer Centre, Royal Surrey Country Hospital, Surrey, United Kingdom
Department of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
Radiation Medicine and Applied Sciences, University of California San Diego, San Diego, California, USA
Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri, USA
Department of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre
Type of Clinical Study or Trial: Realist Reviews in Medicine
Appears in Collections:Cancer Services
Obstetrics & Gynaecology
Radiation Oncology

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