Retroperitoneal Sarcoma Target Volume and Organ at Risk Contour Delineation Agreement Among NRG Sarcoma Radiation Oncologists

Baldini, Elizabeth H.; Abrams, Ross A.; Bosch, Walter; Roberge, David; Haas, Rick L.; Catton, Charles; Indelicato, Daniel J.; Olsen, Jeffrey R.; Deville, Curtiland; Chen, Yen‐Lin; Finkelstein, Steven E.; DeLaney, Thomas F.; Wang, Dian

doi:10.1016/j.ijrobp.2015.04.039

Cited by 33 publications

(20 citation statements)

References 29 publications

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“…Third, the tumors were manually delineated by a team of practicing radiation oncologists or a radiologist. Although prior work has found substantial agreement between radiation oncologists delineating STS gross tumor volumes, 33 interobserver variability could affect radiomic features. Investigations evaluating the impact of interobserver variability in tumor volume delineation will be an important direction for future study.…”

Section: Discussionmentioning

confidence: 97%

MRI Radiomic Features Are Independently Associated With Overall Survival in Soft Tissue Sarcoma

Spraker

Wootton

Hippe

et al. 2019

Advances in Radiation Oncology

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Purpose Soft tissue sarcomas (STS) represent a heterogeneous group of diseases, and selection of individualized treatments remains a challenge. The goal of this study was to determine whether radiomic features extracted from magnetic resonance (MR) images are independently associated with overall survival (OS) in STS. Methods and Materials This study analyzed 2 independent cohorts of adult patients with stage II-III STS treated at center 1 (N = 165) and center 2 (N = 61). Thirty radiomic features were extracted from pretreatment T1-weighted contrast-enhanced MR images. Prognostic models for OS were derived on the center 1 cohort and validated on the center 2 cohort. Clinical-only (C), radiomics-only (R), and clinical and radiomics (C+R) penalized Cox models were constructed. Model performance was assessed using Harrell's concordance index. Results In the R model, tumor volume (hazard ratio [HR], 1.5) and 4 texture features (HR, 1.1-1.5) were selected. In the C+R model, both age (HR, 1.4) and grade (HR, 1.7) were selected along with 5 radiomic features. The adjusted c-indices of the 3 models ranged from 0.68 (C) to 0.74 (C+R) in the derivation cohort and 0.68 (R) to 0.78 (C+R) in the validation cohort. The radiomic features were independently associated with OS in the validation cohort after accounting for age and grade (HR, 2.4; P = .009). Conclusions This study found that radiomic features extracted from MR images are independently associated with OS when accounting for age and tumor grade. The overall predictive performance of 3-year OS using a model based on clinical and radiomic features was replicated in an independent cohort. Optimal models using clinical and radiomic features could improve personalized selection of therapy in patients with STS.

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Section: Discussionmentioning

confidence: 97%

MRI Radiomic Features Are Independently Associated With Overall Survival in Soft Tissue Sarcoma

Spraker

Wootton

Hippe

et al. 2019

Advances in Radiation Oncology

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“…In patients who received a simultaneous integrated boost, a high dose was administered to the posterior tumor margin (CTV1) and a second CTV was created (CTV2) which provided a lower, bowel tolerant dose to a larger area at risk for harboring microscopic disease (Fig. 1 ) as described [ 16 , 17 ]. The planning target volume (PTV) consisted of a symmetric 0.5 cm margin beyond the CTVs.…”

Section: Methodsmentioning

confidence: 99%

Intensity modulated radiation therapy and surgery for Management of Retroperitoneal Sarcomas: a single-institution experience

et al. 2017

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BackgroundPeri-operative radiation of retroperitoneal sarcomas (RPS) is an important component of multidisciplinary treatment. All retrospective series thus far included patients treated with older radiation therapy (RT) techniques including 2D and 3DRT. Intensity modulated radiation therapy (IMRT) allows for selective dose escalation while sparing adjacent organs. We therefore report the first series of patients with RPS treated solely with IMRT, surgery and chemotherapy. We hypothesized that IMRT would permit safe dose escalation and superior rates of local control (LC) in this high-risk patient population.MethodsThirty patients with RPS treated with curative intent between 2006 and 2015 were included in this retrospective study. RT was administered either pre- or post-operatively and IMRT was used in all patients. Statistical comparisons, LC, distant metastasis (DM), and overall survival (OS) were calculated by Kaplan-Meier analysis and univariate Cox regression.ResultsMedian follow-up time after completion of RT was 36 months (range 1.4-112). Median tumor size was 14 cm (range 3.6 - 28 cm). The most prevalent histologies were liposarcoma in 10 (33%) patients and leiomyosarcoma in 10 (33%) with 21 patients (70%) having high-grade disease. Twenty-eight (93%) patients had surgical resection with 47% having positive margins. Chemotherapy was administered in 9 (30%) patients. RT was delivered pre-operatively in 11 (37%) patients, and post-operatively in 19 (63%) with 60% of patients receiving a simultaneous integrated boost. Pre-operative median RT dose to the high-risk area was 55 Gy (range, 43–66 Gy) while median post-operative dose was 60.4 Gy (range, 45-66.6 Gy). There was one acute grade 3 and one late grade 3 toxicity and no grade 4 or 5 toxicities. Three year actuarial LC, freedom from DM, and OS rates were 84%, 64%, and 68% respectively. Positive surgical margins were associated with a higher risk of local recurrence (p = 0.02) and decreased OS (p = 0.04). Pre-operative RT was associated with improved LC (p = 0.1) with a 5-year actuarial LC of 100%. Administration of chemotherapy, timing of RT, histology or grade was not predictive of OS.ConclusionsPatients with RPS treated with peri-operative IMRT at our institution had excellent local control and low incidences of toxicity.

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“…31 In addition, the duodenum is a small organ, in which relatively small differences in contouring can result in large discrepancies. 32 Considering that the peritoneal cavity is easy and quick to contour on planning CT images, and that contouring has small variations between clinicians, further validation studies would be meaningful.…”

Section: Sparing Of Oars For 4 Clinical Casesmentioning

confidence: 99%

Multicenter Planning Comparison of Stereotactic Body Radiotherapy for Hepatocellular Carcinoma with Major Portal Vein Tumor Thrombosis (KROG 16-17)

Bae)¹,

김미숙²,

장원일³

et al. 2018

JLC

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Background/Aims: To evaluate the technical feasibility of stereotactic body radiotherapy (SBRT) for hepatocellular carcinoma (HCC) with the major portal vein tumor thrombosis (PVTT). Methods: Ten institutions affiliated with the Korean Stereotactic Radiosurgery Group were provided the contours of four cases: the first case was the first branch PVTT with sufficient normal liver volume (NLV), the second was the first branch PVTT with insufficient NLV, the third was the main trunk PVTT at confluence level, and the fourth was the main trunk PVTT with entire length. The institutions were asked to make SBRT plans according to their current treatment protocols and to complete facility questionnaires. Results: Based on institutional protocols, SBRT was feasible in nine institutions for the first case (32-60 Gy in 3-5 fractions), in eight institutions for the second case (32-50 Gy in 3-5 fractions), in seven institutions for the third case (35-60 Gy in 3-5 fractions), and in four institutions for the fourth case (35-42 Gy in 4-5 fractions). The other institutions recommended hypo-or conventional fractionation due to insufficient NLV or gastrointestinal organ proximity. With analysis of the SBRT dose to the central hepatobiliary tract, the major PVTT could theoretically be associated with a high risk of hepatobiliary toxicity. Conclusions: Although SBRT is a technically feasible option for HCC with the major PVTT, there was a variability among the participating institutions. Therefore, further studies will be necessary to standardize the practice of SBRT for the major PVTT. (J Liver Cancer 2018;18:130-141)

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Retroperitoneal Sarcoma Target Volume and Organ at Risk Contour Delineation Agreement Among NRG Sarcoma Radiation Oncologists

Cited by 33 publications

References 29 publications

MRI Radiomic Features Are Independently Associated With Overall Survival in Soft Tissue Sarcoma

MRI Radiomic Features Are Independently Associated With Overall Survival in Soft Tissue Sarcoma

Intensity modulated radiation therapy and surgery for Management of Retroperitoneal Sarcomas: a single-institution experience

Multicenter Planning Comparison of Stereotactic Body Radiotherapy for Hepatocellular Carcinoma with Major Portal Vein Tumor Thrombosis (KROG 16-17)

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