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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 11/2012

01-11-2012 | Original article

Multicenter evaluation of different target volume delineation concepts in pediatric Hodgkin’s lymphoma

A case study

Authors: C. Lütgendorf-Caucig, MD, I. Fotina, E. Gallop-Evans, L. Claude, J. Lindh, T. Pelz, B. Knäusl, D. Georg, R. Pötter, K. Dieckmann, EuroNet-PHL RT Group

Published in: Strahlentherapie und Onkologie | Issue 11/2012

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Abstract

Background and purpose

In pediatric Hodgkin’s lymphoma (PHL) improvements in imaging and multiagent chemotherapy have allowed for a reduction in target volume. The involved-node (IN) concept is being tested in several treatment regimens for adult Hodgkin’s lymphoma. So far there is no consensus on the definition of the IN. To improve the reproducibility of the IN, we tested a new involved-node-level (INL) concept, using defined anatomical boundaries as basis for target delineation. The aim was to evaluate the feasibility of IN and INL concepts for PHL in terms of interobserver variability.

Patients and methods

The INL concept was defined for the neck and mediastinum by the PHL Radiotherapy Group based on accepted concepts for solid tumors. Seven radiation oncologists from six European centers contoured neck and mediastinal clinical target volumes (CTVs) of 2 patients according to the IN and the new INL concepts. The median CTVs, coefficient of variation (COV), and general conformity index (CI) were assessed. The intraclass correlation coefficient (ICC) for reliability of delineations was calculated.

Results

All observers agreed that INL is a feasible and practicable delineation concept resulting in stronger interobserver concordance than the IN (mediastinum CIINL = 0.39 vs. CIIN = 0.28, neck left CIINL = 0.33; CIIN = 0.18; neck right CIINL = 0.24, CIIN = 0.14). The COV showed less dispersion and the ICC indicated higher reliability of contouring for INL (ICCINL = 0.62, p < 0.05) as for IN (ICCIN = 0.40, p < 0.05).

Conclusion

INL is a practical and feasible alternative to IN resulting in more homogeneous target delineation, and it should be therefore considered as a future target volume concept in PHL.
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Metadata
Title
Multicenter evaluation of different target volume delineation concepts in pediatric Hodgkin’s lymphoma
A case study
Authors
C. Lütgendorf-Caucig, MD
I. Fotina
E. Gallop-Evans
L. Claude
J. Lindh
T. Pelz
B. Knäusl
D. Georg
R. Pötter
K. Dieckmann
EuroNet-PHL RT Group
Publication date
01-11-2012
Publisher
Springer-Verlag
Published in
Strahlentherapie und Onkologie / Issue 11/2012
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-012-0182-4

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