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NRG Oncology Updated International Consensus Atlas on Pelvic Lymph Node Volumes for Intact and Post-Operative Prostate Cancer. International journal of radiation oncology, biology, physics Hall, W. A., Paulson, E. n., Davis, B. J., Spratt, D. E., Morgan, T. M., Dearnaley, D. n., Tree, A. C., Efstathiou, J. A., Harisinghani, M. n., Jani, A. B., Buyyounouski, M. K., Pisansky, T. M., Tran, P. T., Karnes, R. J., Chen, R. C., Cury, F. L., Michalski, J. M., Rosenthal, S. A., Koontz, B. F., Wong, A. C., Nguyen, P. n., Hope, T. A., Feng, F. n., Sandler, H. M., Lawton, C. A. 2020

Abstract

In 2009, the Radiation Therapy Oncology Group (RTOG) genitourinary (GU) members published a consensus atlas for contouring prostate pelvic nodal clinical target volumes (CTV). Data has emerged further informing nodal recurrence patterns. The objective of this study is to provide an updated prostate pelvic nodal consensus atlas.A literature review was performed abstracting data on nodal recurrence patterns. Data was presented to a panel of international experts, including radiation oncologists, radiologists, and urologists. After data review, participants contoured nodal CTVs on three cases: post-operative, intact node positive, and intact node negative. Radiation oncologist contours were analyzed qualitatively using count maps which provided a visual assessment of controversial regions and quantitatively analyzed using Sorensen-Dice similarity coefficients, and Hausdorff distances compared with the 2009 RTOG atlas. Diagnostic radiologists generated a reference table outlining considerations for determining clinical node positivity.Eighteen radiation oncologists' contours (54 CTVs) were included. Two urologists' volumes were examined in a separate analysis. The mean CTV for the post-op case was 302 cc, intact node positive case was 409 cc, and intact node negative case 342 cc. Compared to the original RTOG consensus, the mean Sorensen-Dice similarity coefficient for the post-op case was 0.63 (SD 0.13), intact node positive case was 0.68 (SD 0.13), and intact node negative case 0.66 (SD 0.18). The mean Hausdorff Distance (in cm) for the post-op case was 0.24 (SD 0.13), the intact node positive case was 0.23 (SD 0.09), and intact node negative case 0.33 (SD 0.24). Four regions of CTV controversy were identified and consensus for each of these areas was reached.Discordance with the 2009 RTOG consensus atlas was seen in a group of experienced NRG Oncology and international GU radiation oncologists. To address areas of variability and account for new data, an updated NRG Oncology consensus contour atlas was developed.

View details for DOI 10.1016/j.ijrobp.2020.08.034

View details for PubMedID 32861817