Consensus Recommendations for Radiation Therapy Contouring and Treatment of Vulvar Carcinoma

David K Gaffney; Bronwyn King; Akila N Viswanathan; Maroie Barkati; Sushil Beriwal; Patricia Eifel; Beth Erickson; Anthony Fyles; Jennifer Goulart; Matthew Harkenrider; Anuja Jhingran; Ann Klopp; Wui-Jin Koh; Karen Lim; Ivy Petersen; Lorraine Portelance; William Small, Jr; Alexandra Stewart; Ericka Wiebe; Aaron Wolfson; Catheryn Yashar; Walter Bosch

doi:10.1016/j.ijrobp.2016.02.043

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Consensus Recommendations for Radiation Therapy Contouring and Treatment of Vulvar Carcinoma

Journal article

Open access

Peer reviewed

Consensus Recommendations for Radiation Therapy Contouring and Treatment of Vulvar Carcinoma

David K Gaffney, Bronwyn King, Akila N Viswanathan, Maroie Barkati, Sushil Beriwal, Patricia Eifel, Beth Erickson, Anthony Fyles, Jennifer Goulart, Matthew Harkenrider, …

International journal of radiation oncology, biology, physics, v 95(4), pp 1191-1200

15 Jul 2016

DOI: https://doi.org/10.1016/j.ijrobp.2016.02.043

PMID: 27130794

Featured in Collection : UN Sustainable Development Goals @ Drexel

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https://europepmc.org/articles/pmc5189987View

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Abstract

Aged

Consensus

Female

Humans

Lymph Nodes - pathology

Patient Positioning

Radiotherapy Planning, Computer-Assisted - methods

Tumor Burden

Vagina - pathology

Vulvar Neoplasms - pathology

Vulvar Neoplasms - radiotherapy

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. 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. 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. 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.

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Details

Title: Consensus Recommendations for Radiation Therapy Contouring and Treatment of Vulvar Carcinoma
Creators: David K Gaffney - Huntsman (United States)
Bronwyn King - Peter MacCallum Cancer Centre
Akila N Viswanathan - Harvard University
Maroie Barkati - Centre Hospitalier de l’Université de Montréal
Sushil Beriwal - UPMC Hillman Cancer Center
Patricia Eifel - The University of Texas MD Anderson Cancer Center
Beth Erickson - Department of Radiation Oncology, Proedtert and Medical College Clinical Cancer Center, Milwaukee, Wisconsin
Anthony Fyles - Princess Margaret Cancer Centre
Jennifer Goulart - BC Cancer Agency
Matthew Harkenrider - Loyola University Chicago
Anuja Jhingran - The University of Texas MD Anderson Cancer Center
Ann Klopp - The University of Texas MD Anderson Cancer Center
Wui-Jin Koh - University of Washington
Karen Lim - Liverpool Hospital
Ivy Petersen - Mayo Clinic
Lorraine Portelance - University of Miami
William Small, Jr - Universidad Loyola Andalucía
Alexandra Stewart - Royal Surrey County Hospital
Ericka Wiebe - Department of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
Aaron Wolfson - University of Miami
Catheryn Yashar - University of California San Diego
Walter Bosch - Washington University in St. Louis
Publication Details: International journal of radiation oncology, biology, physics, v 95(4), pp 1191-1200
Publisher: Elsevier
Grant note: U10 CA180868 / NCI NIH HHS U24 CA180803 / NCI NIH HHS U10 CA180818 / NCI NIH HHS UG1 CA233178 / NCI NIH HHS
Resource Type: Journal article
Language: English
Academic Unit: Radiation Oncology (and Nuclear Medicine)
Web of Science ID: WOS:000378207000015
Scopus ID: 2-s2.0-84964613702
Other Identifier: 991021897264704721

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Collaboration types: Domestic collaboration; International collaboration
Web of Science research areas: Oncology; Radiology, Nuclear Medicine & Medical Imaging